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Dr. Andrew Rynne

Family Physician

Exp 50 years

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Hello. I have a couple of questions, and know I

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Dr. Erion Spaho

Neurologist, Surgical

Practicing since :2004

Answered : 3289 Questions

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Posted on Fri, 25 Jan 2019 in Headache and Migraines
Question: Hello.

I have a couple of questions, and know I may sound foolish, or worrisome. Recently, I've noticed some weakness in my arm. For awhile, I've noticed random "twitches" I guess you could call them, all over my body in my muscles. They are painless and brief (usually last 1 second or less). Over the past few months, I've noticed that I appear to be a bit weaker at the gym, I'm still able to do everything I used to, just seem a bit weaker. I also have just started to notice a strain like tingling or sensation in one of my legs (the same side as my arm that's weak). It is most apparent when I try to make circles with my ankle. I am a runner, and have been able to run, though I have a strain in my knee(the opposite side), and other than that haven't noticed many issues with it. Over the past year or so I've also noticed that I've become more clumsy, and tend to drop things like my cellphone more frequently. My knees also buckle occasionally, causing me to drip until I catch myself. This hasn't happened in awhile though. I've read online about ALS and that the beginning symptoms are usually very subtle and sometimes unnoticeable. I'm a hypochondriac and always assume the worst when I get any symptoms, and it then consumes my thoughts and I think I'm dying. I know the likelihood of this disease (as my family keeps assuring me) is not very high, but I did have a friend that died from a rare form of it when she was 21, and I couldn't imagine going through it. I have a physical exam scheduled with my primary care doctor for next week, as I'm hoping he would be able to give me some peace of mind and would be able to tell if something was wrong with me or not. As a note, this has not affected my daily activities, and I'm still able to do everything I usually do, and I'm walking fine, and talking fine that I can tell. My one concern with my knee was that my one leg was weak so my body was favoring it causing my other knee to get hurt, and for some reason my mind flocked to ALS. I don't like thinking this way, as I know it's not likely, but I also know it's possible, and I'm looking for any advice and opinions I can get. Thank you
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Follow up: Dr. Erion Spaho 0 minute later
Hello.

I have a couple of questions, and know I may sound foolish, or worrisome. Recently, I've noticed some weakness in my arm. For awhile, I've noticed random "twitches" I guess you could call them, all over my body in my muscles. They are painless and brief (usually last 1 second or less). Over the past few months, I've noticed that I appear to be a bit weaker at the gym, I'm still able to do everything I used to, just seem a bit weaker. I also have just started to notice a strain like tingling or sensation in one of my legs (the same side as my arm that's weak). It is most apparent when I try to make circles with my ankle. I am a runner, and have been able to run, though I have a strain in my knee(the opposite side), and other than that haven't noticed many issues with it. Over the past year or so I've also noticed that I've become more clumsy, and tend to drop things like my cellphone more frequently. My knees also buckle occasionally, causing me to drip until I catch myself. This hasn't happened in awhile though. I've read online about ALS and that the beginning symptoms are usually very subtle and sometimes unnoticeable. I'm a hypochondriac and always assume the worst when I get any symptoms, and it then consumes my thoughts and I think I'm dying. I know the likelihood of this disease (as my family keeps assuring me) is not very high, but I did have a friend that died from a rare form of it when she was 21, and I couldn't imagine going through it. I have a physical exam scheduled with my primary care doctor for next week, as I'm hoping he would be able to give me some peace of mind and would be able to tell if something was wrong with me or not. As a note, this has not affected my daily activities, and I'm still able to do everything I usually do, and I'm walking fine, and talking fine that I can tell. My one concern with my knee was that my one leg was weak so my body was favoring it causing my other knee to get hurt, and for some reason my mind flocked to ALS. I don't like thinking this way, as I know it's not likely, but I also know it's possible, and I'm looking for any advice and opinions I can get. Thank you
doctor
Answered by Dr. Erion Spaho 2 hours later
Brief Answer:
I don't think it's ALS.

Detailed Answer:
Hello and welcome to "Ask a Doctor " service.

I have read your query and here is my advice.

ALS is a progressive condition and its symptoms worsen with time.

Since you noticed the symptoms over one year or so, I don't think that ALS is the condition that is causing them because in a year the disease should have progressed significantly.

In the other hand, ALS is very rare in people younger than 40 years old.

The hallmark symptom of ALS is weakness of muscles that progresses and muscle atrophy noticeable as the disease progresses.

In your case, there is no significant weakness, no muscle atrophy, you have no difficulties with everyday activities.

So, in my opinion, yours is not a case of ALS.

Excessive exercising, anxiety, etc. may cause such symptoms.

Hope you found the answer helpful.

Let me know if I can assist you further.





