Experiencing Anxiety and Muscle Twitches

[BrightKnight]

Hi All,I'm a 28 year old female that has been experiencing muscle twitches since the beginning of August.I have always been a high anxiety person. When I first started experiencing anxiety and panic attacks when I was 14, I had the "normal" kind of attacks that would make my heart race, cause shortness of breath, etc.As I have gotten older it seems that my anxiety has been taking on more neurological symptoms (started in 2007 when I believed I was having a stroke, which was ruled out, then in 2008 I began experiencing numbness in the fronts of my legs around my shins and ankles. I feared I had MS which was also ruled out with MRIs.Now here I am in 2009 experiencing muscle twitching and fearing I have ALS.Really my twitching probably began in July above my lip-the whole thing would move like Elvis...Then in August the twitching became very pronounced in my calves, most notably my left one though. The twitching quickly spread into my arms, feet, hands and back. Also in the summer I began experiencing a problem with my right eye- a tiny black dot that follows my eye movements.Anyway, the twitching in my arms is better now, but I experience the occasional twitch in my jaw, in the sides of my neck and of course, my lip. And of course, my calves are still bothering me.Went to see my neuro in October. My reflexes were fine and he didn't see any twitching and couldn't evoke them by tapping. He didn't perform any strength testing. My blood work came back fine except my liver enzymes were slightly raised. He sent me on my way with Xanax and didn't feel any further testing was needed right now. Though he did say I could twitch for a whole year before developing ALS weakness (great).I sometimes feel like I am weak, but it all comes and goes, it's so weird.I think it's perceived because I know it's another ALS symptom so maybe I bring it on. I also have migrating numbness and sometimes I feel like my muscles want to cramp up but it never gets to that point.I don't twitch if I am moving around, and it's sad to say, but alcohol really helps alleviate the twitching.Just wanted to get your opinion and if anyone else has similar symptoms, especially the "weakness", or maybe fatigue that comes and goes.Thanks

 

[BarbiePetals]

Ok,I think panic just set into me. Your neuro told you that you could twitch for a year before weakness sets in? From everything I have read that is not the case. That last neuro I saw told me after 6 months I would be having some major problems. I think my anxiety just went through the roof.

 

[BetteDavisGretchen]

Fiorebello,I have had all of this for 3 years now.....I am still healthy, living life to the fullest, and even stronger than ever. It seems that the anxiety is playing a major role for you. Anxiety can run your life and make your thoughts and body go wild. With regards to alcohol, I believe it alleviates the symptoms because it alleviates the anxiety.Barbie, from all I know about ALS, the twitching comes after the weakness and usually cannot even be felt or seen with the naked eye. Many doctors and my neuro have told me this over and over - I finally believe it!Cheers

 

[Krackersones]

Barbie,Please do not panic. If there is anything I have learned it is that a lot of doctors including neuros make random statements that are not well thought out or even evidence based. Instead they are made off the cuff or based on something they seem to remember hearing. This is less likely if the neuro treats only ALS patients or has made this the focus of his or her career. If they have not, then their knowledge of ALS is probably extremely wanting. It is unclear from the post whether the neuro meant to distinguish between "weakness" and "ALS weakness." So he or she could have meant that you could twitch in a place for a year before being totally unable to move but you would have some impairment long before that. Also, the statement does not indicate how likely it is that you would twitch for a year without any weakness. I have had doctors tell me every spot of my body "could be" melanoma and that every tiny, pen-tip sized nodule in my breasts "could be" cancer. They say this because it is technically true. And if you ask, they do have to cover themselves, if not legally, at least so as not to have to deal with the slightest chance that they would give you a 100% clearance and then be found wrong. Many doctors would rather cause you a bit of worry than to ever deal with being wrong, so they give you all the possibilities. Heck, I had a Johns Hopkins educated ortho tell me, "You could have mad cow disease but you do not have any of the symptoms." If that is not an inappropriate statement, I do not know what is. I also had a dermatopathologist tell me that he has never seen another pathologist (other than himself) say someone did not have skin cancer when asked for a second opinion when another pathologist made the call that they did. He explained that doctors do not want to go out on a limb if they do not have to even if it is to give what they honestly believe is good news.I think you will be less vulnerable to panic from hearing statements like this if you realize that with ALS and many other worrisome health issues there are no 100% certainties. But there is lots of very strong evidence that our symptoms are not life threatening given the way they have presented and the strength of that evidence increases every day. The number of newbies here is amazing. I think it is the power of the Internet shedding light on how much more common these strange neurological phenomenon are. Doctors are too busy to explore this site unless like Simon it is personal. So our existence goes largely unnoticed and unaccounted for in medical science.Krackersones

