Hi @anxiousordying
I read both of your posts. First, let me tell you I've had all the neurological symptoms you have with numbness, pain, massive fasciculations mostly in my legs/feet, especially calves, but sometimes face/eyelids or somewhere else. Numbness issues started in my teens, fasciculations in my 20s and pain issues increased over time. Restless leg syndrome too. I also get the internal vibrations a lot especially upon waking. The good news is I'm 64 and still here!!! Woohoo! None of those things will be the cause of my demise.

8 years ago I suddenly began aspirating all my food. Issues controlling food and swallowing. Muscle fatigue issues during eating process and other areas. I was sure I had ALS. That was not a fun scare so I feel for you on that. We all jump to the worst case scenario. ALS is rare -- only 4-6 people in 100,000 so be very hopeful because it's unlikely to be the cause of your issues.

It just so happens, I already knew I had a rare hereditary neurological disorder (as does my son) called Hereditary Neuropathy with Pressure Palsies (HNPP). Not enough info/data available since it's rare, but nothing on related swallowing issues. Two neurologists worked together to rule out ALS, MS, MG and in the end both determined my swallowing issues are part of my progressive HNPP. HNPP is not considered a lethal disorder, but it sure can be challenging for those of us with the most severe cases. I have a lot of pain in my legs and RLS when I sit in the recliner or lie in bed because of the pressure palsies. Can't wear any pants tight on my calves or I'll get RLS instantly. Anything sounding like your triggers/issues?

What is interesting is that you said your pinky goes numb when you lean on your elbow. That's the kind of thing that happens with HNPP due to the Pressure Palsies part. Do your fingers go numb for a month when you use scissors too much? Carry heavy plastic grocery bags? Do your toes go numb for a month when you wear pumps? Arm start tingling and go to sleep if you hold the phone up to your ear very long? All signs of HNPP. I once sat on a kayak for an hour and when I went to get out, both legs were asleep -- surprise -- the guys had to carry me to the dock. How embarrassing. Talk about painful pins and needles as they came back to life in about 15 minutes. Novacaine injection and my face stayed numb for 9 months because nerves get damaged easily. My son banged both elbows in a fall and had to have nerve transposition surgery (a big deal) on both arms to stop the constant pain and regain use of his last two fingers on both hands. My feet have been numb for years. Only about 16 people in 100,000 have HNPP. It can be diagnosed through a genetic test. Just throwing it out there as another possibility.

One other interesting thing. Earlier tonight, I was in my recliner and fell asleep for a moment and woke up with a gasp because I have sleep apnea and had stopped breathing. I just happened to be checking my oxygen level when I felt asleep (non-related lung issues) and it dipped to 88% when that happened instead of the usual 91-93%. A few minutes later my calves just started going crazy with fasiculations in about 100 different spots. I didn't know sleep apnea is a trigger until now. For me, chocolate is also a trigger, most likely caffeine. That's the only caffeine I ingest and it doesn't take much to cause fasciculations, RLS and muscle cramps. Mentioning all this to see if anything hits home with you.

I just googled and some triggers for twitching are sleep apnea, sleep deprivation, caffeine, vitamin D deficiency, dehydration and stress. And, of course some neurological disorders like HNPP or BFS and maybe others. Do you think you may have some of the more common triggers? Some are easy fixes.

I'm wondering when you were sleeping and woke up with the panic attack if you had maybe stopped breathing momentarily from sleep apnea??? That does wake you up constantly. My nightmares are also worse when sleeping on my back (bad position for sleep apnea). You can do a sleep study if you think you have sleep apnea. Has anyone ever told you that you snore, breathe weird or stop breathing while sleeping?

Know that my EMG/NCS results are not normal starting at 21 when I first had those tests, but again, it's from HNPP not ALS. Phew! I hope my story helps relieve some of your stress about having ALS. Good luck to you and keep us posted! You're in my prayers. 🙂