Unexplained violent leg spasms - possibly MS?

[whitelyy]

Hey guys!

Yesterday I was doing some stretching exercises my PT gave me to help with my pelvic floor dysfunction (bowel, urinary, sexual issues) and had some particularly violent tremors in my legs that most resembled something seizure-like or wild, rapid jerking motions. My muscles get fatigued and shake pretty easy, even when doing simple stretches. Those tremors occurred on the very first stretching exercise.

I recently saw a Neurologist and had complained about hand tremors, tingling/numbness sensations in the legs, slurred speech, dizziness/fainting spells, dysautonomia, constipation/urinary issues, spasticity and tightness in the muscles, short-term memory problems, severe chronic fatigue and pain, brain fog, blurred vision, sensitivity to light and sound, shakiness - the list goes on and on. (Some of these symptoms are also exacerbated by the cold - more severe spasms in arms and legs, slurred speech, prickly tingling feelings in limbs, increased muscle fatigue, etc.)

Regardless, since I told him that I was also diagnosed with depression and PTSD and an anxiety disorder + panic disorder - he stopped asking questions about my physical issues and started focusing on the cause being anxiety and stress. He did the standard exam asking to push/pull, walk on tiptoes, heels, etc. and sent me home with a recommendation to see another psychiatrist. Naturally, I'm a little peeved about that.

My PT doesn't seem to understand why I have so much pain in my muscles, or why they give out so easily in strength training exercises/stretches. I'm not out of shape, I used to be very strong actually, but within the last year I've been getting diagnosed with things like CFS, Fibromyalgia, POTS, with many more doctors appointments to come.

I'd love some advice, maybe some consolation too - I'm a 20 year-old female thrown into the medical system and some of the doctors don't seem to take me very seriously. Regarding the leg tremors, I'd love to hear your experiences with that. Thanks everyone!

[Snoopy]

Hello whitely,

Symptoms can be caused by many things as there is not any symptom that is exclusive to MS. This disease is diagnosed by exclusion of all other possibilities and Neurological exam/evaluation and testing that indicates MS.

He did the standard exam asking to push/pull, walk on tiptoes, heels, etc.

Was the exam normal or abnormal? If it was normal MS might not be the cause for your symptoms. If you are concerned about MS you will need to see another Neurologist and have testing done. A diagnosis of MS cannot be given on symptoms alone.

I was also diagnosed with depression and PTSD and an anxiety disorder + panic disorder

I am sorry. Are you taking any medications to help? Do you see a Psychiatrist and/or Psychotherapist?

[jimmylegs]

hi welcome to tims
if i were to go digging in google scholar, here are the things i would look up in conjunction with your symptoms

pelvic floor dysfunction (bowel, urinary, sexual issues) - magnesium, zinc
violent tremors in my legs that most resembled something seizure - magnesium
hand tremors - magnesium
dizziness - zinc
fainting spells - is it postural hypotension? are you dehydrated?
dysautonomia - how so, need clarification
constipation - what's your diet. tried max oxide? not good for mag absorption, but scary effective laxative!!!!
urinary issues - such as...
spasticity and tightness in the muscles - magnesium
short-term memory problems - cognitive, zinc
severe chronic fatigue - iron
pain - magnesium
brain fog - zinc
blurred vision - zinc
sensitivity to light and sound - not sure, zinc could be in that picture
exacerbated by the cold, more severe spasms in arms and legs - nerve conductivity, influenced by cal-mag balance
depression - magnesium, omegas
PTSD - magnesium
anxiety - magnesium
panic - magnesium
CFS - magnesium
Fibromyalgia - magnesium and zinc
POTS - b12, iron, magnesium, thiamine

here are some recent posts by me with info on magnesium to start, since it appears most often:
http://bit.ly/2jS20JF

[whitelyy]

If my symptoms were explained by deficiencies in magnesium, zinc, etc. we would have been done a long time ago. Doctors tested for that, and ruled it out as a possible cause. They still have me taking supplements to see if symptoms improve, but I've noticed little to no change.

As far as the exam, my neurologist didn't exactly communicate if he thought it was normal or abnormal, he was more hyperfocused on anxiety and stress being the cause. I mentioned briefly that my Cardiologist and Rheumatologist were concerned about me having Ehlers-Danlos and immediately referred me to a Geneticist who specializes in that, but it didn't make a difference and he still ran with the anxiety theory. I've asked him to order more tests to rule out other things, so we'll see what happens.

