Fasiculations and weakness

[nutcase123]

Hello, I have recently had the rabies vaccine (post exposure 4 vaccines) and tetanus vaccine. The day after the first vaccine I started with fasciculation everywhere (even on my tongue) and the day after the second vaccine I started weakness in arms and legs (more so on the right side). I also started having ringing in my ears. All of which have continued.

I had a EMG and NCS ( here are the results)...

Summary (see data below) :
R median DII, prolonged latency with normal amplitude
R ulnar DV and radial sensory, normal
R median and ulnar motor, normal

R sural and superficial peroneal, normal
R peroneal EDB, normal latency with mildly reduced amplitude
L peroneal EDB, normal
R and L peroneal TA, normal
R tibial motor and F waves, normal

Needle EMG of the right upper extremity in sampled muscles innervated by the C5-C8 nerve roots was normal. No abnormal spontaneous activity was seen.

Needle EMG of the right lower extremity in sampled muscles innervated by the L4-S1 nerve roots showed decreased recruitment of large amplitude and long duration MUAPs in the gastrocnemius.
Fasciculations were seen in the gastrocnemius.

Needle EMG of the left lower extremity in sampled muscles innervated by the S1 nerve roots showed normal recruitment of large amplitude and long duration MUAPs in the gastrocnemius.
Fasciculations were seen in the gastrocnemius.


I can't sleep because of the twitching .

I am waiting on a neurologist appointment but am frightened I have ALS. What do you think?

Aslo, when I try to work out I'm too tired (even putting on my makeup) and then my muscles cramp up.

I'm 64 and have had a great life (so far) but am scared.

 

[lgelb]

Can you post the EMG data table?

 

[nutcase123]

SNC

Nerve / Sites	Rec. Site	Onset Lat	Peak Lat	Amp	Segments	Distance	Vel.	Temp.
		ms	ms	µV		mm	m/s	°C
R Median - Dig II Anti
Wrist	II	2.7	3.8	20	Wrist - II	140	52.1	34
R Ulnar - Digit V (Antidromic)
Wrist	Dig V	1.9	2.9	24	Wrist - Dig V	120	63.3
R Sural - Ankle (Calf)
Calf	Ankle	2.7	3.9	7	Calf - Ankle	140	51.3	32.2
R Superficial peroneal - Ankle
Lat leg	Ankle	2.5	3.4	6	Lat leg - Ankle	140	56.5	32
R Radial - Anatomical snuff box (Forearm)
Forearm	Snuff Box	1.7	2.3	30	Forearm - Snuff Box	100	60.0	32

MNC

Nerve / Sites	Muscle	Latency	Amplitude	Rel. Amp	Duration	Area	Segments	Distance	Lat Diff	Velocity
		ms	mV	%	ms	mVms		mm	ms	m/s
R Median - APB
Wrist	APB	3.4	9.1	100	6.6	35.0	Wrist - APB	70
Elbow	APB	7.1	8.5	93.1	7.1	34.5	Elbow - Wrist	205	3.7	55.3
R Ulnar - ADM
Wrist	ADM	2.7	6.9	100	7.2	22.0	Wrist - ADM	70
B.Elbow	ADM	5.5	6.5	94.5	7.1	21.2	B.Elbow - Wrist	160	2.9	56.1
A.Elbow	ADM	7.6	5.7	83	7.1	20.0	A.Elbow - B.Elbow	100	2.0	49.0
R Peroneal - EDB
Ankle	EDB	5.5	1.8	100	6.8	6.6	Ankle - EDB	80
Fib head	EDB	12.4	1.7	95.7	6.9	6.2	Fib head - Ankle	290	6.9	41.8
Pop fossa	EDB	13.7	1.6	88.5	7.0	6.4	Pop fossa - Fib head	50	1.2	40.7
L Peroneal - EDB
Ankle	EDB	4.9	2.6	100	6.2	9.5	Ankle - EDB	80
Fib head	EDB	11.0	2.4	89.7	6.6	9.5	Fib head - Ankle	285	6.1	46.5
Pop fossa	EDB	12.9	2.4	91	6.9	10.2	Pop fossa - Fib head	85	1.9	45.8
R Tibial - AH
Ankle	AH	3.8	4.4	100	8.0	17.4	Ankle - AH	80
Pop fossa	AH	12.2	2.5	55.3	9.0	7.4	Pop fossa - Ankle	370	8.4	44.2
R Peroneal - Tib Ant
Fib Head	Tib Ant	3.1	6.2	100	13.9	52.9	Fib Head - Tib Ant
Pop fossa	Tib Ant	4.2	6.2	99.2	14.0	51.0	Pop fossa - Fib Head	50	1.1	47.1
L Peroneal - Tib Ant
Fib Head	Tib Ant	2.8	5.5	100	13.7	45.9	Fib Head - Tib Ant
Pop fossa	Tib Ant	4.3	5.5	99.5	13.8	44.5	Pop fossa - Fib Head	85	1.5	57.5

F Wave

Nerve	F Lat	M Lat	F-M Lat	Min F Lat	Min M Lat	Min F-M
	ms	ms	ms	ms	ms	ms
R Tibial - AH	53.1	3.8	49.4	28.1	3.8	24.0

EMG Summary Table
	Spontaneous Activity	Voluntary Actvity	Comment
Muscle	IA	Fib	PSW	Fasc	Misc	Amp	Dur	PPP	Recruitment	Pattern
R. Deltoid	Normal	None	None	None	None	Normal	Normal	Normal	Normal	Normal
R. Biceps brachii	Normal	None	None	None	None	Normal	Normal	Normal	Normal	Normal
R. Triceps brachii	Normal	None	None	None	None	Normal	Normal	Normal	Normal	Normal
R. Pronator teres	Normal	None	None	None	None	Normal	Normal	Normal	Normal	Normal
R. First dorsal interosseous	Normal	None	None	None	None	Normal	Normal	Normal	Normal	Normal
R. Vastus lateralis	Normal	None	None	None	None	Normal	Normal	Normal	Normal	Normal
R. Tibialis anterior	Normal	None	None	None	None	Normal	Normal	Normal	Normal	Normal
R. Gastrocnemius (Medial head)	1+	None	None	1+	None	1+	1+	Normal	Normal	Neuropathic
L. Gastrocnemius (Medial head)	1+	None	None	1+	None	1+	Normal	Normal	Normal	Neuropathic
R. Biceps femoris (long head)	Normal	None	None	None	None	1+	1+	Normal	Normal	Normal
R. Gluteus medius	Normal	None	None	None	None	Normal	Normal	Normal	Normal	Normal
R. Lumbar paraspinals	Normal	None	None	None	None					Normal
L. Biceps femoris (long head)	Normal	None	None	None	None	Normal	Normal	Normal	Normal	Normal

 

[lgelb]

Several studies document cases of neuropathy, usually self-healing over weeks or months, after rabies vaccine. That recruitment abnormalities were only seen bilaterally in one commonly-compromised muscle is reassuring as regards ALS, as is the fact that the R bicep did not show acute denervation.

The neurologist, of course, will look at all the major possibilities, of which a post-vaccine issue is only one.

 

[nutcase123]

Thank you! I appreciate so much that you are willing to donate your time to reassure people!

I saw a neurologist today (was supposed to be a consult then he would recommend another neurologist). He was with me for at least 40 minutes. Shorter story is he doesn't think I have ALS or MS or any other scary thing! He recommended gabapentin for the fasciculation and said maybe if I can sleep better the muscle fatigue would stop. So let's hope, no more worrying for me (yet)!

Thanks again!