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Constant Undersole Twitch
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Constant Undersole Twitch

I am a 30 year old female and have a 1 year old boy.  Since November 3rd of last year I have been experiencing a constant twitch under my right foot.  It moves my toes and never stops.  It is annoying.  I had a LEFT SIDED EMG in September of last year on my left calf and left foot due to twitches there that lasted months.  Those have gone away for the most part.  The EMG came back normal but the NCV showed neuropathy in both legs.  I truly can't remember if my Neuro tested me with the needles on the right leg because at the time it was my left foot that was scaring me.  

I keep trying to tell myself that this right foot will stop twitching like my left side did but I am really scared.  It has lasted longer than my left side twitching.  COULD THIS BE ALS?  My Neuro promised me in September that my results WERE NOT indicative of ALS.  I am strongly considering calling her to schedule another EMG on my right foot.  Now my right palm has a constant twitch near my thumb which is very unnerving.  History - I have had 2 MRIs (one with and one w/out contrast) over the past 2 years and both were totally normal.  All my neuro exams were totally normal as well.  I can run up the stairs on my toes and walk easily on my toes and heels.  I do not feel weak.  

If you tell me you think this is stress/diet related I will not call my neuro for an appointment.  Questions are:
1.  Should I go for another EMG?
2.  Should I take Paxil for anxiety - would that stop these twitches?  My neuro had suggested Paxil due to a high stress life with my job/baby.  What do you think?
3.  Can a foot CONSTANTLY twitch like this and NOT be indicative of ALS or a serious disease?
4.  What does an ALS twitch look like?  I have heard that it looks like "rippling" or "worms under the skin".  Mine are pulsating and irregular.  Sometimes fast and sometimes slow.  They are visible to the naked eye.
5.  Can Peripheral Neuropathy cause this foot/hand twitching.  It seems unlikely but I thought I would ask.

I guess I am so scared because the ALS websites all say that it starts in the hands and feet.  I do feel twitches all over from time to time but it is mostly focalized in my hands and feet.  I know you cannot diagnos over the internet but I will trust your judgement from the information I have given you.  I really do appreciate your help.


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Avatar_n_tn
Sorry to hear about your symptoms. Please keep in mind that major decisions regarding your medical care should not be solely based on this post as I have not personally examined you nor have I reviewed your studies. I can understand your concern about the twitching, but not all twitching is fasciculation,nor does it mean you have ALS. Your demographic and reported symptoms do NOT fit the typical case of ALS which is a progressive weakness in a particular distribution of muscles at first - then generalizes, accompanied by reflex changes and special types of twitching called fasciculations which represent degeneration of the spinal cord region that control the muscles. These can look like rippling as you describe and worms under the skin, an dthey're usually not strong enough to actually move a joint.Again I cannot definitively say whether or not you have the disease - just a guess based on the medical literature and my own personal experience.
1.May not need one. Talk to your neurologist and let them know about the constant twitching. Continue with followup for now so they can observe you.
2.Might help, but this is a decision you should make with your docs.
3.Yes, absolutely. New or tight/uncomfortable shoes, trauma to the foot, benign fasciculation syndrome are all possible causes which seem to be the case for you rather than ALS.
4.See above
5.Yes but uncommon.
Good luck
4.
13 Comments
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Avatar_n_tn
Do you have diabetes or something that would give you a peripheral nueropothy? I just read a magazine article about Micheal J. Fox (actor) who had a twitch in his pinky finger before being diagnosed with parkinsons.
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Avatar_n_tn
What are you trying to do - freak me out even more?  My neuro already told me that Michael J. Fox had a tremor in his pinky and that my twitch would be rhythmic if it represented Parkinsons.  She has assured me that I do NOT have Parkinsons.  Not a helpful comment.
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Avatar_f_tn
I thought it was nice of you to have concern for ydg123 to post your ideas for a possible diagnosis, she must not of understood your concern. Sometimes posted comments can put someone one the right tract when they least expect it.
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Avatar_n_tn
I think it is nice of you to stick up for Terrylynn but, did you really read her comment to me?  It was so clearly uneducated of her to imply that I might have Parkinsons Disease.  I clearly stated that I had twitches - not tremors.  They are two totally different things.  It was an uneducated comment that was hurtful, not helpful.
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Avatar_n_tn
I'm so sorry you took it wrong. Please forgive me and I did not mean to upset you. Just thought you were looking for possibilities and parkinsons presents with RESTING tremors relieved my movement. Obviously not your problem so all you have to do is say it's been ruled out and not jump down my throat. Probably nothing will turn up in your tests and doctor appointments.
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Avatar_n_tn
You are the first person I've found to have the same thing going on with thier foot as mine.  The arch of my foot twitches continuously, just popping around like a bag of worms & moves the big toe around too.  This never stops. Pretty annoying.

This has been going on for at least 2 years now.   I also have twitching everywhere in my body that comes & go.  Those don't bother me in the slightest since I know they'll go away.

I've seen 2 neuros, my family practioner, a foot doctor, had 2 MRI's, all the work-ups, etc.   Nobody can find a darn thing wrong.

