Left Leg Weakness and Twitching

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NitrogenN

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First post........... Beginning four weeks ago I began to feel a CONSIDERABLE amount of weakness in my left leg when walking. No pain, just weakness appearing in the left ankle. During this time I have developed mild muscle twitches in various parts of my left calf and especially my left ankle when I am driving or sitting. I cannot see the twitches, but feel them pressing against my paints (especially when I am driving or sitting/working on my computer). I also have noticed that the leg is cramping often in the calfs, although there is no localized pain which I can find, just considerable weakness. I have a very physical job and have taken multiple days off do to the fairly severe weakness which I am feeling. I also notice that the bones in my leg appear to be snaping when I make sudden movements ot even bend down to grab something. This is severly effecting my life as I feel that this can be nothing other then ALS as I appear to have many of the early symptoms of the disease. I am very anxious about this and just want to feel normal again!! IN SOMEWHAT POSTIVE NEWS: Last week I met with a neruo who gave me a complete evaluation. I told him that I had serious concerns about this (especially ALS worries) and he told me that "in his opinion I did not have ALS". He did not tell me what could be causing the "weakness" and percieved balance issues though and my symptoms appear to have gotten worse. I have EMG scheduled for the middle of January, although I had to nearly beg him to do one. I dont understand how a NEURO could not notice anything, when I KNOW there is something wrong with my left leg. I am 22 years old, able to still life the same amount of weight with my legs while also able to run two miles on the treadmill at a fairly vigerous speed. Despite this when walking I notice weakness and am extremely concerned that the NEURO missed something or I did not describe my symptoms well enough. Many people in the ALS forums claim that NEUROS are not good at diagnosing ALS which is why I am considering visiting an ALS clinic if things do not get better. Does this sound at all like BFS? Should I trust the NEURO? Maybe it was too early for him to notice any "true weakness" although I have a feeling things are getting worse. Any words of advice would be helpful.
 
I understand what you're going through as aI've been in that exact place myself. I've thought to myself what could this be other than als. If you're interested in my symptoms you can check my thread history. First off. I've learned these past months that weakness isn't as simple as it seems. If you ask people with als, they don't feel weak, they notice it when they try to do something and they realize they cannot do it. Like turning a key or climbing a staircase. I don't know how your weakness presents, but I assume your neuro let you walk around the room and stuff, in which case he would have noticed if something was wrong with your gait. Try giving your weakness the benefit of the doubt. I know it's hard.Second, there are PLENTY of other more probable things that could cause leg weakness and twitches, including BFS. You are 22 years old. The risk of getting als at this age is rediculously small. (The lifetime risk of getting als is only about 1 in 1000, 80% get it between 40 and 70. It's like a bell curve where 55 is at the top. On both sides the risk drops dramatically down to almost nothing before 30. And neuros are not bad at diagnosing als, but they are cautious. You can tell someone "I think you have pneumonia" and not be 100% sure. But if you're going to bring up als or pancreatic cancer you'd better be *beep* sure, because it's a death sentence. So a lot of the time neuros may suspect als, but they don't bring it up until the evidence become very hard to ignore. This does not sound like you though. I don't think your neuro is suspecting anything – he would have sent you to do further testing. Als IS hard to diagnose, becaues you have to rule out other possible causes first, but when they examine someone with als, he or she usually present with SOME kind of clinical symptom – clinical weakness, atrophy, assymmetrical brisk reflexes, positive babinski … SOMETHING. Your neuro didn't find anything.
 
You must see specialists if you are not getting relief or evidence-supported answers. I learned the hard way that a neuromuscular specialist and a neuro are not the same thing. This area is so subspecialized. Even within the neuromuscular specialty area there are subspecialties. If you have a choice of doctor, do your research. Most of all, if your doctor is dismissing your symptoms (AND YOU KNOW YOU ARE HAVING THEM) you must change doctors. This is what happened to me. When my symptoms did not show up on the clinical or electrophysical tests (EMG and Nerve Conduction Test), the first neuro I saw told me he didn't believe me about my symptoms and said they were caused by a fear of failure. When I saw a neuromuscular specialist, he said he sees one or two patients like me every month and never thought for a second that I was making anything up and took the attitude of let's try everything to see what's going on here.
 
Left leg is tingling today as well, beyond the weakness I already feel in it. Small twitches are also still present in my left ankle. The fact that this is so localized is getting me extremely nervous. I keep telling myself that a good NEURO told me " I did not have ALS" but I just cant believe that these symptoms are not ALS. The EMG on January 11th seems so far away!!
 
