Early ALS symptoms

[sbennes]

Hello all-

I am a 35 yr old male. I have been having some very concerning neurological phenomnea that I would like to have examined.  These symptoms begain approx. two weeks ago. Specifically, fasiculations in legs, feet and at times, other parts of the body.  Simultaneously, I have  a subjective feeling of weakness in the right leg: somedays it seems to involve the entire leg, sometimes just the quads and at others, the calf muscle only.  Curiously, this feeling of "weakness" also presents when my leg is at rest and not being used. I have done all the crazy hyperchondriac tests for strength such as squats, calf raises, etc. but there appears to be no objective appreciation in differences of strength. There seems to be no gait disturbance either.

To further mix up the picture, I have had the same feeling of "weakness" and associated twitches in the rt. leg 9 monthes ago which resolved after a week or so.  Even more mysteriously, two yrs. ago I was  experiencing many fasiculations, myoclonus in the rt. leg and positve Babinski (which was later negative on another exam) and "weakness" in rt. leg.  This, too resolved over a period of time.

Can one experience sensations of weakness in different, alternating aspects of the leg, even when at rest?  Does the ALS pt. initially notice sensations of weakness or do they notice subtle changes in wieght bearing activity?

Does the above presentation sound like a progressive neuromuscular disease like ALS?
Thanks for your time.

[CCF-Neuro-M.D.-PW]

The answer is no, although I cannot give a clinical diagnosis ovcer the internet, and you should have your exam findings confirmed by your local neurologist

Fasciculations are common and usually benign, due to a hyperactive thyroid gland, a benign syndorome, pinched nerves or just related to cold or exercise. In the absence of objective muscle weakness or wasting it is very unlikely to be ALS. Also, the widepread and aternating nature would suggest a benign form, quite common in your age group and not really mysterious!

Good luck

[timetowinarace]

You'll want the Doc's input but right off the bat you should not really consider ALS. Your too young statistically. ALS hits more often after 50. ALS can begin in many ways but an episode two years ago that has been gone for a considerable amount of time isn't very consistant with the usual progression. A reasonable amount of muscle twitching should be considered normal for most of us. I would look towards a pinched nerve, or a spinal colomn problem putting pressure on your spinal cord, or a peripheal neuropathy. At any rate, if you feel that your symptoms are progressing, you should be monitored by a physician to get an answer as early as possible.

[wmac]

I have gone through alot the archives and read als quesions. I was also wondering when they say twitching without weakness or muscle wasting are they talking about weakness that doesnt get better or comes and goes or comes and stays??? The doc replied to me that twitching without muscle weaknes is not als, but I did say I had some weakness in my hand twice this last summer but it got better! mmmm!!! Also the doc told me that widespread twicthing usually is not als. But one person said the same thing and the doc did not say that to him. One of the questions he replied to that this person had  what sounded like symptoms of als and that he should be checked out then I have read many of questions with similar symptoms and then the doc says it doesnt sound like als! Im a bit confused. I would just really like to know what the order of symptoms usually are. Weakness, do they mean like not being able to use the limb at all or tiredness, or stiffness pain, is pain associated with als? When they say it usually affects a hand or foot first do they mean hand literally or just fingers or the whole hand and fingers? Im just really confused I just would like some answers because im also freaking out here about my symptoms.
wmac

[motheroftwo]

Ive had als for over 5 yrs since I was 22 yrs old, believe me symptoms DO NOT improve period!

Als is a progressive disease it doesnt get better, the answers to 99% of your questions can be obtained from searching the net.

[snoopy_301]

Hope you find the answers you're looking for.  I can tell you that I share most of all your symptoms and they do not know what it is.  I was physically active and then one day my foot (rt) began to ache - then both feet - then my calves, quads, hamstrings.  I also have tingling in all of these areas and at times muscle twitchig.  I now have weakness and my rt. knee is bending back further and I was told this is due to the weakening of my leg muscles.  I've had MRI's of my brain, spine and two EMG's and a lot of blood tests.  One EMG showed a minor thing going on in only one muscle so the dr's. dismissed it.  All I know is this began SUDDENLY approx. 4 months ago - I am a 39 yr. old female and before this I was healthy and very active.  At times I do feel the buzzing and sensations on my face, arme, etc...., but I think that might be due to anxiety - because after such a long time, I must admit, this is really wearing on my emotions.  I am frstrated, hurting and am scared.  Again - good luck to you.

[wmac]

I am really really sorry that you do have ALS. How rare for you to of been diagnosed at such a young age. How are you doing with it?? May I ask what your symptoms were to begin with and how long it took for you to be diagnosed? As you can see there are many and many of us here with a few things going on and we are all freaking out and dont know what to do. My prayers are with you.
wmac

[calvo]

Hi all ,

Im a 38 year old male and am a racing cyclist . Three months ago I noticed twitching/fasciculation in my right quadracep . I'd had this before just like most people do from time to time so decided to put it out of my mind . It lasted for over a week so I went to my doctor and he assured me it was nothing to worry about . I then had some minor fasciculations all over my body for the next 3-4 weeks and went to see a neurologist who also assured me that I was fit and healthy . I have no weakness and am still able to cycle upto 120kms without a rest . I guess that suggests that I'm healthy . However , about a month ago I developed a bizarre "cold water sensation" mainly on my legs but sometimes on the upper parts of my body (inside upper arms and between shoulder blades) that only lasts a couple of seconds .
Am very curious as to what this is and am getting scared about potential CNS problems. Am seeing my neuro again today but he thinks Im a hypochondriac . I just want one question answered.........If I had ALS or MS would I be able to cycle 300kms a week without difficulty ? Your answers would be very much appreciated . Nick .

