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Neurology (Expert Forum)
ALS concerns
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ALS concerns
by MCB, Jan 27, 2005 12:00AM
I'm a very physically active 44 y/o male. I have had fasciculations spread over my body (feet, legs hips, chest and face) for approximately three months. Previously I had intermittent fasciculations primarily concentrated in my chest (mainly left breast) and face over the last year. I don't know if the fasciculations are related. My neck has recently become stiff and easily fatigued, and the back of my neck occasionally tires from chewing. I just last week had an EMG/NCV where the neurologist checked both legs one arm and 2 paraspinal thoracic spots and he said the emg was normal. His nurse practitioner is the person who performed the physical exam which he said was normal. The Dr did, however, briefly check the reflexes in my legs and arms. Blood tests all normal. During the EMG, the Dr. only asked me to move the muscle at one spot in each of my legs, and the rest of the spots he only inserted the needle and observed the screen. His diagnosis is BFS. He is not an ALS specialist, but he is a Barrows Neurological Institute-trained (Phoenix AZ) neurologist and I put a lot of stock into that. I am wondering if the exams have been thorough enough and should I be generally reassured that a "trained eye" has checked me out. Also, EMGs/ NCVs performed last year for carpal tunnel and possible radiculopathy/left leg that were normal if that has any bearing on my question. Please comment re ALS concerns. Thank you.
Doctor's Answer
by CCF-Neuro-M.D.-CS, Jan 28, 2005 12:00AM
Although I cannot make a clinical diagnosis over the internet, it looks like you have had a thorough evaluation, and if the tests are normal, you do not qualify for a diagnosis of even possible ALS.
Fasciculations without weakness or wasting of muscles is almost always not due to ALS
there are many other causes including BFS, cramp-fasciculation syndrome, even normal people with lots of exercise, cold, certain medications, pinched nerves
You should be reassured by your evaluation. If you do develop weakness, wasting etc, then just have it reevaluated - time will tell. I cannot give you any more specfic information or diagnosis without seeing you.
Good luck
Fasciculations without weakness or wasting of muscles is almost always not due to ALS
there are many other causes including BFS, cramp-fasciculation syndrome, even normal people with lots of exercise, cold, certain medications, pinched nerves
You should be reassured by your evaluation. If you do develop weakness, wasting etc, then just have it reevaluated - time will tell. I cannot give you any more specfic information or diagnosis without seeing you.
Good luck
