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Dr. David
Dr. David, Board Certified MD
Category: Neurology
Satisfied Customers: 46937
Experience:  Experienced physician in Neurology
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Since 1 month and ~ 1 week I notice fasciculation in my

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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?

Hello, this is Dr. David. I am reviewing your question now and will be with you momentarily.

1. an EMG would not miss ALS, PLS or any MND

I am sorry about the loss of your dad

2. EMG would not diagnose, but radiculopathy is also best confirmed by MRI scan of the spine.

fasciculations are often caused by bad anxiety symptoms

3. you will not get ALS in the future

if your anxiety symptoms are bad, you may need some treatment for your anxiety symptoms

4. you should talk to your doctor about treatment for your anxiety symptoms. you don't need more testing. more testing will continue to show no ALS or MND

Customer: replied 1 month ago.
Ok, I am still in a scary mood and doctor recommended Zoloft but he didn't insisted too much on this. Just because it will take time to take effect.
sometimes I have days when I feel my calves muscle stiff, but this is because I am probably lifting up my body on my toes 10-15 times each leg because of my scary symptoms that I might get weaker ( I read a lot on the internet and I know I did the worst thing in my life ).The last and main question .
I know it's akward, The worst twitching I get in the morning when I wake up stressed. In the evenings they are less noticeable.
If I drink more then 2 bottles of wine / beers I see they stop ( I also asked my friends to check In case I get dizzy and I don't see them probably ). How can we explain this ? Can it be explained by nerve irritability?I am doing finger tapping tests every day and I know it's a severe anxiety but I will try to find a psychiatrist to fix this.I asked for different opinions. I will do an MRI of the spine if that will confirm radiculopathy I will be 1000% relieved. But if It will not confirm I will probably still have some bad tougs, as I know that ALS it's hard to be diagnosed :(And last question after the previous. What percentage you think I should rely on the EMG study ? About ruling this out of my mind.

you should be taking zoloft

you didn't do the worst thing in your life.

the zoloft will help decrease your anxiety symptoms over time.

and will help decrease these twitching symptoms as well.

the zoloft will help decrease these bad thoughts and anxiety thoughts.

you don't have ALS

let me know if you have other questions.
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Customer: replied 1 month ago.
At least I can get some medication which stops the twitches and spasms? Carbamazepin Gabapentin? In the morning after waking up they act lije crazy. After 12.30-1 they still twitch but at least I don't feel them if I'm not lookint

you should start your zoloft medication.

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