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How is Motor Neuron Disease treated ?

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Practicing since : 2001
Answered : 504 Questions
Hi and thank you for your opinion. I am a 35 yo white male. Former college football player. I am now a father with two young boys. Approximately 3 weeks ago I started developing muscle twitches. I understand that in my age these are mostly benign. They started in my right triceps and now occur throughout my body. I went to a neurologist who ordered blood work and said if that wasn't revealing, that he would order an EMG. at this point I was thinking it was BFS.

I felt better after talking with the neurologist but then another symptom appeared out of the blue. I woke up on Monday morning and my right calf muscle was very very stiff. only my right one. I did absolutely no exercises for two day previous. I have not felt this feeling before even in my athletic days. I stretched it out as much as possible and then went for a long walk. The stiffness subsided. The stiffness did not return on Tuesday or Wednesday morning. however there is quite a bit of twitching happening in this right calf as well and some minor twitching that comes and goes all over.

I exercise rather regularly and do pushups and sit-ups 3x a week. I don't notice any weakness at all anywhere. But then again I am fairly muscular so I would think that it would be very subtle if I was weakening.

I am completely freaked out at this point and it is affecting my ability to live normally and be productive both professionally (engineer at a large company) and socially as well as a parenting.
I have read that my odds of getting ALS is 1 in 165,000,000 before age 38 but with some of the stuff I have put in my body over the years (steroids, drugs, alcohol, although very clean now) I can't help but think my chances are much better for contracting ALS.

I know it is difficult without seeing the EMG, but do you have an opinion on the above symptoms? Please be as honest as possible with your answer instead of trying to appease my obvious anxiety. Thank you very much for your time.
Posted Sat, 14 Apr 2012 in Bones, Muscles and Joints
Answered by Dr. Shiva Kumar R 3 hours later

Thanks for the query.

You have two symptoms at this point of time. One is muscle twitches or fasciculations occurring through out the body. Second one is probably a cramp in your leg.

Fasciculations has many causes varying from benign diseases like Benign Fasciculation Syndrome to most serious diseases like Amyotrophic Lateral Sclerosis or also called as Motor neuron disease like Amyotrophic Lateral Sclerosis starts usually after the age of 50 years. It starts as weakness and wasting of the muscles particularly around the shoulder and then gradually spreads to other parts of the body. Only Familial Amyotrophic Lateral Sclerosis occurs in the younger age groups which is very very rare condition. They can also have nocturnal cramps particularly in the calf muscles.

What you have at this point of time is twitching of 3 weeks duration with one episode of cramp in the calf muscles. Benign fasciculations are usually seen around the shoulder muscles and calves and never migrate or increase or change in severity.

Other common causes like Thyroid problems, Calcium abnormalities, Muscular disorders can also produce twitchings. I feel the symptoms do not fit in to the diagnosis of Amyotrophic Lateral Sclerosis in you. Mostly they are Benign Fasciculation Syndrome.

Do get evaluated for Thyroid and Calcium related problems. Get an Electromyography done to refute the diagnosis of Amyotrophic Lateral Sclerosis.

Hope this answers your query. In case of any doubts, I am available for the follow ups.

Wishing you a good health.

Dr Shiva Kumar R
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