Call every morning at 8am and ask if they have cancellations. Tell them you have changing symptoms. Do what you got to do to get in and get peace of mind.Lovely
 
Eric, at 22 the odds of you getting ALS are off the charts. Do not beleive or read into anything you read on the internet, I have been through the Neuroligical ringer over the last three years, and the one thing I have learned is that ALS is not a difficult diagnosis, to someone who knows what they are looking for it presents very clearly.I have leg issues as well, and I was absolutely astonished that nothing could be found wrong with the muscles in my right leg.In july I was fairly sure that by December I would be having trouble getting up the stairs in my house, well it is december, my leg is still weak and twitching like crazy, but I can get up the stairs no problem. The Neurlogists were correct, and the fact they cannot find anything wrong, when I know something is up, it is not because they are not doing there job properly, it is just what we have is not identifyable by medical tests, which is much better than something that can, like ALS.Your Neurologists is correct, but you already are doubting him, which is common with many on this board, as well as myself, but in the end your story is going to be the same as ours, no ALS, and probably no explanation for why these symptoms are occuring. Good luck, and remember, if your Neuro thought there was any chance of ALS, you would not have to beg him for an emg.
 
If I could rewind these past six months and go back to when my right leg started having sensations and (percieved?) weakness, and my back started burning, I would have done everything I could to avoid the panic and anxiety that plagued me the following months. I would have cancelled my internet access and not gone through all of this testing that has led me nowhere. If I had, I honestly think I could have avoided the tsunami of symptoms that came at me late september. Arm weakness, chills in my thighs, twitches, jaw fatigue, speech difficulties, trouble swallowing, trouble breathing, cramping chest pain etc. I was a mess. I'm down to just a few of these now. Unfortunately I'm stuck with the ones that are the most suggestive of als (leg and arm weakness, twitches and the oral stuff). But I have decided to roll with the neuros opinion that these symptoms are benign. (My own theory is that my scoliosis is acting up, causing some pain and nerve disturbance.) My anxiety has subsided in a big way and I am enjoying life again. I do think about my symptoms a lot, but I don't think they are als. I have accepted that I cannot know what's causing my symptoms at this point, but unless I develop a foot drop or my speech starts slurring for real I have decided to just let my symptoms be. (Not quite true – I'm scanning my brain for MS on sunday, but I'm fully expecting the MRI to come back clean)I will not comment on your symptoms. I don't know how severe they are. So you gotta do what you gotta do. If you want to go through months and months of testing and probably not get anywhere nearer an answer – by all means do that. But the most important part of this is to manage your anxiety or your symptoms are very likely to get worse.
 
I called this morning for any cancellations and will be going in on Thursday for the EMG!! I am nervous but relieved at the same time. How accurate is this test? I have had small twithces in my calves and ankle with some increased weakness. Would an EMG pick up ALS? Are the odds at least preety good that the test would see something. I can live with the symptoms if I KNOW that it is not ALS. Also the doctor doing the EMG is a Neuromuscular Neurologist, not the General Neurologist who I saw for the evauation. How many needles should I tell them to put in? Should they do it just at a localized location since I only have the weakness in my left leg? Or should I have them go all out and put them in tongue, arms and legs? NEED SOME ADVICE?
 
Eric, it is indeed a long and painstaking process to confirm an ALS diagnostic, because it's an exclusion process, BUT a neuro will immediately suspect it as a possibility as soon as you walk in his/her practice. If he/she says "no", then it's NO - right from the start. It may take a long time to confirm ALS, but it takes a very short time to confirm that it is NOT.
 
(continuation) Patients on ALS sites (you really should not go there, but anyway), when they say that neuros are not "good at ALS diagnostic", very often mean that it took them a very long time and the the patient kind of knew that it was ALS way before the official diagnostic arrived. This is for the reasons listed above: it's an exclusion issue. I mean no disrespect to the ALS patients of course, but neuros have seen many ALS cases. They do know what they are talking about. Not us. In what you write I can recognize myself 18 months ago: I too was absolutely certain that I had ALS, and I could tell where the many neuros and neuro-muscular specialists made a mistake when they said that I was fine. In retrospect, it is now hard to even understand how I could even have thoughts things like that, but hey I remember the quasi-panic state I was in. I almost lost my job, and it put a lot of tension in my family. Now, a few months later, all is fine - you will get there too. You will learn to recognize anxiety for what it is and you will control it.
 