 

[simonw00]

Just to help reassure worried readers I'd like to add to JRO's post by saying that, being a doc, I have access to our local medical library and, when I was at my most anxious, I did a lot of reading and I think I have reviewed every relevant article/ paper in the local Med School on this subject! I certainly don't pretend to have the knowledge of a neurologist so my comments are those of 'an informed patient' rather than a specialist, but these comments are;1. Fasciculation is common, ALS is rare. If your only motor symptom is fasciculation then the odds are very very very strongly in favour of a benign diagnosis.2. The details are a little rusty now, but I do remember reading one paper in which the researchers asked a whole bunch of people (about 120 I think) with confirmed ALS whether they had noticed any fasciculation before they were aware of their weakness. This, I suspect, is where the neurologist who spoke with FioreBello got his/ her facts from. In this study, less than 10% said yes they had noticed fasciculatiin before weakness (I think it was something like 7% who said yes). The interval between noticing the twitching and becoming weak was, on average, something like 5 months, with a range from a few weeks to 13 months. ALL of these patients only went to a neurologist after they noticed weakness, not before. If they had gone to a neurologist earlier, then it is extrememly likely that the neurologist would have discovered something to point towards ALS during their clinical examination.3. Amongst shelf upon shelf of research papers, and amongst page upon page of 'user pays' 'health professional only' internet search findings, I have only ever found ONE case report of someone who had fasciculation AND a normal clinical exam AND a non-diagnostic EMG (it was abnormal but non specifically so... now you guys understand why I get a bit freaked about my abnormal EMG!!!) who later went on to be diagnosed with ALS. He was in his 70s and had had a significant back injury and the time lag between onset of fasciculation and weakness was quoted as 1 year. Again, I assume this has contributed to FioreBello's neurologist's statement. Unless you are a 70 year old person with back injury, then please be reassured that there has never been a case described in which fasciculation preceded weakness AND there were no signs that a neurologist / EMG would have picked up on.4. On this site, I have heard people report that their neurologist has told them a variety of things about time lag between onset of fascicualation and being completely sure you are 'all clear' - the range is from zero (i.e. if there is no weakness then don't even think about ALS) to 18 months. This tells me that different neurologists have different comfort levels about reassuring people and that this is more about the neurologist than the evidence.So to summarise, if you have fasciculation AND no weakness AND your neurologist says you are fine then believe him/ her. You do not need to wait a year to reassure yourself that this is the case.Hope this helps.RegardsSimon

 

[Smiley20]

Fiorebello,all the symptoms you describe sound like classic bfs! My twitches also started end of july and, without vision problems, i experienced similar symptoms (maybe a bit more bodywide as i twitched literally everywhere). Before the onset of twitching i went through a period of very intense health anxiety and after all tests came back normal my neuro referred me to a psychologist to treat anxiety. with the help of (cb)therapy and this board i am now able to handle twitching and accompanying anxiety. still there are some bad days but i am much better now!!! also less anxiety &stress = less twitching; works for me too...Yes i also had weak feelings, especially on the right side of my body, mostly right upper leg. it lasted for a few weeks on and off. percieved weakness in my eperience gets better when you do not concentrate on it and don´t do any self-testing exercises. easier said then done because again anxiety figures with this.Simon,thank you for your reassuring post!!!

 

[BarbiePetals]

Sorry I panicked. I have been having alot of anxiety lately and that statement just sent it sky high. I am calmed down. The funny thing is I was over the ALS scare for months now but when I read stuff like that it just sends me back 9 months.~Leslie