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Dr. Frank
Dr. Frank, Board Certified Physician
Category: Neurology
Satisfied Customers: 9000
Experience:  Board certified general Adult Neurologist, with experience in experimental neuroimaging and neurodiagnostics.
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I am worries that I have Mnd,I am not sleeping not eating

Customer Question

Hello doctor,I am worries that I have Mnd,I am not sleeping not eating well for over three months,I convinced myself that it is als and cant live like this
Submitted: 1 year ago.
Category: Neurology
Expert:  Dr. Frank replied 1 year ago.

Hello welcome to JA. How can i help. Have you seen a neurologist and had a Neurodiagnostics study? I can review your studies or discuss bfs benign fasciculation syndrome. Let me know. Dr Frank

Customer: replied 1 year ago.
Hi Dr Frank,I have seen a neuro,no abnormalities with my strengths etc,have my emg booked next week,but that seems ages all started with a bit of a tingling around my face,followe by a massive headache and vomiting.Then a few weeks later I stressed myself with MS and tingling spread everywhere.Lasted for about two weeks and then the twitching settled in.Going like millions of fireworks around my body.Still continues..Of course I stressed myself to hell that its mnd,is it how als usually presents itself?
Customer: replied 1 year ago.
I've got no clinical weakness that is found,no atrophy,however I did read thats als may start with twitching around the body.If I squeeze my eyes the immidiately start to twitch for 10 sec or so
Expert:  Dr. Frank replied 1 year ago.

No that is not how als starts in young adults. It is extremely rare and presents with rapid severe atrophy with loss of motor tone at onset ( you are floppy). It is a disease of old men You might have bfs or you could have some other illness even ms as i havent looked at you. Most facial twitching though are facial motor tics brought on by stress. They arr most commonly seen in that settong in the eyelids and around the eyes because those delicate muscles have a low number of muscle cells per nerve fiber so they express the nervous tension that you feel. An emg will exclude mnd but you might have bfs. Benign fasciculation syndrome. Please remember to rate my service if satisfied by clicking on the stars. Dr frank

Customer: replied 1 year ago.
I have very fine twitches though,sometimes like in my calves I cant even feel them but I can see them.I thought Bfs were more severe twitches.
Expert:  Dr. Frank replied 1 year ago.

The size of the twitch depends on the size of the motor unit. I can go over your emg if u need an explanation. Dr frank

Customer: replied 1 year ago.
Is there anyone whose first symptoms were muscle twitches without any weakness or atrophy?
Expert:  Dr. Frank replied 1 year ago.

Yes it can start with fasciculations first. But they are segmental. Isolated to one area. Like c 4/5 and you have it in the shouler muscles of your left arm. Maybe some in biceps but within weeks the muscle melts away. Bulbar symptoms create rapid bilateral bells palsy ou tongue fascics with slurred speech.

Customer: replied 1 year ago.
Can it start widespread and after a period of a few months isolate itself to a particular area?
Expert:  Dr. Frank replied 1 year ago.

No it spreads segmentally. Not like bfs where any muscle can twitch. Bfs has problems with regulation of potassium through channels in the muscle cell membrane. I hope that answered your question. Dr frank

Customer: replied 1 year ago.
Could emg be ever done too early?I mean could anything be missed if its done too soon after twitching started?Is it better to wait longer before getting it done?Is there anyone who would have a normal emg and a few months later diagnosed with mnd?Thankyou
Expert:  Dr. Frank replied 1 year ago.

There is a clear cut criteria (escorial) which demonstrates motor fiber change characteristics that identifies the problem. Very difficult to miss. You seem extremely anxious and i would consider the BFS support groups that are available online. They can help to reduce anxiety when facing this issue. I hope that helps. Please remember to rate my service as that is how I am compensated for my work. Click on the stars. Dr Frank