As far as psychiatry goes, my body doesn't tolerate medication very well for a slew of reasons that are too lengthy to discuss here. Been there, done that many times, the only thing that works for me is weekly therapy and we'll keep it at that.

[jimmylegs]

ah good a test! can you share the serum mag result? can we assume you know your daily magnesium requirement based on your weight and activity level? how specifically do you meet that requirement from food?

as for the science, they'll get around to it. nutrition science is a baby.

from 2015, excellent work unpacking magnesium deficiency within normal range.

Magnesium in Prevention and Therapy
http://www.mdpi.com/2072-6643/7/9/5388/htm
Dietary surveys of people in Europe and in the United States still reveal that intakes of magnesium are lower than the recommended amounts [20,21,22]. Epidemiological studies in Europe and North America have shown that people consuming Western-type diets are low in magnesium content, i.e. <30%–50% of the RDA for magnesium. It is suggested that the dietary intakes of magnesium in the United States have been declining over the last 100 years from about 500 mg/day to 175–225 mg/day. This is likely a result of the increasing use of fertilizers and processed foods [5,9,22,23,24].

In healthy individuals, magnesium serum concentration is closely maintained within the physiological range. The normal reference range for the magnesium in blood serum is 0.76–1.15 mmol/L [7,16,17,18,19]. (JL: that varies, this range is on the high side which is better. i've seen 0.65-1.05 as a normal range on lab work, which is lame)
According to many magnesium researchers, the appropriate lower reference limit of the serum magnesium concentration should be 0.85 mmol/L, especially for patients with diabetes [17,18,52,53]. For example, in the NHANES I study the reference interval for serum magnesium was determined in 15,820 individuals between the ages of 18 and 74 years. The results of this study identified the reference interval as 0.75 mmol/L to 0.955 mmol/L (JL: ugh more laaammme, represents a whole society with crap mag status) with a mean concentration of 0.85 mmol/L[54]. In a European study, magnesium deficiency was determined clinically and compared with the serum magnesium concentration. It was found that in individuals with serum magnesium level of 0.70 mmol/L, 90% of the individuals had clinical magnesium deficiency and at a cut off magnesium level of 0.75 mmol/L, 50% of individuals had clinical magnesium deficiency. At a cut off level of 0.80 mmol/L, 10% of individuals had clinical magnesium deficiency and at a cut off of 0.90 mmol/L, only 1% of the individuals had clinical magnesium deficiency [55].

what that means is that mag tests can come back normal all day long, docs may say it's 'normal', but that doesn't mean ppl arent deficient. it's like that for many nutrients known to be low in ms. i hate to think how many ppl are getting diagnosed with various things based on signs and symptoms related to side effects of nutrient deficits.

edit: related from 2011

Widespread vitamin D insufficiency: A new challenge for primary prevention, with particular reference to multiple sclerosis
http://www.vitamindwiki.com/dl1704
(JL: from full text, concluding remarks)
There can be no genuine arguments over the financial cost of a near generalized vitamin D supplementation, which appears to be very inexpensive compared to the potentially gigantic savings to be made from prevention of many serious and currently frequent diseases.
Lastly, there is no point in waiting for official recommendations from the health authorities, since the medicine in this case already appears to be a century late. Moreover, correcting a vitamin insufficiency does not require official authorization since it is an elementary medical duty: indeed, failure to do so could even soon been seen as negligence.
All things considered, the time has clearly come to supplement all those in a state of vitamin D insufficiency, i.e. both patients and ‘normal’ subjects, as some pioneers have been recommending for several years. This is certainly a huge programme, involving the whole of the medical establishment, which should organize it. However, if it can be set up, the time will come, perhaps in 10 or 20 years, when its benefits will be observed.

lol bc it's not seen as negligence NOW sheesh

[Scott1]

Hi,

You first issue was shaking while you stretched. The second was the long list of issues your are dealing with. Starting with the second issue first, you should see a neurologist and start with an MRI.

On the leg shaking in a stretch. That's normal if you have tight hamstrings. You haven't described the stretch but it doesn't matter. What that shaking represents is a muscle or a tendon fatiguing. Maintain the stretch till it stops. If your PT is any good he or she should have told you that. Make sure your exercises are predominately eccentric rather than concentric movement. You will get a lot of violent shaking but just laugh it off, hold the stretch and it should gradually stop.

Regards,

[Snoopy]

The reason I asked about treatment for your PTSD and anxiety is some of your symptoms can fall into the physical symptoms that can happen with PTSD and anxiety. Have you discussed your symptoms with your Therapist?