Catherine Maurice

This is likely not related to Alzheimer. This question is difficult to answer online since the "twitches" could be many things, and the key to diagnosis is to see the twitches ourselves, or filmed on smart phone. We can determine the "type of movement" by direct observation: myoclonia, myokimia, cramp, fasciculation, tremor, etc. then we can isolate the cause. The best advice I could give is to make sure your brother consents, and to film the twitches with a phone camera, and to show this to the next visit to family doctor. Could be as simple as some vitamins (calcium, magnesium) supplements required, but the key is seeing those movements. Most family physicians are familiar to identify those, no Neurology necessary at this step; I hope it helps,
Thank you.

The reassuring aspect is that multiple sclerosis is a disease requiring "a combination of multiple factors" to develop. Most often (more than 95%) of the time, patients diagnosed with MS will not transmit it to their children. We usually do not require a mandatory screening for children of MS patients, unless they present symptoms suggestive of the disease, as more than 95% of the children will never develop MS. The diagnosis is based on clinical symptoms of isolated neurologic deficits restricted in time (3 days-3 months) and space (lesions seen on the brain MRI). People need to be careful if they wish to do a brain MRI without any symptoms. First, without Sx MS is unlikely going to be diagnosed no matter the results of the MRI, and no treatment would be offered anyways if the person is asymptomatic. Secondly, if we do brain MRIs to everyone of the population, most people present some variants of the normal, from birth, migraine, or due to deep small vessels that reorganize, so most totally healthy persons will have a little dot somewhere without significance. I suggest to express the concerns to the family physician, but to proceed with complete investigation only if there is clinically a legitimate reason to suspect new symptoms related to MS.

The first suggestion is to make sure that "over the counter" meds are not overused. More than 8-10 days a month of OTC can contribute by itself to chronicize a migraine. Making sure to sleep well, sleep well, limit pain medication yo max 8-10 days a month, good support of the neck during sleep with a good pillow, improving stress management, being mindful of certain food (especially containing nitrites or caffeine), coenzyme Q10, are natural ways to help migraine. If pain is present more than 50% of the time (ideally use calendar to document), temporary use of "preventive medication" for a few months is suggested to "break" the chronic state and this could be eventually tapered after a few months. Best thing to do at the time is to be mindful of good health habits and document the days per month of headache, and the days requesting OTC medication. The family doctor will be able to help optimally at next visit with the use of this tool. Hope it helps!
Thank you CM

If I interpret well the abbreviation "MD" as "Muscular Dystrophy", it can't be contagious. The disease involves genes, responsible for protein production. Without proper protein production, muscles become unhealthy. This is the basic nature of the disease. It can't be transmitted by physical contact. Hope it helps,

CM

Best way to help neuropathy: the best possible control of diabetes, it could improve the current neuropathy, and prevent its progression. Since DB neuropathy involves the smallest nerve fibres, those are unlikely to be affected by chiro. However, the patient is the best guide to tell us what he needs, some feel better after chiro sessions overall, and if people feel overall better, I suggest to keep a winning recipe. On a physiologic basis, no movements/manipulations can affect nerve fibres that small. The machines sold at pharmacies doing vibration that people place under their feet could help temporarly, if there is sustained uncontrolled pain the best is medication such as cymbalta, or lyrica, or gabapentin, that could be discussed with family physician and adjusted at the lowest dose required to manage the symptoms.