Odd suddent onset of symptoms

[TJM24]

I'm a 36 year old male who exercises and is in good shape.  I awoke two weeks ago with pins and needles in my left foot mainly but slightly in my right as well.  This stressed me and worried me a bit but I ignored it and figured maybe it was due to me being more sedentary with work and recently started attending 4 hour evening classes several times a week where I sit continuously.  Since I started the classes I've been exercising much less.  Within a few days of the pins and needles, I awoke in the middle of the night with calf twitches/fasciculations.  Mostly in the same left leg but quickly spreading all over (both calves, feet, eye, nose, arms, hands).  I was pretty stressed over this and the stress seemed to actually excascerbate the twitching.  I went to my GP who was somewhat dismissive of the symptoms and the sudden onset of the widespread twitching. I confided my fear of something ominous like ALS or MS and he assured me that these symptoms don't fit and these disorders are more rare than a more common cause like a recent viral infection or stress or change in exercise routine.  I felt better for a day or so after leaving the doc. The twitching abated to a minimum for several days but has returned.  Its been about 2 weeks and the fasciculations aren't present when I'm moving around, only while sitting and at worst at night and upon waking up.  I also wake up with the left foot tingling like its half asleep.  It usually gets better once I walk around.  I don't notice any weakness during exercise.  ALS anxiety is still in my mind and I find myself now looking at my hands for signs of wasting, worrying about muscle strength/fretting.  My questions are:
1) Does this sound benign vs ALS since the first symptoms were a very sudden onset of muscle twitching and leg parasthesia?
2) Is it common for something like MS/ALS to present with a focal tingling and twitching all over?  
3) Are sensory symptoms like pins and needles an unusual sign for ALS?


Thanks,

[mkj980]

A former boss was diagnosed with restless leg syndrome with similar symptoms.He said it was no joke and extremely uncomfortable and distressing, keeping him up at nights, etc.

[TJM24]

I used the term "fasciculations" because that was the term my PCP used.  Patients/individuals expect doctors to provide meaningful answers to their questions (I think that's the purpose of the forum). I tried to be as descriptive as I could and to articulate my questions clearly in order to be helpful and instead end up basically derided for it.  Perhaps I could rephrase my question without the layperson sin of using medical terms of art and maybe get a better response (PS- I am on here because I'm quite concerned about my symptoms/situation):

I'm having tingling/pins and needles sensations in my left foot. I'm having twitching in my calves and feet (more on the left leg and its also a pulsing sensation in my calf).  I'm also having some twitching in my arms,  hands, and eyes.  But most of the twitching is in my calves and feet.  Any ideas what this could be?  Lastly, I didn't mean to confuse ALS and MS, those were obviously two conditions which worried me.  Thanks,

[magnolia23]

I agree with "munchmetta." Sometimes I think doctors want patients to present themselves as  (I'll be kind) rather ignorant.  Mine was incensed when I suggested needing the very tests that in fact Dr. Kantor asked if I had had in my initial question to him.  (I answered his questions but have not heard back.)   I just clicked on the forum because I've had a bad day physically, and reading this sure doesn't help.  My best to you.  

[muchmetta]

what a completely insensitive and typical "neurologist" answer to a well asked question. Jargon or no, the guy had a problem and was seeking help. You blew it.

[Quixotic1]

I invite you to the MS forum where we have dealt with this kind of question many times before.  I can help you with the answer.  I am a physician with MS.

http://www.medhelp.org/forums/Multiple-Sclerosis-Support/wwwboard.html

Quix

[Dr. Daniel Kantor, MD]

While we all feel for you, it is not helpful when you use words like "fasiculations" because you box in your diagnostic possibilities.

Patients expect doctors not to use jargon, and we suggest that you don't either. It can delay the diagnosis because it leads us down a wrong path and it is difficult to keep an open mind.

Also you lump ALS and MS together when they are completely different diagnoses.

You are correct that ALS is an upper and lower motor neuron disease. The operative term is "motor;" so, yes, sensory changes would be a separate issue.