I got the EMG moved up to tommorow!! The question I have is this...... Should I have the neuro put the needles in multiple limbs or do they take offense to telling them where to put them. I was going to ask her to do them in my arms, legs and even tongue just so MAYBE I can have a peace of mind if there is nothing there. In regards to peace of mind, if symptoms persist but EMG comes back clean I just have to accept it right? I have heard that twitching and weakness would show up on an EMG as ALS, so if test comes back negative am I in the clear? Thanks So Much For Your Support!! Eric
 
Good job, you got your appt moved up- do this...Just let the neuro work their own lil way. They know what they are doing try not to be little them and make them think your so anxiety ridden- let them take you serious- ofcourse ASK for answers- and tell them you want to know good or bad news right away and NOT wait for results (considering if a neuro or a tech is doing your emg).If your EMG is clean your clear- Bulbar ALS is highly unlikely to be detected by tongue EMG it is usually on a clinical basis- you can ask about that, but MOST neuro's leave the tongue alone.Good luck tomorrow but ya dont need it-Ask questions and let us know how it goes.Lovely
 
Actually I had the tongue and another muscle related to bulbar done. It's tricky since even breathing can give EMG activity when the electrodes are on the tongue region, and one has to really relax and stop breathing to stop activity. I was moving my jaws nad breathing and that first led to some "positive sharp wave"-like activity: the neuro who did the EMG said: "wow, I tought for a moment you had the disease" - :eek: :eek: :eek: :eek: But no, all is well (that was 18 months ago so I'm pretty sure now I'm fine, bulbar would not have been silent for 18 months). You'll be fine Eric. Since then I asked for other EMGs when I was in a semi-panicking state, and the neuros said intelligently that they refused to do another one, that all clinical signs were OK and that they did not need any EMG when clinical is fine. THat's the same for you: they do the EMG to calm you, but the clinical was fine: no ALS . Now I know you probably won't believe it still, but that's a fact, no clinical signs= no ALS, EMG or not.
 
I went in today for the EMG and the doctor told me due to time constraints they had to do it in two segments, arms today and legs on Monday. Although my LEFT arm has been only 1 percent my problem (SLIGHT TINGLING) the results did come back fine. Despite this I wish they did my legs today, since my legs weakness has been my main problem. I will let everyone know how it goes on Monday. If things come back good on Monday how do I deal with the weakness? Although I will be relieved that I am not in the process of dying, it is still very debilitating, especially since I have a job in which I need to be on my feet often. Although my family thinks this "is all in my head" why would I do such a thing to myself? If no ALS on Monday then there has got to be a reason for the sudden weakness in these legs.
 
Unless there is a serious cost/lack of insurance issue, I would ask for all blood tests that could lead to reasons for your weakness. I've had 30 viles of blood drawn in a few minutes, so it's not that big of a deal and in my case they found something that could explain things. It took me three neuros to get these tests, so you have to push for them sometimes.
 
I've been going through something strange with my left leg as well. At first, it felt strange..not pain, but simply different. I noticed it particularly while walking. As I had already gone through the ALS fears years ago, the first thing I evaluated was my strength. No changes. As I do get occassional tingling (usually lasting seconds to a few minutes) in various parts of my body, my thoughts ran to Multiple Sclerosis. Then I started checking for other changes such as loss of balance, coordination, and proprioception, as well as muscle tightness and spasticity. Again, no discernable changes. Its been about a month now, and the leg doesn't feel as strange, but it also seems to have localized to my quadriceps. I've been getting occassional muscle aches in my left quads, hamstrings and calf. The quads sometime feel crampy for a few seconds, but only once or twice a day. I've also had twitches in my legs, primarily my left, as well as occassional arm, finger, and abominal twitches. I also have gotten patches of apparent numbness (not real...as when I touch the area, it feels normal) on my face and left arm, but these last seconds to a few minutes at most. ALS is not my worry. MS is my latest concern. I got to keep reminding myself that I am a twitcher...going on over 4 years now...and that others have experienced the transient tingling, strange sensations of numbness, and muscle aches and cramps. As for the strange leg feeling, who knows. I am starting to think that when one focuses on a part of the body, especially someone like me who is a hypochondriac and prone to anxiety, one can develop neural patterns that become more "aware" of that part of the body. A cycle develops. As I've grown older, I have been able to talk about my symptoms and fears with my family. My sister has tingling, twitches, jolts, and complains that her eyes wiggle. My dad recently went through a period where at first his legs felt a vibration, then the vibartion feeling moved up his body until he felt like he was vibrating everywhere. It subsided and is gone now, but it is amazing the strange sensations people get. Best wishes with your EMG!
 
