Strange Onset of Symptoms After Psoriasis Diagnosis

[Trees]

I am a 28yr/m, in the beginning of February I started with a small face tremor, very subtle, looked like my heart pulse. This was a a couple of weeks after being diagnosed with Psoriasis. Then my left ring finger started to tremor. I also started to feel tinging on my hands at night, muscle pain in calfs, fore arms, biceps and side of the knees. I also felt unbalance when standing up, excessive sweating and cramp sensation on my left foot. I went on Dr.google and saw MS, I panicked, when to the ER and they did Cat scan and blood work, all normal. I was the referred to a Neurologist who did all the neuro tests, and it was normal, but just to rule out MS he ordered a brain MRI w/o contrast which was normal. In the meantime I developed twitching all over my body. So I went on Dr.google and saw it as a symptom along with the cramp feeling of **S. So I panicked again and got my GP to order a full EMG. This was done in the first week of March. It was normal, even for carpel tunnel, so the Neurologist doing the EMg said to go to an Arthritis specialist just to rule out Arthritis. I kept twitching all over the place, my hands kept getting numb at night and I would still get random muscle pain. So the Neuro did some blood work and found me to be Vitamin D deficient, I am at 17 and normal range is 30 and above, ideally to be 60. He put me on vitamin D prescribed 50,0000 units x2 a week, which was in the end of March. Got tested for Lyme, Thyroid, Diabetes,Wilson's, CPK, the CPK was at 109 which is normal, all other tests were normal as well. So I went to Dr.google again and started reading about Bulbar **S and of course I started to feel like I had too much saliva, constantly feeling like I was choking on saliva, I checked my tongue and its scalloped, no twitching on tongue though, but my lips would tremor when I would raise them to see my tongue. My jaw started to feel weak and I felt pain on the back of my head, along with my shoulders and shoulder blades.My face started to feel like it was getting droopier on both sides and my cheeks look like they have holes on them, kind of like their sinking in. So my doctor ordered an EMG of the face to check and neck, even my tongue and it all came back normal. I even asked the EMG Neurologist doing the test to put the needle in my left hand between my thumb and index finger because I could see fasciculations there but it was normal on the EMG. This was done at the beginning of April. I was not satisfied with the constant cough and clearing of saliva and now feeling of drooling. I though it was because of my impacted wisdom teeth, so I had all of the removed a that next day after the face EMG. Two weeks ago I was able to see the Arthritis specialist who did all the strength test along with the reflexes and Babinsky tests and all were normal. I told him about the muscle pain and numbness and he said that it wasn't caused by anything he specialized on. He did order Calcium and Magnesium test, with the Calcium being normal and the Magnesium being at 0.6, a little high. I went a head an made an appointment with the head of **S research in the University of Illinois at Chicago hospital. I did this because I started to see constant contraction fasciculation on both my thighs, they look like ripples or worms, along with constant cramp feeling on the back of my left knee. I saw her last week and she did all the strength tests, looked at my muscles and checked my reflexes and said that everything is normal. She saw the thigh fasciculations and said that shes pretty sure I dont have **S, but just to be sure she needs to do an EMG of the thighs. I asked her if the EMG done in March would have caught it if it was bad, she said most likely if I was tested when the thigh was contracted, which I think he did, he asked me to bend the knee and raise my leg, that counts right? So I have the EMG scheduled for next week, but right now I am freaking out, my thighs look like they got smaller, even though I lost 10 lbs but I think it was caused by not eating well because of my wisdom teeth removal. My legs tremor when I try to squat only using one leg at a time. I went shopping with my wife on Saturday and on Sunday I felt like I had ran a marathon. I keep getting cramp like feeling on calfs and behind my left thigh. My pants feel looser around the waist and hip, my right hip looks smaller than my left and it looks like theres a dent on it too. I am a big guy and I often get confused for a football player, but now I feel like I am loosing muscle definition more so on my chest and arms. Is it possible to loose muscle and not loose weight? After the initial loss of weight I can eat better now and have maintained the same weight. Are my thigh contraction fasciculations the bad kind? Do **S ever start on the thighs? Since they are always there when I make a muscle? Why does it look like my face cheeks are sinking in and theres a dent on both sides? Since I just had the face EMG and it was normal, I shouldnt have facial weakness, righ? I am so scared right now, I dont know how I will make it until next week, what if she finds something wrong, I am screwed then. I have also been getting twitching on my butt, specially my left side,my left eye lid, and my feet sometimes feel like they are vibrating. Now my numbness at night only happens to my pinky ring and middle finger on both hands. I worked out on Monday just to see if I could still lift weight on my thighs and they tarted to more at nigh spasm and twitched more, along with more cramp feeling that night and the whole next day I felt really week,which worried me more. How long after twitching should I worry about muscle weakness?

 

[Krackersones]

Big 'O',I totally know what you are going through. If you read my early posts you will see I had a similar journey. If it helps, I am no worse and maybe better than I was in July 08 when all this started and I have not been given any horrible diagnosis. In fact, the neuros say that they in no way think I have any of those bad diseases. In my case, the best guess is an autoimmune attack on my nerves but this is speculation based on some immune abnormalities (high ANA titre, high levels of immune complexes, and the sudden onset of my symptoms). It sounds like you are doing all you can. I hope your doctor is knowledgeable about all the possible explainations for your symptoms and is able to reassure you even if he/she cannot give you a precise dx. I was also told that sudden onset of widespread symptoms strongly argues against ALS. Klonopin greatly helped the symptoms that bothered me on a daily basis and interfered with my life. Levocarnitine has probably helped my nerves heal so that I only need half the dose of Klonopin I needed previously. Keep us posted.Krackersones

 

[FantasticFurball]

HiTake a deep breath, will ya?First of all, ALS is a rare disease. Its strike 1-2 out of 100.000 each year or about one out of 1000 during a lifetime. Traffic is more dangerous. BFS is a lot more common than ALS since everyone twitch more or less. Only 10% of ALS cases are below 40 and almost nobody gets ALS in their 20s. Furthermore you had an EMG. An EMG can not be done too early. An EMG will always be "dirty" if ALS is present. Theres a lot of posts about that. Read them if you like. You passed one EMG, so you will most likely pass another one. You passed a clinical examination as well. If ALS is present then a clinical xm would have been dirty as well meaning that your odds are even lower. You asked about how long time to "wait" before weakness sets in. I have been reading a lot about the subject. But unfortunately such a nice timelimit do not exist. ALS doesnt work that way. Some patients are going down within months others - such as Steven Hawkins - live with ALS for years and years. Some are able to live a close to normal life for years on - others are bound to a wheelchair pretty fast (most likely).There are, however, some quotes from neuros and some small unofficial private investigations on the subject. After 3 months and no weakness, you are pretty much ok as 95% of ALS-sufferrers do have some kind of notable wekaness involved during this time. The world record of twitching before weakness is something like a year or so - but thats rare. But you dont have to be scared about all that. Becourse if you passed a clinical AND an EMG its the same as 100% no ALS. Not in 3 months, not in a year - but right away. Hope that it helped.Regards

 

[JoggingCub]

EXCELLENT POST BY FOX 2 RUN!!Big O - My symptoms which started at the same time as yours, are quite similar. Got all that crap: facial tremor, fasciculations all over, numb fingers at night, wierdo arm pain, I initially lost weight (probably from fear) and also had low Vitamin D (mine was 19), and am going through a HUGE A-WORD panic as well. Did the neuro who did the EMG ever actually witness the twitches? And none of them showed on the EMG, right? Did they ever say to you "Benign Fasciculation Syndrome"?Regardless, You saw the head of ALS research, you can't do much better than that, and your EMG was clean (They would have told you if not - as you know, all sorts of crap show up on an EMG of someone with ALS: fibs, polyplasts, sharp waves, etc.). So continue to remind youself about that. I suppose you are like me now, start counting the days - at the end of July you will have six months under your belt (great milestone).

