A 16-Year-Old Feared ALS — But the Real Cause Was Stress-Related Somatic Symptoms

Alex was 16 years old and had always performed well at school. But over the past three weeks, something began to feel wrong. His muscles started twitching for no clear reason — sometimes in his hands, sometimes in his thighs, with no fixed location.

At first, he did not take it seriously. But when the twitching was followed by pain, he did what many anxious patients later regret: he searched his symptoms online.

The word that frightened him most was ALS, also known as amyotrophic lateral sclerosis. The descriptions he found seemed similar to what he was experiencing. From that moment, his fear grew rapidly.

Soon, more symptoms appeared: palpitations, hand numbness, dizziness, and a heavy sense of pressure. His grades began to decline, and his parents brought him to the hospital for evaluation.

Alex was seen by Dr. Chu from the Department of Neurology. During the physical examination, Dr. Chu found no muscle wasting in Alex's arms or legs, and his neurological examination was normal.

To thoroughly rule out organic neuromuscular disease, Dr. Chu recommended electromyography, or EMG. This is an important test used to help distinguish functional symptoms from true nerve or muscle disorders.

"The EMG result showed no evidence of neurogenic or myogenic damage. ALS was ruled out."

When Alex and his parents saw the report, they felt as if a huge weight had been lifted. The disease he feared most was not present.

After reviewing all the information, Dr. Chu gave a diagnosis: somatization disorder related to anxiety, accompanied by autonomic nervous system dysfunction.

In simpler terms, Alex's muscle twitching, pain, numbness, palpitations, and dizziness did not mean that his muscles or nerves were structurally damaged. Instead, long-accumulated stress and emotional pressure were expressing themselves through physical symptoms.

Dr. Chu explained that this pattern is not uncommon in teenagers. High academic pressure, emotional suppression during adolescence, and autonomic nervous system imbalance can all contribute to real physical symptoms.

"The pain is real. The symptoms are real. But the root cause may be the brain's stress circuit, not damaged nerves or muscles."

Because Alex was still a minor, Dr. Chu wanted to avoid unnecessary medication side effects. She arranged a non-invasive, radiation-free treatment called navigated repetitive transcranial magnetic stimulation, or rTMS.

The principle is to use pulsed magnetic fields to stimulate specific brain regions and help regulate neural excitability. This was combined with oral neurotrophic support as part of the overall treatment plan.

After four to five sessions, Alex's muscle twitching began to ease, and his mood became more stable. Later, the twitching disappeared completely. He was no longer easily irritable, became more willing to make eye contact, and his attitude toward his parents became calmer.

"After the EMG came back normal, it felt like he had been pulled out of deep water. He was not being dramatic — he had truly been drowning in fear."
— Alex's mother

This case is a reminder for parents: physical symptoms in teenagers may sometimes be emotional distress sending a signal. Muscle twitching, numbness, palpitations, headaches, and dizziness should first be evaluated medically. If no organic disease is found, the child's suffering should still be taken seriously.

The right approach is not to dismiss the child as "pretending," but to treat both body and mind together.