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Since 1 month and ~ 1 week I notice fasciculation in my

calves and when I run...
Since 1 month and ~ 1 week I notice fasciculation in my calves and when I run or workout or randomly some very very mild cramps. Sometimes after working my calves. ( doin strength test each morning by pushing my body using my toes up to see If I get weak ).I get also twitches all over in tights , biceps triceps , eye, temple but they are rare and go away.Actions I took:1st week : went to see 1st neurologist which dismissed ALS/MND from the beginning based on a quick clinical exam
2nd week: Saw a board neurologist with 50 years o experience is his field which he dismissed ALS as well and he didn't even considered necessary to have an EMG
3rd week: Finally found a neuro-muscular specialist with 10 years of experience which agreed to do an EMG in 3 limbs ( Legs, Right hand ) and a nerve conduction study.What he told me ( still waiting for a final report yet ):
1. No evidence of MND , he clearly stated on a white paper for me to be re-assured
2. He suspects a lumbar radiculopathy ( I do have some pain around L4-L5 )
3. A pinched ulnar nerve ( light ) in the right elbow ( according ncs ) which doesn't bother me.
4. 3rd clinical exam without any clinical weakness or athrophy noticed by all doctors.The reason I am experiencing this anxiety is that my DAD died of ALS in 2003.
Mom mentioned that a neurologist made a genetic test for me and he found that I have no predisposition.
Dad was sporadic and nobody from it's family had any neuro diseases in the past ( He has 2 sisters and 1 brother ). Grandparents were ok.Last doctor said no EMG is required for follow up, but if I can do a spine MRI ( no contrast ) In 3 months would be good.So, finally my questions are. ( Being 30 years old ). (Condensing)1. Could EMG miss ALS/PLS or any MND ? If it can, what Is the chance? ( found 2,3 cases on the internet with people which claimed they started with fascics and then weakness ).
2. Could EMG study misdiagnose? How it gets the radiculopathy ? F or H waves? No evidence of MND means that the MUAP was around good values?
3. I am still anxious but I really need a host answer, would this generate me ALS in the early future ?
4. What do you think I should do ? CK blood tests? Should I do a spintal tap ? I want to be assured or not, this anxiety is killing me.
5. Could EMG miss PLS ? I heard some cases.
6. Radiculopathy should show denervation? It's there any chance I could be diagnosed wrongly?
What do you think I should go do in the near future and what to search from now on?
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Answered in 2 minutes by:
8/21/2017
DrRussMd
DrRussMd, Board Certified MD
Category: Neurology
Satisfied Customers: 65,553
Experience: Internal medicine doctor, diagnose and treat neurology patients, many years
Verified

Hi.
Welcome to just answer. I am here to answer questions for education and information. I will respond shortly with an answer, or a question for you

Ask Your Own Neurology Question

You are looking at this incorrectly.

EMG does not diagnose any of these.

It rules them out inconjunction with a neurological exam.

In fact, it is simply confirmation of what the exam shows.

So the answer to your concerns about ALS and PLS, etc. is that you do not have them.

You do not have to have denervation for radiculopathy, that can come later if it is not addressed. It can start simply with irritation.

It is very clear that you are suffering from anxiety, which will make the fasiculations worse.

Here is what can also aggravated them:

low magnesium

thyroid disease

low vitamin D

Low B vitamins

Other less harmful causes, any structural stress, and any spinal disc disease.

You need to get a physical medicine and rehabilitation assessement and MRI immediately and go on a program to prevent disc deterioration.

No, you are not at higher risk of getting ALS later.

OK, let me know if you have more questions.

Also, please click a positive rating on the rating scale. In fact, a 5 rating squares me with just answer and allows me to provide prompt and accurate service to you, but does not increase your cost. And, I will be here for any follow up needed.

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Customer reply replied 3 months ago
Yesterday I met at a party a guy which has the same problem as me.
But he has it for 4 years, he mentioned that he has a herniated disc as he's working in constructions. Worst are in the morning. 20 minutes after waking up they are crazy, some other period during the day they're slow.
In the evenings they still stay but they become less noticeable.I know this sound funny but when I drink 1,2,3 wine glasses, or beers they stop, or at least they are not visible any more.
I don't know why they are crazy during the morning and this time distribution it's a bit akward.I will start taking Paroxetine HCL to stop the anxiety anyway.
Any advice I should repeat the EMG study? The last doctor told me to do an MRI but in 3 month as the herniated disc seems to be mild according tot the EMG.So in the end:
1. There's absolutely no chance that ALS to be misdiagnosed as radiculopathy by mistake?
2. How the EMG study catches radiculopathy and how ALS is diagnosed? If I have an LMN onset this cannot be missed in the early stages?
3. In ASL fascics would never go away using wine correct?

I see only a need for MRI

I see no need for a repeat EMG

I seen a huge need for anxiety treatment.

OK< please click a 5 rating on the scale at the top of the page, that must be done manually.

Come back as needed.

DrRussMd
DrRussMd, Board Certified MD
Category: Neurology
Satisfied Customers: 65,553
Experience: Internal medicine doctor, diagnose and treat neurology patients, many years
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Category: Neurology
Satisfied Customers: 65,553
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Experience: Internal medicine doctor, diagnose and treat neurology patients, many years

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