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Mental Health > Anxiety and Stress Forum > ALS (amyotrophic lateral sclerosis), MS (multiple sclerosis)
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Q: ALS (amyotrophic lateral sclerosis), MS (multiple sclerosis)
asked by: DoctorQuestion on November 7th, 2006
I am having muscle twitches all over, from under my eye, stomach. back, legs, arms, toes, and to my feet. I have had bladder problems since the birth of my second child, and also had hypothoridism. My thyroid has been working fine without medication for 2 years. I just had a test done a month ago, antibodies high and slight elevated t-3 on a reverse t3 test. I have been having twitches for 2 months now. I went to a neurologist 3 weeks ago and she did blood work, I am thinking all work was fine, I haven't heard anything. She did mention ALS, but said I didn't have anything to worry about. My physical neurology test was great. I have been reading a ton on ALS and the thought of having it scared me to death. I am having some tingeling in my right toes, foot and calf. I also have tingeling in my right fingers. I am using the computer a lot these days, I am in a masters' program online. I am wondering if the pain and tingeling in my leg could be from the sciatic and same idea with my fingers?? I am worried I have MS or AlS, What is your opinion?


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Dr. Nikola Gjuzelov , MD
replied on November 29th, 2006
Anxiety & Stress Answer A1810
Amyotrophic lateral sclerosis (ALS) affects the motor neurological system (part of the nervous system that controls the muscle contractions). During ALS, the nerve cells (neurons) in the brain and spinal cord responsible for muscle contractions die for unknown reasons. Degeneration of the motor nerves leads to muscle weakness and inability to perform movements of the extremities and the whole body. Senses (touch, smell, sight, hearing…) and cognitive functions (thinking, intelligence…) are not affected. ALS usually occurs after the age of 50 and is slowly progressive. Dominant symptoms in ALS are muscle twitching, cramps, weakness, atrophy, paralysis, disturbed movements… In time, the respiratory muscles can become affected and breathing can be disturbed; these conditions can lead to death. Diagnosis of ALS is established with neurological exams, electro-myo-graphy (EMG), and genetic tests. A CT-scan or MRI of the head and spinal cord, breathing tests and blood analyses should also be performed to exclude other diseases with the same symptoms.


Multiple sclerosis (MS) is autoimmune demyelinizating disease of the central nervous system (CNS). During MS, the immune system creates antibodies against the myelin covering of the nervous tracts in the brain. Lesions can affect any nerve’s tract, so any nervous function can be disturbed (motor, sensitive or cognitive). The severity and diversity of the symptoms during MS depend upon the number and localization of the brain lesions. People diagnosed with MS may experience periods of remission, but generally, MS is a progressive disease. MS is diagnosed with a CT-scan of the brain to visualize the lesions and a lumbar punition to detect anti-myelin antibodies in the cerebrospinal liquid.


According to your physical neurology test, both ALS and MS are almost excluded. You can request an EMG and CT-scan for a more relevant and accurate diagnosis. EMGs are also useful to examine the sciatic nerve. An X-ray of the vertebral spine can be also done to exclude spondylosis. You can visit a neurologist to perform these examinations. If everything appears ok, then anxiety may be a possible cause for your symptoms.





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