31 Year Old Male - Healthy and not on any medication - Help/Advice

[Ivan90]

Background - I am a 31 year old male, exercise regularly, normal BMI, no medication, no allergies

Since end of February (symptoms started as gastrointestinal) I have been experiencing:

• Feeling of weakness/heaviness in both legs since Friday 18th March. Exacerbated by moderate exercise (walking). Particularly calf muscles.
• Feeling of weakness/lack of coordination in my left hand/forearm since 26th, however have experienced numbness/tingling in third and little finger for a couple of weeks.
• Faciculations in the calf muscles - experienced in the past after exercise but not to the same degree.
• Episodic finger twitching in left hand
• Episodic joint pain - predominantly left side and mainly left ankle
• Episodic extreme fatigue and brain fog
• Episodic nausea mostly associated with food
• Lack of appetite and feeling of fullness after a relatively small meal
• Episodic dysphagia
• Feeling the need to chew food more to swallow
• Over the past few days - I have been feeling a similar weakness in my right hand/forearm as per my left.

Note that blood tests - Blood profile, creatine kinase, coagulation screen, CRP, full blood count, liver function, magnesium and renal profile (Na, K, creatine, urea and eGFR - are all normal. Also the more exotic autoimmune blood tests - ANA, ENA and protein electrophoresis (IgA, IgG and IgM) - all normal too.

My biggest concern is that this is something neurological especially considering how suddenly the symptoms have come on and with no other apparent explanation based on blood tests outlined. I will be seeing a private neurologist tomorrow to discuss my case. I have a few questions and was hoping someone could provide some help?

(1) Are there any particularly pertinent questions I should ask the neurologist?
(2) Are gastrointestinal complaints associated with early stage MND?
(3) Is muscle weakness in early stage MND a perceived weakness (feeling) or a measurable weakness? Correct me if people feel these are one and the same.

Appreciate that this may be long covid, as I was infected in December 2021 the day after receiving the booster. However I recovered from infection in early Jan and have been feeling fine until end of February (as outlined).

Any comments or answers to the questions above would be greatly appreciated.

[Ellie]

Ivan90 MND Connect monitor this sub-forum Monday to Friday, 9-5, so may not get around to answering your questions before your appointment.

The Neurologist however, will be able to answer them.

Take care.

[Ivan90]

Hi Ellie,

Thank you for your prompt reply.

Appointment is at 17:00 tomorrow - so hopefully time for others to comment as appropriate.

Many thanks and best wishes

[Graham]

I had clonus after heavy exercise as an early indicator and unusual fatigue.

Further, it was apparent that I was spastic, hitting the squash ball particularly hard.

Having said that, no two MNDs are the same, other than the fact that you will have lost a significant percentage of motor neurones already if you have MND.

[PeterPan]

(1) Are there any particularly pertinent questions I should ask the neurologist?
(2) Are gastrointestinal complaints associated with early stage MND?
(3) Is muscle weakness in early stage MND a perceived weakness (feeling) or a measurable weakness? Correct me if people feel these are one and the same

I’m not a medic, but there must be scores of conditions that would present as you’ve described. Please do try to avoid anxiety at this stage, which could bring on additional symptoms.

I think it’s interesting that you can pinpoint weakness to a precise day as MND presents over months not days. No way could I have done that. Re your questions:

1 take a printed list of your symptoms to save time. Focus on listening to answers rather than asking too many questions
2 not in my experience
3 Weakness is a physical thing best measured by others and not a feeling

Best of luck. Let us know what happens 😀

[MNDConnect]

Dear Ivan 90,

As has previously been suggested, it can help when attending a neurology appointment to have written down, in bullet points, the symptoms that are worrying you, with dates of when you first noticed them.
Motor Neurone Disease is a very individual condition, for many this can present as a clinical weakness in an area of the body under voluntary muscle control. A clinical weakness can be defined as a decrease in muscle strength, this would mean that a movement you could previously carry out with no restriction would start to become more difficult.
The Neurologist will look to see if any of your muscle strength has decreased. Based on his observations he would know if there was any clinical weakness present.
If you would like to talk to an MND Connect Adviser about your symptoms or your concerns, please do call the team on freephone 0808 802 6262
With kind regards
Jacqui Anderson
Senior MND Connect Adviser

[Ellie]

The Neurologist will look to see if any of your muscle strength has decreased. Based on his observations he would know if there was any clinical weakness present.

The OP did not say which gender the Neurologist is - so disappointing to see an assumed gender assigned to the Neurologist 😩😩

[PeterDaviesNotts]

Similarly to yourself I have had gastrointestinal issues, however developing for a long time. I am also trying to find out if I have MND. Just an idea, allot of what you have stated as symptoms can be from dehidration and I have to make special efforts to stay hydrated. Also anxiety doesn't help.

Additionally I have general leg weakness and slowness, some muscle wastage on my left calf and continuous subtle spasms in my calfs (started with left side now both), but only mild strength loss on my left calf (can only do a couple of calf raises Vs lots on my other calf)

[Johnny5]

Lots of people jump to MND first. I think this happens because we fear the worse, hope for the best...?

This monster presents in so many different ways. That is why you need to see specialists to rule out a huge number of other conditions before they even think about MND/ALS.

[Ivan90]

Hi All,

Thank you for comments. Visited a consultant neurologist specialising in neuromuscular disorders.

His conclusion: not MND or any other neurological condition e.g MS, myasethnia gravis, peripheral neuropathy etc. He thought the most likely cause is post viral fatigue (potentially ‘long covid’) many of my symptoms match.

Recommendation was to rest with moderate exercise and hopefully symptoms should improve over the next 2-3 months.

There was some mild weakness with thumb abduction (right and left hand) but the cause could be carpel tunnel syndrome. Everything else normal.

I will update in 2-3 months on progress as this should help others who may have anxieties/concerns.

As a thank you, I will donate £50 towards the MND association.

If anyone has any questions feel free to ask.

All the best