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What Causes Foot Weakness In Leg And Twitching In Body?

Posted on Thu, 6 Nov 2014

Question: Hi, I have been on here before to ask questions, I have another one for you.

I have experienced foot weakness for 4.5 years and hand weakness for quite a while. I have been nervous to go into a neurologist because I have been worried of ALS and MS. I finally got the courage to go in and I got good and bad news. She says she didn't find any upper motor neuron signs but she did see symmetry in my hand weakness and enough symmetry in feet weakness to say it is most likely a lower motor neuron disease, but not ALS or MS.

I told her that I experienced twitching off and on randomly for a while, sometimes more than others, sometimes not at all, through my body. And she told me not to worry, she would need to see multiple upper motor neuron signs, not just one.

Anyways, she wants me to come back in to get an EMG to see if it is something less severe than what she thinks, but I am worried to get it, what if they find fasciculation's? If they did see fasciculation's would there need to be other upper motor neuron signs as well? Would they just be considered benign if there weren't any other upper motor neuron signs? I am very worried to get the EMG because of my stupid off and on twitching... should I be scared of the twitching? She told me she was an expert on ALS and neuro diseases and not to worry about that.

Also, I have heard of this issue called Multifocal motor neuropathy, and I was curious about that being a cause, or a lower motor neuron disease like she thought.

Thanks for your time.

Answered by Dr. Sudhir Kumar (1 hour later)

Brief Answer:
Unlikely to be multifocal motor neuropathy.

Detailed Answer:
Hi,

Thank you for posting your query.

I have noted your symptoms, details of consultation and a plan for EMG studies.

First of all, I would like to reassure you that your symptoms are not suggestive multifocal motor neuropathy (MMN). In MMN, the symptoms are asymmetric and progresses rapidly. Deep tendon reflexes are absent, and the diagnosis would be obvious after a neurological examination.

Regarding ALS, i feel you do not have ALS, even if the EMG shows occasional fascisulation. It could still be benign fasciculations. In any case, muscle twitching is a lower motor neuron sign and not an upper motor neuron. We need to have a combination of lower and upper motor neuron signs to make a diagnosis of ALS.

I also feel you should get an EMG study done to determine the cause of your symptoms of 4.5 years.

I hope my reply has helped you.

I would be pleased to answer, if you have any follow up queries or if you require any further information.

Best wishes,
Dr Sudhir Kumar MD (Internal Medicine), DM (Neurology) XXXXXXX Consultant Neurologist
Apollo Hospitals, XXXXXXX
For DIRECT QUERY to me: http://bit.ly/Dr-Sudhir-kumar
My blog: http://bestneurodoctor.blogspot.com/

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Sudhir Kumar (17 minutes later)

Thank you very much for putting my mind at ease for my upcoming EMG and my twichting.

I will close the discussion now.

Regards,
XXXX

Answered by Dr. Sudhir Kumar (3 hours later)

Brief Answer:
Thank you.

Detailed Answer:
Thank you and best wishes,

Please keep me informed about your progress.

Best wishes,
Dr Sudhir Kumar MD DM (Neurology)

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar