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Question: Hello, I'm twenty-one years old and my symptoms began about four months ago when I had gotten a chest facillation rather close to where my heart is and I had a panic attack. Also please note I'm terrified of having ALS, MS, or Parkinson's. This followed with a really bad brain fog(after the panic attack; however I no longer have this symptom), during this time I was actively playing an MMORPG videogame. This involved heavy mouse use, and at some point my wrist/hand had this really strange static shock like feeling in it. When I had gotten this feeling and moved my index finger it would twitch, pretty much rapidly. This was my right hand and I did some tests on it after looking up ALS on the internet.
I began getting facillations all over my body, but primarily in my right arm. Since this time I've noticed now that when I walk long distances of two or more miles at one time, my legs with get facillations, not just in one area but all over. I also attributed the right arm issues(I had pain at one point but this is gone now) with the mouse use(I work on a computer), however my left hand does the same thing now.
My left middle and index fingers twitch and tremor sometimes randomly, usually like once or twice a day. I also just noticed today if I hold my cell phone in a certain position my index finger will tremor. My right middle and index fingers do the same thing on occasion as well, and also has the same postural tremor as my left. If I take my fingers(index or middle) and push(using my finger) up against my palm, my finger will jitter rapidly(like finger clonus) but only when doing this and it is always reproducible on either hand.(This is possibly from cracking my knuckles.)
I also have weird pins and needles sensations and recently while I was resting my elbow on my arm rest and dug in the place my hand on the mouse my whole arm had a massive pin/needle sensation(my right arm). I also want to say these symptoms don't generally interfere with my life, they're just worrisome.
My legs do the same rapid shake/tremor thing if I lean into them/on them in certain positions, and if I cross my legs(one over the other while sitting down) and I shake my foot up or down, it jitter while going back into a resting(down) position.
Maybe this is from my severe anxiety/depression?
I began getting facillations all over my body, but primarily in my right arm. Since this time I've noticed now that when I walk long distances of two or more miles at one time, my legs with get facillations, not just in one area but all over. I also attributed the right arm issues(I had pain at one point but this is gone now) with the mouse use(I work on a computer), however my left hand does the same thing now.
My left middle and index fingers twitch and tremor sometimes randomly, usually like once or twice a day. I also just noticed today if I hold my cell phone in a certain position my index finger will tremor. My right middle and index fingers do the same thing on occasion as well, and also has the same postural tremor as my left. If I take my fingers(index or middle) and push(using my finger) up against my palm, my finger will jitter rapidly(like finger clonus) but only when doing this and it is always reproducible on either hand.(This is possibly from cracking my knuckles.)
I also have weird pins and needles sensations and recently while I was resting my elbow on my arm rest and dug in the place my hand on the mouse my whole arm had a massive pin/needle sensation(my right arm). I also want to say these symptoms don't generally interfere with my life, they're just worrisome.
My legs do the same rapid shake/tremor thing if I lean into them/on them in certain positions, and if I cross my legs(one over the other while sitting down) and I shake my foot up or down, it jitter while going back into a resting(down) position.
Maybe this is from my severe anxiety/depression?
Brief Answer:
The most likely cause of your symptoms is anxiety
Detailed Answer:
Hi,
Thank you for posting your query.
I have noted the detailed description of your symptoms and would like to reassure you that they do not suggest any serious neurological illness such as ALS, MS or Parkinson's disease.
These symptoms could occur with physical strain, and get exacerbated with anxiety.
At this stage, you would benefit from taking rest (or reducing your physical work load). I also agree with you that taking anti-anxiety medications would benefit you.
Detailed neurological examination may be done by a doctor, however, I feel further evaluations with MRI brain/spine and needle electromyography may not be needed at this point in time.
I hope my answer helps. Please get back if you have any follow up queries or if you require any additional information.
Wishing you good health,
Dr Sudhir Kumar MD (Internal Medicine), DM (Neurology) XXXXXXX Consultant Neurologist
Apollo Hospitals, XXXXXXX XXXXXXX
Click on this link to ask me a DIRECT QUERY: http://bit.ly/Dr-Sudhir-kumar
My BLOG: http://bestneurodoctor.blogspot.in
The most likely cause of your symptoms is anxiety
Detailed Answer:
Hi,
Thank you for posting your query.
I have noted the detailed description of your symptoms and would like to reassure you that they do not suggest any serious neurological illness such as ALS, MS or Parkinson's disease.
These symptoms could occur with physical strain, and get exacerbated with anxiety.
