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arrigoar 10-15-2006 11:01 AM

Please Help!
 
Hi All. I am a 25 yr. old male and have a huge ALS fear. I have twitching in various places throughout my body and my right arm and leg feel week. I have been to my GP twice who has done strength tests and reflex tests. Everything was fine. I fear I am getting some atrophy in my right thumb pad by my wrist. I have full function of my thumb and wrist though.

I believe the weakness is perceived, but things feel heavier in my right hand than in my left. (I am right handed). I had an MRI of my C-Spine and brain and everything was okay. My GP insists that anxiety is bringing upon these symptoms, but asked if I would like to go to a neurologist for piece of mind. I am going in two weeks.

My symptoms have been going on for about a month and a half now. Shouldn't I have more significant weakness by now if I had ***?

Also, is the sequence of the disease like profound weakness, followed by atrophy then twitching????

Please help...I am so scared!!

Many thanks,

Tony

Paul Wicks 10-15-2006 12:02 PM

Hi Tony,

Sorry to hear you're so anxious about this. First off, I would say that ALS in someone of your age is highly unlikely. Not to say it's impossible, at least one of our regular members here was dx'd at an earlier age than that.

Have you met anyone who's had ALS? How did you come across it? It's very common for someone to read a list of symptoms, become worried that they have them, and fall into a cycle of distorted thinking about how they're getting a terrible illness.

Unfortunately from the pattern of signs that you've described (i'm not sure I'd say they were symptoms at this stage), it's impossible to say very much. If this were ALS, I'd say keep an eye out for muscle wasting in your hands. This shows up as the bones in your hand becoming more prominent.

Twitching is fairly non-specific and frequently occurs in healthy muscle. It can certainly be caused by anxiety. In ALS there are fasciculations which are different because they look like rippling patterns underneath the skin, and tend to happen in large muscles like legs, forearms, and the chest.

What do you mean by weakness? Do you mean you can no longer lift a heavy saucepan? Does your foot drag along when you walk? If it simply feels like very heavy things are quite hard to lift but you can still do it, that's probably nothing significant.

If you have other symptoms of anxiety or a mood disorder you might want to consider seeking treatment for those, particularly if worrying about ALS is causing you a great deal of distress or the thoughts you get are intrusive.

See your neurologist, let us know how it goes.

All the best

Paul

JAH39 10-15-2006 08:12 PM

Hi Tony,

Paul is correct, someone as young as yourself, it is unlikely but not impossible to be ALS. Have you had an electromyogram (EMG) test performed? If not, have your neurologist perform this test. It is a painful test and to be blunt, it hurts like Hell. Here's a link that outlines what an EMG test is.

http://en.wikipedia.org/wiki/Electromyography

Best of luck,

Jeff

arrigoar 10-16-2006 10:42 AM

As far as my weakness symptom goes, it feels like my right arm is weaker than my left. I lift a book with my right arm and it feels heavier. I can still lift heavy objects. I can go to the gym and curl weights, run on the treadmill, etc.

Isn't profound weakness usually the first sign?

I am going to my GP today to follow up and I have a neurologist appointment next friday.

My GP doesn't see the need to go, but offered for piece of mind. I am a hypochondriac, and he thinks these symptoms are somatic.

Do you think I am okay???

lisag 10-16-2006 11:10 AM

Hi..I really can't add too much to what Paul and Jeff have said...although I feel if your doc thinks it is anxiety related it probably is..reading a list of symptoms tends to play tricks on ones mind..a few might fit for a terminal disease but they may too fit for things that are completely benign..so be careful and try not to self diagnos...anxiety can also have adverse affects on the body..it can cause twitching of muscles..and many other physical symptoms...I'd try to see if there is anything the docs can do to help get the anxiety more under control..Lisa

PS...In regards to muscle weakness you are probably right ..one arm is more than likely stronger than the other ..which as a former exercise instructor ..I can tell you is "completely normal" as very few people have perfectly symetrical strength..such a thing is virtually non -existent...as people tend to use one limb more than the other to carry heavy things with ..and therefore the limb that is used more hypertrophies more than the other..." absolutely normal" for this to occur...my advice there is if your doc feels you do not have ALS is... to try train the weaker arm with a slightly heavier dumbell than the stronger arm...see if after awhile the weaker arm does not become stronger..get plenty of rest and eat a proper diet..now if you had ALS such trainig would probably cause you to become weaker faster...as fatiguing muscles is not a good idea with the disease..however since you can still lift the same amount of weight at the gym..having ALS is highly unlikely...Lisa

arrigoar 10-16-2006 12:19 PM

The problem is Lisa, is that my right arm is my dominant arm. It feels clumsy, but I can do everything. It feels a little "off" per se.

I hope I am okay...I am scared out of my mind!

lisag 10-16-2006 12:23 PM

Well ..my less dominant arm is stronger than my dominant one...I do things with my dominant and tend to carry heavier things in my less dominant..therefore my least dominant arm is stronger..I do not have ALS my husband does..
I'd again try to train using a heavier weight in the weaker arm..if you feel after awhile you are losing more strength go back to your doc,,,in the meantime try to avoid reading too much about ALS..see if the doc can prescribe something better for the anxiety...medications too may cause an off- feeling and some weakness,,,but they are often worth the side effects...Lisa
PS..A book feeling heavier in one arm means very little..if you were telling me however that in one arm you couldn't lift a book at all or struggling very hard to do so..then I'd be more concerned that something more serious than anxiety was going on physically ...as this would be an example of "profound weakness"

arrigoar 10-18-2006 08:53 AM

Thanks for the info guys. Just an update on me. I went to my GP again on Monday. He tested my reflexes and stated that they were a 2 (which is normal), tested my arm strength and could not detect any weakness. I am starting anti-anxiety medication (Lexapro), but he did say for me to keep my neuron appointment, just for added piece of mind.

My complaint to him was that I am having perceived weakness in my right arm and it feels different when I walk (sorta weird).

Don’t you think a GP would be able to pick up on some sort of weakness/reflex change, that would lead him to demand that you go to a neuron? Also, when I left the office, I flat out asked him if I had ALS. He said no.

Can I trust my GP, that the cause of my perceived arm weakness is anxiety/somatic?

lisag 10-18-2006 12:14 PM

Yes, you can trust your GP ...everything was normal...perceived weakness is not a sign of ALS..'profound " weakness may be or may be something else....you had no clinical signs of the disease ..Lisa

Paul Wicks 10-18-2006 01:04 PM

"Don’t you think a GP would be able to pick up on some sort of weakness/reflex change, that would lead him to demand that you go to a neuron?"

Sure. Unless there wasn't a real one, it just felt like there was.


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