It even looks like some mucle atrophy there in the foot, but the doctors still say nothing.  Probably just an irritated nerve from my back problems I've had.  I had back surgery for a bulging disc (L-5, S-1) about 6 years ago.  This was causing pain & weird sensations in my foot, leg & butt.

I just keep socks on while I'm sitting around so I don't see it happening & wiggle my feet around so I don't feel it so much.

Time will tell.   The good thing is I'm feeling strong as ever after over 2 years now.

Please keep me posted about your condition, as you are the only I've found with similar symptoms.

Feel free to e-mail anytime, ***@****
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Avatar_n_tn
Twitching/spasms/cramping maybe you need to drink more water. Sometimes people drink fluids but not enough water. It will cause those symptoms too. Many med's for those symptoms such as zanaflex/baclofen ask your doc any doc can prescrib it.
I have the twitching in my fingers, various areas in my hands and in my big toe and arch. I have Multiple Sclerosis too (dont get scared now.. if you have to get a neuro disease its the best one to have)

Good luck. You seem to be searching for the reason and I hope you find it.
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Avatar_n_tn
What kind of sensations did you have in your foot from your L5 S1 disc? I had a left hemilaminectomy in 1990 and a right one in 1995 for that level. Since my last surgery I have trouble with numbness in my right ankle/foot, and usually that foot is cold but at times it flushes hot. My feet bother me a great deal and I've been trying to post a question to the doctor on this forum but it's always filled. If I overdo I will have one foot flushed hot and red with the veins distended and the other cold and white. Also when I overdo my right ankle will get more numb and actually have foot drop where it's hard to lift the ankle and I trip easy. Back exercizes don't make any difference although I still do them every day because it helps my pain, not the numbness and cold/flushing sensations. I was wondering if you still have problems and what helps.
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Avatar_n_tn
I agree with you, if you have to have a neruo desease, that would be one I could deal with.  I actually know several people with MS & you wouldn't know it if they didn't tell you.

I've yet to be diagnosed with anything, but 2 1/2 years ago when all the twitching, numbness, buzzings, etc. started I was freaking out that I had MS and I do mean freaking out.  I read every book on MS in book stores & was on the verge of a nervous breakdown.  Every symptom I read about I ended up getting immediately after reading it (imagine that).

Well, then one doctor mentioned ALS & MS all of a sudden sounded like a walk in the park compared to that.  I'm still concerned about ALS, I really want to watch my kids grow (7 & 4 year olds now) & just enjoy being alive. But the good thing is I'm still strong after 2 years if it were ALS you'd think I'd have some serious stuff going on by now.  If a doctor tells me I have MS he's probably going to think I'm nuts (I probably am) since I'll be pretty happy & shaking his hand.  

How long did it take for you to get properly diagnosed?

Thanks
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Avatar_n_tn
I had numbness & pain that went from my right butt cheek, down into my right hamstring & into the two toes next to my big toe.  I continue to have numbness in my butt, legs & foot when sitting wrong.  I just get up & shake it off.

I also would get cold, white feet & still do.  I warm slippers up in the drier & put them on.  Works great.  I don't know if the cold feet have anything to do with the irritated nerve as with a circulation issue.   They seem to get that way when I'm laying around all day on a Sunday & not very active.

The body sure does alot of weird things.  As long as I'm not in serious pain I can usually deal with it & carry on, business as usual.
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Avatar_n_tn
I was not looking for the MS dx. I went in for pulsatte tinnitus and the ENT ordered an MRI and it came back clean except "you have ms lesions"  That lead to three MS specialists all over my fine State of Florida two of which I went as a Jane Doe and paid cash and just took nameless MRI's cuz I was so nervous for an easy jumper to a DX and it was confirmed MS.  I was one of the lucky ones. I was DX'd before I knew I had it.  It takes a long while for MS to manifest itself. i am on copaxone daily injection treatment and am a poster patient for them.I am doing great. I have never had an MS attack and do have symptoms and mild flair ups a/k/a exaccerbations but they are very mild and I totally recover. My only constant symptoms are short term memory loss, fatigue which I combat with Provigil excellent drug, and  burning sensation in arms accompanied by twitching in arms and feet.  The burning and twitching is brought on when I am over doing it (even in the whimpiest way)  Yes I agree you probably dont have ALS Thank your God and mine.  Again MS is so treatable (not curable) the drugs for the symptoms are great even for those that are older (40+) and were not dx'd properly in their late 20's and did not know how to care for themselves.  The important thing is to listen to your body. Even if you dont have a dx of any sort try to relax, take care of yourself until you know. Anytime you over do it you will cause a problem and for some reason with neuro diseases the CNS goes wacko when it is fatigued.

Good luck to you. I hope you dont have MS cuz why have anything but if you do get a good MS neuro (cleveland clinic) get on treatment and be happy its not anything else that could happen in the brain, brain stem, spinal column cuz everything else stinks

Have a great week :)
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Avatar_n_tn
I had a spinal fusion of L4/L5 and have experienced pain from the sciatic nerve running from the butt to the right side of my foot (right leg)with other symtoms (symptoms) that I won't go in to. While researching about it I learned that it is probably Neurogenic Claudication. I also learned that there is something called Vasular Claudication and some of those symptoms sound similar to yours. I don't know much about the subject but you probably could speak to your doctor about it. Hope this helps, Ezreader.
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