Mystery Weakness in Forearms at 22

Someone on an ALS support site redirected me here, so here goes. Most of this is copy/pasted from my post on there.I am 22 years old. A month ago while I was arranging books I noticed a strange sensation of weakness in my forearms. I examined my hands closely, and tried gripping tightly, which I could barely do. I was concerned for a little while, but I dismissed it as stress due to upcoming exams. And it went away.Then a week later I noticed the same sensation again (trembling arms, weak grip). I thought the same as before, but this time it didn't go away. As the weekend came on and I had to go to work, I became more anxious after reading the symptoms of ALS online. I started sensing similar sensations in my legs: A sort of trembling infirmity whenever I knelt down, like they were about to give or something, and I had more of the same in my arms. Then as the night went on the sensations seemed to diminish, so once again I dismissed it.Then the next day the symptoms returned, only this time they didn't go away. I had a feeling like I was losing my grip on things more easily, and my legs began feeling even weaker. I was so shaken that I had to call off work early. At that point I had convinced myself that I had ALS. For the next several days until my doctor's visit, I experienced odd fluctuations in strength perception: some days I would wake up feeling weak, and then I would improve as the day went on. Other days (usually the following) would be the opposite, I'd wake up feeling fine and then would gradually feel the weakness coming on again. It would always be the same places: arms and upper legs. At one point I went to the gym and did one set of moderate weight on each major muscle. I had little to no difficulty and felt better afterward, only to feel weak again later. Twitching in various areas also became worse. I began to feel twitching all over my body, mostly in my limbs. The night before the appointment my feet and lower legs were twitching so much they were practically having seizures. From then I noticed my shins and calves having weakness too.Saw the doctor, who of course told me that ALS was highly unlikely and suspected either a psychological cause or a deficiency and ordered blood-work.My symptoms would continue to fluctuate, until finally one day I felt like I had reached a plateau where I had gone nearly an entire day without any major symptoms. Then the next morning I woke up and everything felt worse. My calves were sore, my quads were sore, and so were my arms and forearms.Now I feel as though the weakness has changed: where once it was a mere trembling sensation, now it is more like a true fatigue. I tried exercising again, and was able to pull the same weight, but afterward felt even more sore, far more so than what I'd usually experience after working out.At this point it a month since this all began. The bloodwork came back normal, which actually uneased me even more since the chances of it being diet/lifestyle related are even less likely now. I can still walk normally, run, and go up steps, but I feel as though I am tiring faster and faster. Riding my bicycle has become difficult; I am feeling out of breath faster each passing day. My fingers and hands still seem fully motional and able to perform dextrous tasks like tying shoes, opening bottles, turning keys, buttoning, solving a puzzle cube. I play a cello; my left hand seems to have little difficulty with fingerings, but my bow arm and hand tire very fast, due to the special grip and motion involved. I am getting a paranoid sensation that my fingers seem stiffer than they used to be. Tasks that require very delicate motions like handling papers or opening envelopes seem to require a bit more attention and slower motion. Even during something as simple as scratching an itch, I can feel the extensor muscles in my forearms tiring after using my fingers for just a little bit. Twitching actually seems to have diminished from earlier but it still continues, whenever my muscles are at rest, usually in my left leg. I have suffered no loss of control, for the most part, just this rapidly increasing fatigue and soreness in all of my limbs.I've tried long and hard to find some deficiency, some other condition that these symptoms could be attibuted to, but none seem to fit the bill. ALS seems to be the only one that fits, and needless to say I am very frightened. My doctor has now referred me to a neurologist. The appointment is in two weeks.Current symptoms: Arms and legs fatigue VERY quickly, even doing mundane actions like walking up a few steps or holding a phone to my ear. Perception of slight clumsiness in my hands. Some twitching, mostly in the left leg - a very prominent and uncomfortable twitch sometimes starts in my left quad and goes on for HOURS. Calves become sore after resting. Even becoming excited causes a rapid heartbeat that forces me to stop and take a breather-without hardly even moving.Could BFS be causing this?

