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What Causes Body Wide Tingling, Vibrations In Feet And Muscle Twitching?
Question: I am a 25 yrO male who has been suffering from various symptoms for the past 17 months. It all started last year when I developed a pain / discomfort under my right rib cage. I went to the doctor who did a CT and ultrasound and it was deemed normal. Shortly after that I developed bodywide muscle twitching, this sent me into a spiral and I thought I had ALS. Went to a neurologist who did an EMG and a full physical work up and deemed me healthy as can be. I also visited a physiatrist who sent me for a CT scan of my head which was also normal. My neuro told me it was BFS, prior to all this I had a MRI roughly 3 years ago which was all normal besides some inflammation in my sinus. I am currently suffering from bodywide tingling, vibrations in my feet and still some muscle twitching. My twitching has reduced in severity tremendously. I am current absolutely petrified of MS and I having so much trouble believing its BFS. I am worried my MRI was outdated and that my doctor just dismissed me for anxiety etc because I am in pharmacy school. I am really struggling. I can still lift heavy weights in the gym, play basketball, snowboard, jump up 4 steps etc. I check mu reflexes on a daily basis and they seem fine (babinksi and knee jerk). I recently saw another neurologist and she assured me 99% that Its not MS however, she wants to run some blood test and do a MRI of my spinal column and another EMG. She said she is doing this to help me get over these fears. Yesterday i shoveled snow and since then my right arm is tremoring and feels week. I was able to do 30lb curls 20x. I am worried of MS now with this occurring, should I be alarmed or just accept its BFS. Please help me and be honest and don't dismiss me with anxiety. Thank you
Brief Answer:
Definitely not MS.
Detailed Answer:
I read your question carefully. I understand you are under great distress and I am really sorry about that.
I'm going to start by saying rightaway that I am sure your symptoms are not due to MS. It looks that your main symptoms are wide spread fasciculations and abnormal sensations. Fasciculations are not a symptom of MS. I'll try to explain why so that I might hopefully be more convincing. Impulses reach the muscle through two motor neurons (nerve cell), the first starting from the brain surface and reaching the brain stem or the spine, while the second from the spine or brain stem sends the impulse to the periphery through peripheral nerves. Involvement of these two parts has different manifestations, if the first is affected it shows increased reflexes and spasticity, meanwhile the second shows fasciculations and loss of reflexes. MS shows manifestations corresponding to the first motor neuron, while fasciculations are related to peripheral involvement. So the presence of fasciculations is actually a symptom which speaks against MS, there is no reason whatsoever to think MS is the cause.
Of course MS involves other systems as well such as vision, ocular movements, balance and coordination etc which would have been noted on the exam performed by your neurologist.
I guess spine MRI will serve to put your mind at ease, but I really believe you should dismiss that MS possibility from your mind (and stop checking your reflexes and Babinski). A second EMG will also reinforce the lack of peripheral neurological disease.
One last suggestion I could make is to have some blood tests like blood count, blood sugar, liver and kidney function tests, thyroid function, electrolytes (especially calcium and magnesium). Probably you have done them already, but just in case you haven't I suggest you do to look for common conditions predisposing for both anxiety and benign fasciculations.
That is my honest opinion rest assured about that, it would be much easier for me to send you into doing all sorts of unnecessary tests, but I have your best interest at heart.
I hope to have been of help.
Definitely not MS.
Detailed Answer:
I read your question carefully. I understand you are under great distress and I am really sorry about that.
I'm going to start by saying rightaway that I am sure your symptoms are not due to MS. It looks that your main symptoms are wide spread fasciculations and abnormal sensations. Fasciculations are not a symptom of MS. I'll try to explain why so that I might hopefully be more convincing. Impulses reach the muscle through two motor neurons (nerve cell), the first starting from the brain surface and reaching the brain stem or the spine, while the second from the spine or brain stem sends the impulse to the periphery through peripheral nerves. Involvement of these two parts has different manifestations, if the first is affected it shows increased reflexes and spasticity, meanwhile the second shows fasciculations and loss of reflexes. MS shows manifestations corresponding to the first motor neuron, while fasciculations are related to peripheral involvement. So the presence of fasciculations is actually a symptom which speaks against MS, there is no reason whatsoever to think MS is the cause.
Of course MS involves other systems as well such as vision, ocular movements, balance and coordination etc which would have been noted on the exam performed by your neurologist.
I guess spine MRI will serve to put your mind at ease, but I really believe you should dismiss that MS possibility from your mind (and stop checking your reflexes and Babinski). A second EMG will also reinforce the lack of peripheral neurological disease.
One last suggestion I could make is to have some blood tests like blood count, blood sugar, liver and kidney function tests, thyroid function, electrolytes (especially calcium and magnesium). Probably you have done them already, but just in case you haven't I suggest you do to look for common conditions predisposing for both anxiety and benign fasciculations.
That is my honest opinion rest assured about that, it would be much easier for me to send you into doing all sorts of unnecessary tests, but I have your best interest at heart.
I hope to have been of help.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Doctor,
Thank you for your detaliled and prompt response. I have been trying overcome these fears but it has been rough. I am a pharmacy student and the stress is high and trying to deal with all these symptoms makes it worse. In regards to the muscle tremor after shoveling and while holding things, what could that be? Thank you again and god bless.
Thank you for your detaliled and prompt response. I have been trying overcome these fears but it has been rough. I am a pharmacy student and the stress is high and trying to deal with all these symptoms makes it worse. In regards to the muscle tremor after shoveling and while holding things, what could that be? Thank you again and god bless.
Brief Answer:
Read below.
Detailed Answer:
Some degree of tremor after heavy exertion is normal.
Tremor can have many causes, many of which are excluded by your age and normal neurological examination by your neurologist.
At your age the most common form of tremor is physiological tremor which is up to a point experienced by many people but can be heightened by factors like anxiety, use of coffee or other stimulants, metabolic changes like low blood glucose, high thyroid function etc (for which I suggested the above mentioned blood tests). Tremor after exertion is a form of physiological tremor as well.
Wishing you good health!
Read below.
Detailed Answer:
Some degree of tremor after heavy exertion is normal.
Tremor can have many causes, many of which are excluded by your age and normal neurological examination by your neurologist.
At your age the most common form of tremor is physiological tremor which is up to a point experienced by many people but can be heightened by factors like anxiety, use of coffee or other stimulants, metabolic changes like low blood glucose, high thyroid function etc (for which I suggested the above mentioned blood tests). Tremor after exertion is a form of physiological tremor as well.
Wishing you good health!
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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