 

[Trees]

Krackersones, Konoplin has helped the past couple of days to get a good night sleep. My doctor prescribed them to me about a month ago but I try to use them only when I really need them, I dont want to get addicted to them. In the meantime I have also been getting help from a phycologist that I visit once a week. It does help for a couple of days but them I am back to my old paranoid self. FantasticFurball,Thanks for the information, it calmed me down A LOT.. JoggingCub,When I had my first whole body EMG, the neuro did not see any Fasciculations on me, he did mention that some people have benign fasciculations but that they usually show on the EMG. The second time when he did the face EMG, I could see some twitching on between my thumb and finger but he couldn't see them visually and when he placed the needle nothing showed up. Now I am thinking it could just be related to the vitamin D deficiency since I read that is slows down speed of muscle contractions so it could be why they twitch when the muscle is contracted and stop when the muscle is at rest, thats my guess, Ill ask the neuro this tuesday about it. As far as counting the days, I just want it to be Tuesday all ready and for the neuro to tell me that theres nothing malignant about my thigh fasciculations, then I can join the BFS world and move on with my life. Just an update, Since I was freaking out on Monday and Tuesday I made an appointment with my GP and asked him to test me for CPK, since I keep seeing my thighs fasciculate and they seem to be getting smaller, but not loosing weight that the CPK would show if my muscles are being damaged. I just got the call right now as I was typing this and the CPK levels are even lower than last month, at 95. So I take that as a good sign.Once again thanks for all the support and positive feedback. I will try not to get anxious and panic.

 

[Krackersones]

I only recommend Klonopin if you need it to have a decent quality of life because of your actual physical symptoms. I do have a physical addiction to it since if I go off it completely I feel nauseated after about three or four days. However, I was able to go from .5 mgs twice a day to .5 mgs once a day after the twice a day dose for almost a year without ANY problems. I attribute the reduction to some healing in my nerves from levocarnitine. This is just my experience for what it is worth. I was told that if you take the drug for a physical reason rather than a psychological one then the addiction issues are somewhat different. I do wonder how long the nausea would last if I just stopped forever. I have never tried this because I still need the once a day dose to keep my twitching/tingling symptoms at bay.

 

[Trees]

Another question,My left hand feels weaker, and I feel like my feet are dropping more than they used to when I walk, Is my anxiety playing tricks on my mind. I know that I have a very, very small change of it being **S, but the anxiety seems to hit me all of a sudden. I was ok yesterday and today, but this afternoon I started to get the bad feeling again. This after seeing my triceps twitch a little bit when I contract them, or when I make a muscle they twitch so this is getting me more worried. Contraction fasciculations on my thighs and now my triceps, doesnt seem like good news.

 

[Trees]

Just an update, I had the EMG on my legs, thighs, feet, left arm, back and the tongue an its all normal. There were some fasciculations seen during the test on my thighs but no muscle damage, I have healthy muscle. So the Neuro told me that its BFS. She said that theres no need for a follow up, since by this time if I had **S I would be very weak and it would have definitely show on the EMG. I feel great now, and I will try not to relapse into another panic and anxious attack thinking that I have **S. I just wished I knew why I still feel that my tongue is too big for my mouth and getting more scalloped tongue. The tongue muscle was good on the EMG so can it probably be TMJ????

 

[FantasticFurball]

Are you dumb?The neuro just told you, it was BFS. Not something else. Its like looking on a red flag, and you are saying: "Could that flag be yellow?" We cant be smart all of us. Its ok man, dont be sorry. To be unintelligent is an honest thing. You just have to live with it... Dont let that lack of smartness stand in your way to a good life... There are millions of fools outhere - you are not alone...

 

[Trees]

FantasticFurball, lol, no I am not dumb, I am too curious for my own sake, which is why I am a Mechanical Engineer. I asked my PCP for a copy of the EMG report and thats where I saw I have fibrillations on my shin area and psw on my lower back. So even though she told me after the EMG I have BFS, she contradicted herself on the final report with saying it looks like I have Lumbar Radiculopathy vs BFS. I made an appointment to follow up next month and ask all the questions that I have since I last saw her. Since then I did have an x-ray done on my back and it showed a slipped L5 and S1 disc, but my PCP thinks its not something to worry about, she said its just a "finding". The neuro thought it was the cause of my fasciculations and numbness on my legs along with the contraction fasciculations, be it as it may, I dont have a clean EMG. I guess time will tell whats really going on with me. At this moment no MND, so Ill keep telling myself and by the way thanks for the pick-me up speech.