Unmanageable Muscle Spasms
At age 23, I've been enduring muscle spasms since I turned 14, alongside persistent fatigue. There are times when I feel so drained that getting out of bed seems impossible, and both standing and sitting for extended periods are a struggle due to significant back pain. At times, my legs lose strength so severely that I find myself crawling on the floor; during these moments, it’s not a loss of consciousness I experience, but simply an overwhelming sense of weakness. The spasms affect various parts of my body, especially in the back, but they also occur in my face—around the mouth and eyelids—as well as in my thumbs and the soles of my feet and the front of my thighs. This condition is incessant, and I often carry tension in my shoulders and neck as well. To manage these muscle spasms, I’m prescribed Vyvanse at 50 mg, Baclofen at 10 mg three times daily, Diazepam at a total of 12.5 mg each day (distributed over four doses), and Magnesium Citrate every day. I've only been on Vyvanse since September 2024, and I haven’t noticed any worsening of my muscle spasms since starting it. In addition to these physical symptoms, I also face a spectrum of psychiatric and neurodevelopmental challenges, including Complex PTSD, social anxiety disorder, ADHD, insomnia, and atypical anorexia. Furthermore, I deal with endocrine issues such as PCOS and hypothyroidism. It's also worth mentioning that I have a hypertonic pelvic floor, and all of these conditions have been professionally diagnosed. I underwent a comprehensive adrenal evaluation, which ruled out adrenal insufficiency. While I previously experienced symptoms like fainting, dizziness, and low blood pressure, these have subsided significantly in recent times, aside from some lingering issues. During my teenage years, I was misdiagnosed with epilepsy because the muscle spasms appeared similar to myoclonic jerks. An EEG from years ago indicated hyperactivity in my prefrontal cortex, and despite three EEG tests not recording any seizures, I was treated with anticonvulsants, but the jerks remained unchanged. Eventually, a prolonged at-home EEG confirmed that I did not have epilepsy. Currently, no jerks are present; only the ongoing muscle spasms continue. Recently, my endocrinologist recommended that my primary care physician refer me to a neurologist for an EMG test. However, I’m apprehensive about whether this might be unnecessary. I've already had multiple MRIs (including brain, lumbar spine, and sacroiliac joint) and extensive blood tests, including the ACTH stimulation test. I'm reluctant to embark on yet another exhausting and potentially redundant diagnostic journey if it turns out there could be no significant underlying condition. Do my symptoms present as warranting an EMG exam? Could they suggest a specific medical issue that requires further investigation?
Answers (1)
3/19/2025, 11:30:49 PM
OpenHealth AI
Your symptoms, including persistent muscle spasms, significant fatigue, and episodes of weakness, certainly warrant careful consideration. Given your complex medical history, which includes conditions such as hypothyroidism, PCOS, and psychiatric challenges, it's understandable to feel apprehensive about undergoing further testing like an EMG.
Explanation
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Muscle Spasms: The spasms you describe can arise from various causes, including neuromuscular conditions, stress, medication side effects, or electrolyte imbalances. Given your history of neurodevelopmental challenges and endocrine issues, it's crucial to ensure there aren’t other underlying causes.
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Diagnostic Evaluation: An EMG (electromyography) is a test that can help assess the health of muscles and the nerve cells that control them. It may help identify if there is any nerve damage or muscle dysfunction contributing to your symptoms. Although you have undergone many tests already, this one focuses specifically on neuromuscular function, which may provide valuable insights.
Next Steps
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Consultation with Your Primary Care Physician: Discuss your concerns regarding the EMG. Share your history of extensive tests and ask for clarification on how this specific test could affect your management.
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Symptom Diary: Start keeping a detailed symptom diary. Note the frequency, duration, and intensity of your muscle spasms, fatigue levels, any triggers, and the effectiveness of your current medications. This diary can provide a clearer picture for your medical team.
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Review Current Medications: Talk to your physician about your current medications (Baclofen and Diazepam); these may have side effects that contribute to your muscle spasms and fatigue. Sometimes medication adjustments can lead to significant improvements.
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Lifestyle Modifications: Focus on stress-reduction techniques such as gentle yoga, meditation, or deep-breathing exercises. These may help with muscle tension and overall well-being.
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Support System: Engage with support groups or local resources that understand chronic conditions. Sharing your experiences can provide emotional relief and practical advice.
While feeling hesitant about more tests is valid, proceeding with the EMG could be worthwhile if it leads to better management of your symptoms. It’s important to communicate openly with your healthcare team and work collaboratively to address your concerns. You're not alone in this journey, and with the right support and management plan, improvements can be achievable.
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