Above answer was peer-reviewed by : Dr. Prasad
doctor
doctor
Answered by Dr. Erion Spaho 0 minute later
Brief Answer:
I don't think it's ALS.

Detailed Answer:
Hello and welcome to "Ask a Doctor " service.

I have read your query and here is my advice.

ALS is a progressive condition and its symptoms worsen with time.

Since you noticed the symptoms over one year or so, I don't think that ALS is the condition that is causing them because in a year the disease should have progressed significantly.

In the other hand, ALS is very rare in people younger than 40 years old.

The hallmark symptom of ALS is weakness of muscles that progresses and muscle atrophy noticeable as the disease progresses.

In your case, there is no significant weakness, no muscle atrophy, you have no difficulties with everyday activities.

So, in my opinion, yours is not a case of ALS.

Excessive exercising, anxiety, etc. may cause such symptoms.

Hope you found the answer helpful.

Let me know if I can assist you further.





Above answer was peer-reviewed by : Dr. Prasad
doctor
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Follow up: Dr. Erion Spaho 25 minutes later
Thank you for the answer and reassurance. I have noticed some progressive weakness while at the gym lately. My biggest concern is my lower leg as it feels strained whenever I move my ankle, and I didn't do anything to aggravate it, but it started a couple days ago a few ays after I noticed the weakness in my left arm. I just know the symptoms start out very subtle, and I want to make sure I'm not missing anything. I had a friend who died when she was 21 because of ALS. My family keeps telling me how unlikely it is, and I know it is, but I also know it's possible, and it just scares me.
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Follow up: Dr. Erion Spaho 0 minute later
Thank you for the answer and reassurance. I have noticed some progressive weakness while at the gym lately. My biggest concern is my lower leg as it feels strained whenever I move my ankle, and I didn't do anything to aggravate it, but it started a couple days ago a few ays after I noticed the weakness in my left arm. I just know the symptoms start out very subtle, and I want to make sure I'm not missing anything. I had a friend who died when she was 21 because of ALS. My family keeps telling me how unlikely it is, and I know it is, but I also know it's possible, and it just scares me.
doctor
Answered by Dr. Erion Spaho 22 hours later
Brief Answer:
Other reasons besides ALSmay cause muscle weakness.

Detailed Answer:
Welcome back.

As I mentioned before, ALS is very unlikely to be found in people before their fourth decade of life.

Genetic forms of ALS tend to be found in youth and are very rare.

Since you go to gym strained muscles for example may feel weakened.

Hope I helped you.

Take care.

Above answer was peer-reviewed by : Dr. Raju A.T
doctor
doctor
Answered by Dr. Erion Spaho 0 minute later
Brief Answer:
Other reasons besides ALSmay cause muscle weakness.

Detailed Answer:
Welcome back.

As I mentioned before, ALS is very unlikely to be found in people before their fourth decade of life.

Genetic forms of ALS tend to be found in youth and are very rare.

Since you go to gym strained muscles for example may feel weakened.

Hope I helped you.

Take care.

Above answer was peer-reviewed by : Dr. Raju A.T
doctor
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Follow up: Dr. Erion Spaho 10 minutes later
Okay thank you. Just one last thing. I should’ve be worried about the weakness/fatigue feeling in my forearm/radius area in my left arm? It appears to be getting a bit weaker, and it feels fatigued, and right now is my biggest concern. But it sounds like you don’t think this is too much of a worry. When my friend died from it, they linked it to the Gardisol vaccine, which I also received (about 10 years ago), but I’d like to think that if anything were to happen, it would have happened by now.
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Follow up: Dr. Erion Spaho 0 minute later
Okay thank you. Just one last thing. I should’ve be worried about the weakness/fatigue feeling in my forearm/radius area in my left arm? It appears to be getting a bit weaker, and it feels fatigued, and right now is my biggest concern. But it sounds like you don’t think this is too much of a worry. When my friend died from it, they linked it to the Gardisol vaccine, which I also received (about 10 years ago), but I’d like to think that if anything were to happen, it would have happened by now.
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Follow up: Dr. Erion Spaho 29 minutes later
I also haven’t been working out nearly as much as I typically have, which is concerning as to my symptoms
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Follow up: Dr. Erion Spaho 0 minute later
I also haven’t been working out nearly as much as I typically have, which is concerning as to my symptoms
doctor
Answered by Dr. Erion Spaho 12 hours later
Brief Answer:
Gardasil vaccine is not found to cause ALS scientifically.

Detailed Answer:
Hello again.

As I mentioned before, there may be other reasons for some muscles weakness besides ALS.

Gardasil vaccine is not found to be linked significantly statistically speaking with ALS or other serious complications.

Furthermore, there is a ten years gap between the vaccination and your current issues, so, it is very unlikely that this could be a possibility.

Hope this helps.

