4231827 tn?1396844077

ALS Anxiety

My name is Marissa and I am a 24 year old single mother to one very active three year old. In July of 2012 I had an odd experience with sudden right side numbness and weakness. I went to the ER and after a CAT-scan they found nothing and attributed it to a possible pinched nerve and referred me to a neurologist. I was never able to go and the numbness went away almost at once until this month. Two weeks ago I started to notice a horrible pinching feeling in between my shoulder and neck. The pain radiated down under my arm and through to my fingers. That turned into an irritating tingling sensation that I could not control or comfort. Some days that numbness would go away completely and I would be fine but the next it was back and even worse. Through the wonderful search network of "Google" I discovered a plethora of very unpleasant diseases, the main two being MS and ALS. MS I wasn't too concerned about, but the ALS, now that got to me. It was instant panic and for the past week I have been experiencing twitching all over my body in the most random and bizarre places. It's mostly in my legs, the right more so than the left, but it happens anytime and all the time in other parts of my body. For example, my eyes, my abdomen, my feet, my hands, and my arms. I have had twitches before, but never as many, or maybe never as many that I noticed, before, or for so long. Here's the the thing though, I have been doing these crazy strength tests just to prove to myself that I do not have ALS before I go to my doctor. I have been relentlessly unscrewing the lids off of nail polish bottles and peanut butter jars, balancing on each foot for as long as possible, hopping around on each foot, doing grip tests on my daughter's toys, and even hopping up stairs... The pain comes and goes throughout the day. It seems to go away completely when I'm distracted or busy. To be honest, I don't feel sick. I feel paranoid. I think that I have driven every member of my family absolutely insane and my psychology professor believes that I have a severe form of Hypochondria and health anxiety.
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Avatar universal
Thanks for using the forum. I am happy to address your questions, and my answer will be based on the information you provided here. Please make sure you recognize that this forum is for educational purposes only, and it does not substitute for a formal office visit with a doctor.

Without the ability to examine and obtain a history, I cannot tell you what the exact cause of the symptoms is. However I will try to provide you with some useful information.

I am sorry to hear that you are going through such a tough time.

The first incident you mentioned was the right side weakness and numbness and the possibility of a pinched nerve was raised. There is a condition called cervical compressive radiculopathy.
Radiculopathy occurs when nerve roots (coming out of the spinal cord) become compressed at the neck or spine and this results in pain, tingling, and numbness, with or without loss of function in the area supplied by the affected nerve. Common causes of cervical radiculopathy are neural foramen narrowing (neural foramen is the canal through which the nerve exits) , usually caused by cervical arthritis in older adults, and cervical disk lesion caused by disk degeneration or herniation. Disk degeneration results in loss of disk space, with closer approximation of the vertebrae on either side of the involved disk space and subsequent impingement on the neural foramen. The decrease in size of the neural foramen results in nerve root compression. The cervical disk spaces are more often affected. Disk herniation also occurs more often in these.

Common symptoms include pain radiating to the shoulder or down the upper extremity (which you are reporting), which may be aggravated by coughing, sneezing, or strainig; tingling of the fingers; and less often, weakness in the extremity. You may have  tenderness on the neck, limitation in certain movements of the neck.

A good diagnostic test  a MRI of the cervical spine which identifies soft tissue structures and may show displacement of the disk.

As for the twitching, it must be emphasized that in the MAJORITY of cases they are BENIGN meaning that they are of no consequence and are not resulting from a serious cause. In such cases, the twitches may be related to anxiety/stress (which may be playing a big role in your case), caffeine, and often occur after recent strenuous activity or muscle over-use. It is important in such cases to reduce stress/anxiety levels and to reduce caffeine intake.

Benign fasciculation syndrome, which I will abbreviate as BFS, is a condition in which there are involuntary twitches of various muscle groups, most commonly the legs but also the face, arms, eyes, and tongue. If the diagnosis is confirmed and other causes are excluded, it can be safely said that the likelihood of progression or occurrence of a serious neurologic condition is low.

When BFS is present but not particularly bothersome or disabling, treatment is not necessary. If severe and it requires treatment, there are a few medication options though this condition is not very common, and the research that has been done on its treatment is limited. Minimizing caffeine and stress, and treating anxiety if it is present, will improve your symptoms.

However in general (and please understand I am not trying to imply I feel this is the case in you), when fasciculations occur in the setting of associated symptoms such as progressive loss of sensation, tingling or numbness, weakness, trouble swallowing and other symptoms, the cause may be due to a peripheral nervous system problem. In general the symptoms would not be episodic and triggered by certain things but would be more constant/frequent without consistent triggers. The location of the problem could be the anterior horn cells, the area where the nerves that supply motor innervation to our body comes from. These are the cells that give off the nerves that allow us to voluntarily contract our muscles. The diseases that might affect the anterior horn cells include ALS (also called Lou Gherig's disease), a condition called spinal muscular atrophy, polio-like viruses, west nile virus, and other infections.
I suggest follow up with your primary doctor and you may benefit from evaluation by a neurologist as your primary doctor feels fit. It is important that you discuss your concerns with him/her.

Thank you for this opportunity to answer your questions, I hope you find the information I have provided useful, good luck.

Helpful - 1
2143641 tn?1396678143
while you wait for the Expert's answer let me share my experience with you because I've been through the same already.

It isn't a daft idea to test your straighten and I really don't see anything "crazy" in the way you're behaving.

You have had more than enough reason to be worried about your health therefore the word "hypochondria" is totally out of place.

The reason why your search came up with results such as MS and ALS is that they match some of your symptoms.

On the bright side, there are other conditions that are temporary and can heal spontaneously over time.

I've been having mild to severe weakness for almost a year in the legs primarily, when it began to heal I experienced some twitching in muscles, finger and even the eye. They eventually disappeared and everything went back to normal except one foot that is still being unfriendly to me.

Since you're OK now and your symptoms are mild, stay calm and don't worry about psychology and psychologists. You're doing the right thing to post here and be prepared for the eventuality that the symptoms will reappear.

Good luck.
Helpful - 0
2143641 tn?1396678143
*strength not straighten
Helpful - 0

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