I definately believe in how powerful the mind can be if you focus on something- I used to have bad Irritable Bowel Syndrome and when I'd have attacks I could displace my pain until it subsided to another part of my body like my head or back or somewhere else.Also, the other night- My boyfriend whom actually went to school for psychiatry but later decided he was not into the medications for things being "solutions" had me do this technique in bed- he had me lay on my back and start with my toes..He told me to imagine if I had my feet on cotton and to let them relax and sink into the cotton- immediately my feet got lighter- then he worked VERBALLY :oops: :sick: :LOL: up the rest of my body to my head to where he BY WORDS only made my scalp tingle and I felt like I was floating- afterwards I fell asleep and it was soooo peaceful. I finally had relaxed my body and mind so much for the 1st time and I didnt EVEN FEEL A TWITCH (yikes) it was amazing-So do believe in the power of the mind- I surely do. I've been a hypochondriac my whole life and so far every disease Ive THOUGHT i've had has been debunked.Warm Wishes, Lovely
 
I definately believe in how powerful the mind can be if you focus on something- I used to have bad Irritable Bowel Syndrome and when I'd have attacks I could displace my pain until it subsided to another part of my body like my head or back or somewhere else.Also, the other night- My boyfriend whom actually went to school for psychiatry but later decided he was not into the medications for things being "solutions" had me do this technique in bed- he had me lay on my back and start with my toes..He told me to imagine if I had my feet on cotton and to let them relax and sink into the cotton- immediately my feet got lighter- then he worked VERBALLY :oops: :sick: :LOL: up the rest of my body to my head to where he BY WORDS only made my scalp tingle and I felt like I was floating- afterwards I fell asleep and it was soooo peaceful. I finally had relaxed my body and mind so much for the 1st time and I didnt EVEN FEEL A TWITCH (yikes) it was amazing-So do believe in the power of the mind- I surely do. I've been a hypochondriac my whole life and so far every disease Ive THOUGHT i've had has been debunked.Warm Wishes, Lovely
 
Ok..... kind of a strange story to report. Although I went to the Neuro to recieve a second EMG on my LEFT LEG (first EMG was conducted on my left arm).. He told me that the first EMG was VERY GOOD and that there were no problems with it. I asked him why they did it on my arm instead of my leg and he said that an EMG of the arm would pick up abnormalities anywhere expect for possibly Bulbar ALS (which I know I dont have) which is more difficult to diagnose. When I asked him about the constant weakness in my legs he told me that I am not "clinically weak" and that the EMG (although it was done in the WRONG LIMB!!) results were perfect. He said he did not want to do an EMG of my leg because he felt it would be a waste of time and he did not feel it would reassure me. He also said that there was no reason for him to do the EMG in the first place. He believes that the constant weakness (rubbery legs) feeling is all in my head. He also reasurred me that "I DO NOT HAVE ALS". He wants me to work out the legs to see if I can increase my strength every week (he said if I could there is NO ALS) and he also put me on 10mg of Celexia which he feels will calm me down a bit. I wish he just did the EMG of my left leg. Could they really find ALS from my arms if I never had weakness or fascilations in my arm? I still find it hard to believe that the weakness is all in my head. Has anyone had CONSTANT WEAKNESS for over a month and not known what it was? My main question is should I trust this Neuro's opinion when I still my body (legs) appears weak?
 
Hey there- I am going through simuliar thing- I feel like both my legs are "rubbery" feeling- wet noodles per say. That WEIRD feeling ya know. I know ya know. For me, its been my arms before- its gone away- simuliar story you can dig up my old posts- RIGHT after my EMG I swore my left shoulder/arm/hand was going out on me, It was very weak (to me). I constantly tested it. Yep, felt so weird- I had just had a EMG of my WHOLE RIGHT SIDE OF MY FREAKING BODY like a week before that and here I thought- Here I go...she didnt do my left side- she missed it- (though I twitched all over) so I rang back- Got same reply you did basically- if I had als of any limb (bulbar as you said not included b/c its more of a clincal picture ) EMG would detect it. So these neuro's arent lying to us. I just went to two Internists today about "weak legs". When I went to the lab to get lab work the one doctor labeled reason for lab "malaise/fatique" NOT WEAKNESS , Why she said? Because she said clinincally I didnt have any. THOUGH I FEEL IT most of the time (past two weeks since I had a bad virus and now a bad sinus infection).I get scared to stand up b/c Im afraid I wont be able to but they never fail me I get up. I was going to wear some pretty heels the other night but I didnt because I was scared my legs wouldn't hold me. Its becoming a fear. I didnt fall today when I was chasing doctors around. The last doctor I saw because the 1st one scared me today told me that A LOT of this and he shyed away sorta said "I think is anxiety and in your head". (Flooding your senses) So hes telling me Im causing myself to feel this- or he said it can be a virus and your just double freaking over it. Anyhow- Im glad you spoke to your neuro and he assured you- Most wont even call you back once you get the fat BFS!Happy Holidays...Lovely
 

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