Hi,actually at 22 you are far too young to get ALS, first of all. Then, you seem to be a student and probably close to graduate (as you mentioned exams), and working at the same time, I can imagine what is going on with your sleeping schedule and all things related... We do not see the whole picture of course but I am sure you had a lot of sterss before that all had happened. You mihgt also consider recent flu, any single stressful condition preceding to the onset... anyway you know your life better.What good signs I can see in your case are:-intermittent nature of your problems (no matter they seem to be on increasing trend - we all have that trend in certain periods of BFS)-the fact you mentioned that your conditions usually relieve a bit at the evening and night time (that is good because it points to their anxiety nature)-the fact that you have reached some plateu and that at this plateau you still can use your musclesall the rest - increased twitches before appointment, hihg heartbit - this is already secondary to your anxious condition which is quite understandable. Anxiety might increase also your excersise intolerance and may cause that soreness and pains in the muscles and generally makes you feel in the moring like for the whole night you were working hard for the pixies it also makes you apply much more efforts during self test, that is why you feel like a wreck after it (I know thattrick for sure).So before your neuro appointement try to care about yourself as much as you can. Take some over the counter antianxiety meds, like valirana root or leonuria drops or pills - this is strongly advised, they would not harm you and they would improve your sleep too. Try to force regular sleeping schedule not less than 7 hours. Reduce alcohol, if any (it makes things worse). I know it is not easy to care about yourself in anxiety but do this simple things to break out of vitious cirlce.And please remember there is a lot of conditions causing such problems and the ALS is not typical for youngsters (while huge stresses and pressure are very typical). It is just the most prominent in the internet and sometimes in the commercials (which have a little of connection to the real life and pursue their own goals). wish you a good relief with your neuro visit.RegardsYulia

Hi There,So, I want to just explain a few things.ALS is a disease of the motor neurons. You have many different kinds of neurons in your body but there are specific ones muscle control. As there are implications for voluntary and involuntary neuron degeneration in motor neuron disease.Hence the name of the disease motor neuron. The signals to the muscles begin to die through the long chain of command basically and can no longer fire the appropriate signals to the muscle hence the hallmark muscle weakness. Because your brain is trying to send signals to your nervous system to preform simple tasks, these tasks as they say such as "difficulty turning a key, slurring your speech, or walking and dragging your foot" are a hallmark of motor neuron disease. The reason patients with motor neuron disease ( I hate calling it ALS because its such an exclusive term for an inclusive disease) begin to have muscle twitching is a sign of the "death" of the nerves to the muscle. Its trying to say work work work! but it just cannot due to dying of the connection of nerves to the muscles. I hope this makes sense. If not feel free to contact me! You'll be okay =)

I should edit that but, read the above and basically you would have had these symptoms in advance (months) before twitching and rapid heartbeat has nothing to due with neurons.

Thank you all for your responses, but I am still highly skeptical of this suggestion that BFS is the cause since fasciculations are only a minor symptom. The major one has been this pervading sensation of weakness. It's especially poignant in my hands - everytime I open and close them the motion seems to be rigid and jerky, rather than smooth. That is the one symptom that has not changed, since the beginning of all of this. I feel like my hands are timid to handle things. Everytime I test myself with some dextrous task like playing piano or solving a puzzle cube, I can feel a certain stiffness in them (even now as I am typing one-handed methinks I am missing more keys than usual), and when I stop to look at them they appear to be shaking. I have suffered no real loss of strength in them (I can still grip tightly and extend fully), just this (perceived?) loss of coordination and control.Does this really sound like BFS, even when twitching is occacional? Are there other benign conditions that may be the cause? At least it does not sound like ALS?

Hi, lionthunder,actually the rule for ALS is 'weakness first' but unless you do not ahve real weakness - clinical weakness- but only certain lack of free movements, it should not be ALS. Not talking already again and again that in 22 you are far too young for ALS.As I probably told here, for me that feeling of awkwarndess in hands, lack of dexterity and even certain loss of grip (happily percieved) was secondary to the twitches, however for now I have the same condition as yours - twitching are minor, while hand and legs percieved weakness still bothers me.However my grip issues later appeared might be attributed to cold hypersencitivity common for hypermobility (Ellers Danlos syndrome) which is my case too. All ALS stories I read on our local (Russian) ALS sites before I found this site were looking like sudden complete inablity to use hand or leg or fingers - complete and irreversible, like "my husband was digging up the garden and could not take a hand out from the shovel" or "I can not use scissors" etc.Tremor after doing fine work might result from too much efforts you put to those actions, which is natural in case you suspect there is something wrong with you.Take care for your anxiety - and you would see if there would be anything in the dry residual.

It doesn't matter if your twitching is occasional or 24/7 in all your muscles. There are many levels of twitching in BFS, and the fact that you have all these other symptoms just further reinforces the benign nature of the cause. Myself and soooo many others have experienced the exact same symptoms. The focus should not be on the strangeness of these other symptoms, but rather on the fact that all these symptoms point AWAY from ALS.