Anxiety and Twitching: A Med Students Story

[bassfreak2002]

I'm a 28 year old med student. I've had some anxiety issues in the past and man has this twitching added to it. In May of 2004 (19 months ago) I saw a guy on TV with ALS who said his first symptom was twitching. I thought "Oh my god, I twitch too". So I started the "research" and scared myself to death. I had my first EMG/normal exam the next month. I felt better for awhile but a couple of months later fell back into the same thing. I started Lexapro and that eased the anxiety but didn't help the twitches. After a year of twitching I stopped the Lexapro and tried to handle things without the ssri. I went to my primary and she thought I could see another neuro and also ENT due to some GERD symptoms. The neuro exam was normal again but the ENT noticed some "vocal cord paresis" on my left. Imagine that, telling someone worried to death about MND that they have a partially paralyzed vocal cord. I don't notice any change in voice quality but it really has pushed my anxiety up. With the increased anxiety I went to another neuro a couple of months later. Again, the EMG and exam were normal. So, it had been a few months since anyone looked at my vocal cords so I thought I'd go back. Again, the same thing. So, I couldn't feel good about the normal EMG because I still have this vocal paresis. My family has been trying to reassure me the whole time and finally got me to go to the area's ALS specialist. He told me after my history that there was 0% chance that I had ALS but also threw in at the end "now watch, in 6 months you'll come back with ALS". So, with all this reassurance I still obsess about my symptoms and feel doomed almost every minute of every day. I've read a lot of posts on this site and thought I'd introduce myself and see what people's thoughts are.

I twitch the worst in my hands and feet and face. Lately I can start them just about anywhere just by flexing or making a fist. I've had the tingling tongue thing but never really can see it twitch. I have the teeth impressions on the sides of my tongue but the neuro didn't really notice any atrophy. My strength is OK. I can still do all the things now that I could do 19 months ago. Also, I shiver every morning in bed before I get up. It's strange because I don't really feel cold but it's this really strong urge to tense up my muscles and shake. Over the last couple of months I've also noticed periodic vibrating sensations in my hands that I've had in my feet for a year. My tongue feels uncoordinated or too large sometimes but no one has told me I'm slurring my words. Sometimes I'm sure that I have ALS but I feel that it's just too early on for it to be officially diagnosed. All day long I try to come up with other things that might be causing this stuff but I'm running out of ideas.

I've got some theories of my own that I'd like to bounce off some of you:

Many years ago I noticed a persistent fasciculation in my bicep that lasted 3mo after stopping my Paxil prescription. When all these symptoms started 19 months ago, I had just stopped another trial of Paxil. I know that ssri's have caused motor symptoms and thinking that the meds might have caused the twitches helps sometimes. I'm just wondering if anyone else has had similar experiences with any of the ssri's.

I've noticed some people mention thyroid disease. I too have autoimmune thyroid disease with relatively normal thyroid funcion tests.
Just wondering how common thyroid problems are with people here.

I was also wondering how many people here have actually been diagnosed with ALS after months/years of twitching.

I apologize for the length of this. I'm just at the end of my rope and would like to hear from someone else that has gone through this stuff.

Thanks,
Jay

 

[KrackerjacksyBeel]

Jay,

A quick answer to one of your questions....

"I was also wondering how many people here have actually been diagnosed with ALS after months/years of twitching."


Answer: 0


Hope that helps!

Paul

 

[DStar]

Jay, If you havent already done so I would have my thyroid checked
it can cause problems. I had graves disease when I was nineteen and
twitching and the shakes were two of my symptoms.

DStar

 

[Diego4Life]

Jay, you are a med student, so you have done homework and you know that PNH/BFS is a real entity, so why can't you have that? Why does it have to be als despite two clean emg's/neuro exams? Try and be rational.

I am a chiro and I have done the same angsting as you, maybe because I have too much knowledge. I have twitched for 10 years. My neuro, an als specialist told me that he would not consider als even as a differential
dx if only twitching was present with no weakness past 3 months. You don't have it mate.

Diego4Life

 

[bassfreak2002]

Thanks for your comments. It does help to know that there aren't any people here that have been diagnosed with ALS. Yeah, I've had my thyroid checked a few times over the years and it's usually pretty normal if anything, I'm a little hypothyroid. I don't know why I can't accept a benign diagnosis. Hopefully, I'm just crazy, not dying.

 

[ydav3yat3s]

Hmmm... 0% chance you have ALS...

So why are you worried?

Anyway, be sure to look up the Mayo paper on benign fasiculations. That helps quite a bit. I've read of at least another poster who went to see one of the authors and was told they are still monitoring the results and it's holding its conclusion.

Also it's correct nobody with a clean clinical and EMG has turned out to have ALS on either this forum or the Braintalk forum. That's hundreds if not thousands of cases, backed up by the mayo and other studies... really, all the signs are good.

I am hypothyroid... specifically, hypopituitary. lots of that seems to be around this symptom. my neuro thinks that may be causing it despite the synthroid.

Also, just because someone said on TV that twitching was their first symptom doesn't mean if that person had shows up at his neuro on the same day the twitching started, the neuro wouldn't have found all sorts of other things going on...

also bulbar is the most rapidly progressing form of ALS so if your vocal cords were thus affected it should have progressed by now... you have so much going in your favor that you should happily accept the odds given to you. Be happy with your odds and get back to being you.