Cramps

I have been seeing a neurologist now for approximately 3 months.  I noticed twitching and cramps started 8 months ago.

My neurologist has said that it appears to be "benign fasciculations", and that it should not be progressive.

The last month my cramps have kicked into overdrive.  They aren't debilitating, but I noticed that where my leg tendons meet my pelvis that when stretched slightly will start to cramp, and my back when stretched slightly to one side or the other will have a tendency to cramp.   In fact, these tendons/muscles all seem to have gotten much stiffer in the last month.

Also, when I sneeze, my stomach will rumble with rippling twitches for about 3-4 seconds afterwards.

Other than this, I have what seems as though my calf muscles are enlarged and I have brisk reflexes.  This was pointed out by several doctors.  Does this mean I have both lower and upper motor neuron symptoms and could be showing early signs of ALS?

Thank you

[CCF-Neuro-M.D.-JT]

Without seeing you personally, I can't make an accurate diagnostic opinion. It's not uncommon for younger people (30s or younger) to have generally brisk reflexes.  The question is, how brisk is brisk? ALso, muslce weakness and wasting (which is well known to be a part of ALS) was not mentioned in your post. Hopefully, it will just turn out to be something that isn't serious like benign fasciculation syndrome. But if everything is getting worse or prominent you should consider getting an EMG for further evaluation. Routine lab work should also be done to look at thyroid, muscle proteins like CK and aldolase, and electrolytes. In the meantime, over the counter magnesium supplements in recommended doses as well as soda water *which contains quinine, a substance that may have cardiac side effects when taken as a pill in predisposed individuals, but is ok in the amount of soda water* can be helpful for symptomatic relief.  Good luck

[joe2]

Also, I had an EMG with normal readings done by my neurologist.  Normal blood tests as well.   He says my EMG showed twitches, but they looked normal (benign?).

[David_M_M]

Joe -

The EMG signature of ALS fasciculations has a different frequency range than "benign" fasciculations, so your neurologist would know what to look in the EMG. You might stop by the nearest university with a medical school and get a copy of this article:

LONG-TERM FOLLOW-UP OF 121 PATIENTS WITH BENIGN FASCICULATIONS
BLEXRUD MD, WINDEBANK AJ, DAUBE JR
ANNALS OF NEUROLOGY
34 (4): 622-625 OCT 1993

Dave