[wmac]

what is the typical als?
wmac

[motheroftwo]

"If I had ALS or MS would I be able to cycle 300kms a week without difficulty ?"

It would solely depend on what type of als onset you had & if you was in the very early stages of als, it would be possible to cycle 300Kms.

I can cycle (indoor exercise bike) 15 miles in 20 mins, my upper body is weaker than my lower.

I'm Not a Dr, but it doesn't sound like you have als, one major tell tale sign is also very brisk reflexes.

[wmac]

I cannot figure out how to get to your site I dont understand URL is not used.
wmac

[wmac]

I looked at your website, very nice. My question to you is, when you had stiffness in your foot was there any pain with it was it just your foot or your toes also? Did you  have any twitching, if so just in one localized area or all over body? Im guess im just really freaking out now. Please help!!
wmac

[motheroftwo]

Hi, it was stiffness in my left ankle, no pain or twitches.

9 months after my first symptom, i went to my GP who performed a manual neuro test, i presented with stiffness, clonus, and brisk reflexes.

If your Dr thinks you have a CNS problem he will perform a Babinski test (please see http://www.medterms.com/script/main/art.asp?articlekey=7186 for Babinski sign definition.)
Please dont try to perform this test at home, get a proper Dr to perform it.

good luck.

[motheroftwo]

Dear Mods, I do apologize for posting links on this site, i purely forgot, sorry!

[wmac]

What is clonus?
wmac

[patsy10]

Was your diagnosis given at a large, academic facility?
Has lyme been considered.

You just don't fit the typical als pt.

Lyme can cause all these symptoms.

[motheroftwo]

My neuro first dxed me with PLS, I wasn't convinced because i started showing signs of atrophy in my hands, I asked my neuro to refer me to a als specialist whom confirmed my suspicions of als.

I dont believe i have als but it could be my way of coping, i did have a Lyme's test a few years back & it came back negative, the test was just a normal blood test through my GP. I have however asked my GP to refer me to a Lyme's disease specialist & he is in the process of doing that. I know I'm grasping at straws & its a stab in the dark but else is one to do, i refuse to sit back & die.

To wmac: what is clonus ? An abnormality in neuromuscular activity characterized by rapidly alternating muscular contraction and relaxation.

[Warrior47]

I admire your courage and positive attitude and sincerely wish you all the best.

I have some health issues of my own and I hope you can answer the below questions:

What exactly were early signs of atrophy in the hands? Did the muscle between thumb and index finger shorten (atrophy?) first? Were the hands stiff and aching? Did the muscles between knucles on the outside of palm ache, specially when lifting? Was there any problem with wrists? Did the arms shake while lifting e.g a frypan?

Thanks for taking your time and all the best once again.

Jossan

[motheroftwo]

My hands started with stiffness on opening & clenching hand shut, followed by atrophy in between my thumb and index finger(as you described)then atrophy started near my thumb (palm side up)and my palms, then went onto the back of my hand.
No aches or pains apart from cramps, I do now have problems with wrists weakness due to forearm atrophy.

when i make a coffee, putting coffee & sugar in a cup is kinda awkward as my wrist/hand shakes & I have to guild the spoon hand with my other hand to prevent it shaking.

good luck. :-)

[Warrior47]

Thanks for your answer. I have some more questions and will really appreciate if you could take some more time to answer those:


Were both the hands affected at the same time? Was stiffness worst in the mornings or did it stay all the time? You said atrophy moved to your thumb palm side up, do you mean the thenar muscle? Did you have a kind of feeling of puffiness in the hands? Atrophy in palm, how did it look like?
Sorry, I am asking so many questions. I guess I am very scared.

Take care.
Jossan

[motheroftwo]

Hi, Yes in my case both hands developed stiffness at the same time but atrophy developed at different stages, I feel stiffer more in the mornings. No puffiness feeling.

Yes the thenar muscles, wasting of the palm & thenar look like this http://medicine.ucsd.edu/clinicalmed/extremities-left-thenar-wasting.jpg

Severe atrophy looks like this http://www.spectroscopynow.com/ftp_images/2X6-hand.jpg

good luck

[patsy10]

I'm no expert but by typical I mean female, young.  It's more common in males, older.

[wmac]

When your talking about stiffness that means hard to move??? And no pain right?
wmac

[motheroftwo]

slow movement stiffness, right no pain apart from cramp pain.

[patsy10]

My thoughts and prayers are with you.  I sincerely hope they are wrong and you don't have really have it.  I would go to any means to find another cause for your symptoms.

Just curious, do you have numbness and tingling or just weakness and atrophy?