At this stage, you would benefit from taking rest (or reducing your physical work load). I also agree with you that taking anti-anxiety medications would benefit you.
Detailed neurological examination may be done by a doctor, however, I feel further evaluations with MRI brain/spine and needle electromyography may not be needed at this point in time.
I hope my answer helps. Please get back if you have any follow up queries or if you require any additional information.
Wishing you good health,
Dr Sudhir Kumar MD (Internal Medicine), DM (Neurology) XXXXXXX Consultant Neurologist
Apollo Hospitals, XXXXXXX XXXXXXX
Click on this link to ask me a DIRECT QUERY: http://bit.ly/Dr-Sudhir-kumar
My BLOG: http://bestneurodoctor.blogspot.in
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Hello Dr. XXXXXXX
Thank you for responding to my question, however are you certain that physical strain could effect my body like this for so long? It's been a few months since my symptoms started.
Also I would like to mention that my fingers don't twitch/tremor left to right like many of the people I've seen with BFS; They twitch up and down.
Thank you for responding to my question, however are you certain that physical strain could effect my body like this for so long? It's been a few months since my symptoms started.
Also I would like to mention that my fingers don't twitch/tremor left to right like many of the people I've seen with BFS; They twitch up and down.
Brief Answer:
Symptoms can be prolonged in some cases.
Detailed Answer:
Thank you for getting back.
When you ask about certainty, one can not be 100% sure without the needle EMG, however, it can be said with 99.9% certainty that your symptoms are not due to ALS or PD.
In some cases, physical strain related symptoms can persist for a few months.
Also, twitching in BFS may be up and down in some people.
Best wishes,
Dr Sudhir Kumar MD DM (Neurology)
Symptoms can be prolonged in some cases.
Detailed Answer:
Thank you for getting back.
When you ask about certainty, one can not be 100% sure without the needle EMG, however, it can be said with 99.9% certainty that your symptoms are not due to ALS or PD.
In some cases, physical strain related symptoms can persist for a few months.
Also, twitching in BFS may be up and down in some people.
Best wishes,
Dr Sudhir Kumar MD DM (Neurology)
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Alright last follow up question.
If this is due to physical strain why is it practically symmetrical in both my hands/fingers?
Hypothetically speaking, if I were to schedule an appointment with you and come into your office presenting these symptoms to you, would you feel the need to run tests? Or would you dismiss them as anxiety related?
Thank you for your time
If this is due to physical strain why is it practically symmetrical in both my hands/fingers?
Hypothetically speaking, if I were to schedule an appointment with you and come into your office presenting these symptoms to you, would you feel the need to run tests? Or would you dismiss them as anxiety related?
Thank you for your time
Brief Answer:
I would not run the tests.
Detailed Answer:
Thank you for posting your query.
In your case, associated anxiety is leading to symmetrical symptoms. I agree with you that strain-related symptoms tend to affect one side more than the other.
I would be very pleased to see you in my office (even if it was real!). I would not run any tests such as MRI or EMG at this point in time. I would start you on anti-anxiety medications and follow you up closely.
Best wishes,
Dr Sudhir Kumar MD DM (Neurology)
I would not run the tests.
Detailed Answer:
Thank you for posting your query.
In your case, associated anxiety is leading to symmetrical symptoms. I agree with you that strain-related symptoms tend to affect one side more than the other.
I would be very pleased to see you in my office (even if it was real!). I would not run any tests such as MRI or EMG at this point in time. I would start you on anti-anxiety medications and follow you up closely.
Best wishes,
Dr Sudhir Kumar MD DM (Neurology)
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Do you get patients who come in often with symptoms like this?
Brief Answer:
Yes.
Detailed Answer:
Thank you for getting back.
I run a very busy practice in XXXXXXX XXXXXXX and see about 60-70 patients with neurological problems per day. I have been doing this for about 16 years now.
I routinely see people with similar symptoms and most of them are young people like you. In my case, most people are software professionals who spend a lot of time on computer, and they also google a lot about their symptoms leading to more anxiety.
Best wishes,
Dr Sudhir Kumar MD DM
Yes.
Detailed Answer:
Thank you for getting back.
I run a very busy practice in XXXXXXX XXXXXXX and see about 60-70 patients with neurological problems per day. I have been doing this for about 16 years now.
I routinely see people with similar symptoms and most of them are young people like you. In my case, most people are software professionals who spend a lot of time on computer, and they also google a lot about their symptoms leading to more anxiety.
Best wishes,
Dr Sudhir Kumar MD DM
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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