Greetings.
Above answer was peer-reviewed by : Dr. Remy Koshy
doctor
doctor
Answered by Dr. Erion Spaho 0 minute later
Brief Answer:
Gardasil vaccine is not found to cause ALS scientifically.

Detailed Answer:
Hello again.

As I mentioned before, there may be other reasons for some muscles weakness besides ALS.

Gardasil vaccine is not found to be linked significantly statistically speaking with ALS or other serious complications.

Furthermore, there is a ten years gap between the vaccination and your current issues, so, it is very unlikely that this could be a possibility.

Hope this helps.

Greetings.
Above answer was peer-reviewed by : Dr. Remy Koshy
doctor
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Follow up: Dr. Erion Spaho 5 hours later
Thank you. I’m able to run, and do other workouts at the gym without much trouble so I guess that’s a positive sign as well
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Follow up: Dr. Erion Spaho 0 minute later
Thank you. I’m able to run, and do other workouts at the gym without much trouble so I guess that’s a positive sign as well
doctor
Answered by Dr. Erion Spaho 19 hours later
Brief Answer:
Yes, it is a positive sign.

Detailed Answer:
One of the aspects of the ALS symptoms and damages is that there is interfering with every day activities.

So, it is a positive sign that you have no problems of this nature.

Wishing you good health.
Above answer was peer-reviewed by : Dr. Nagamani Ng
doctor
doctor
Answered by Dr. Erion Spaho 0 minute later
Brief Answer:
Yes, it is a positive sign.

Detailed Answer:
One of the aspects of the ALS symptoms and damages is that there is interfering with every day activities.

So, it is a positive sign that you have no problems of this nature.

Wishing you good health.
Above answer was peer-reviewed by : Dr. Nagamani Ng
doctor
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Follow up: Dr. Erion Spaho 8 hours later
So I shouldn’t worry? I have had muscle twitches for about a year or so, and I have noticed a drop in my running performance in the past year or so. I don’t feel awkwardness when I run, but I’m not performing as well. My forearm is just concerning me because it feels tired and weak, kind of tight as well. And has for about a week and a half or so. I just can’t get this out of my head
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Follow up: Dr. Erion Spaho 0 minute later
So I shouldn’t worry? I have had muscle twitches for about a year or so, and I have noticed a drop in my running performance in the past year or so. I don’t feel awkwardness when I run, but I’m not performing as well. My forearm is just concerning me because it feels tired and weak, kind of tight as well. And has for about a week and a half or so. I just can’t get this out of my head
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Follow up: Dr. Erion Spaho 10 minutes later
It hasn’t really been a year of poor performance, it’s been about 6-7 months or so I’d say
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Follow up: Dr. Erion Spaho 0 minute later
It hasn’t really been a year of poor performance, it’s been about 6-7 months or so I’d say
doctor
Answered by Dr. Erion Spaho 19 hours later
Brief Answer:
Answered below.

Detailed Answer:
Welcome back.

One year is a long period when it comes to ALS, the typical symptoms should be clear by now.

It is clear that anxiety is playing a major role in your symptoms, so, try to calm down.

I think the upcoming medical evaluation will clear your doubts.

Take care.
Above answer was peer-reviewed by : Dr. Kampana
doctor
doctor
Answered by Dr. Erion Spaho 0 minute later
Brief Answer:
Answered below.

Detailed Answer:
Welcome back.

One year is a long period when it comes to ALS, the typical symptoms should be clear by now.

It is clear that anxiety is playing a major role in your symptoms, so, try to calm down.

I think the upcoming medical evaluation will clear your doubts.

Take care.
Above answer was peer-reviewed by : Dr. Kampana
doctor
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Follow up: Dr. Erion Spaho 59 minutes later
Should he order an EMG, or should he be able to reassure with a simple
Physical exam
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Follow up: Dr. Erion Spaho 0 minute later
Should he order an EMG, or should he be able to reassure with a simple
Physical exam
doctor
Answered by Dr. Erion Spaho 23 hours later
Brief Answer:
EMG and nerve conduction study should be done.

Detailed Answer:
At this point, I think an EMG and nerve conduction study should be done for two reasons;

1- To evaluate any nerve entrapment that may cause the weakness.

2- To ease your mind.

Hope I helped you so far.

Greetings.
Above answer was peer-reviewed by : Dr. Prasad
doctor
doctor
Answered by Dr. Erion Spaho 0 minute later
Brief Answer:
EMG and nerve conduction study should be done.

Detailed Answer:
At this point, I think an EMG and nerve conduction study should be done for two reasons;

1- To evaluate any nerve entrapment that may cause the weakness.

2- To ease your mind.

Hope I helped you so far.

Greetings.
Above answer was peer-reviewed by : Dr. Prasad
doctor
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