Aa
DOES THIS SOUND LIKE ALS???
During the last 2 years i have been experiencing back ackes muscle cramps and paresthesias...In the last 2 months i noticed fasciculation in buttocks and thighs and then in legs calfs feet belly,left hand :above little finger and next to elbow....i have them in eyes and cheeks.I try to flex my arms when i get them but they dont stop and that is scary...I also feel cramps and stifness in feet and in achilles tendon the fasciculations scare me as it might be ALS...The fasciculations are pulling and pulsating but most of the time i feel only a singular pulsating-pulling..I have also noticed that my left arm wrist area is thinner than the right and the hand has more lines...I havent noticed any profound weeakness as i can lock the door open jars etc...I am a 22 year old female..I know ALS is rare in my age but i also know it does happen..Im going to have an EMG next month to evaluate my leg pain as the doctor suspected a herniated disk was the cause of my back pain..I had mentioned fasciculating but he didnt seem concerned...I didnt mention als but since then fasciculations became more pronounced.I also have soem neck issues the neck of my muscles(near throat) one day were stiff and cramped..I sometimes get the in the same spot in buttocks,calves and feet but also in random places ....Im really scared i know only an EMG will tell me but i would also like to ask your opinion...
Thank you...
(p.s a will also like to add that when i had buttock fasciculation earlier i got up and walked..it stop momentarily but when i stood still i think i felt it a bit more.it cant be bfs because it always stop with movement and occurs when muscle is at rest right?..despite the other symptoms that maybe related to disk herniation i worry about propable atrophy and the non stop fasciculations)
Thank you...
(p.s a will also like to add that when i had buttock fasciculation earlier i got up and walked..it stop momentarily but when i stood still i think i felt it a bit more.it cant be bfs because it always stop with movement and occurs when muscle is at rest right?..despite the other symptoms that maybe related to disk herniation i worry about propable atrophy and the non stop fasciculations)
MEDICAL PROFESSIONAL
Thanks for using the forum. I am happy to address your questions, and my answer will be based on the information you provided here. Please make sure you recognize that this forum is for educational purposes only, and it does not substitute for a formal office visit with a doctor.
Without the ability to examine and obtain a history, I can not tell you what the exact cause of the symptoms is. However I will try to provide you with some useful information.
It must be emphasized that in the majority of cases of muscle twitches are benign meaning that they are of no consequence and are not resulting from a serious cause. In such cases, the twitches may be related to anxiety/stress, caffeine, and often occur after recent strenuous activity or muscle over-use. It is important in such cases to reduce stress/anxiety levels and to reduce caffeine intake. Tremors of the hands can be physiological that is exacerbated by stress/anxiety and caffeine.
Benign fasciculation syndrome (BFS) is a condition in which there are involuntary twitches of various muscle groups, most commonly the legs but also the face, arms, eyes, and tongue. If the diagnosis is confirmed and other causes are excluded, it can be safely said that the likelihood of progression or occurrence of a serious neurologic condition is low.
When BFS is present but not particularly bothersome or disabling, treatment is not necessary. If severe and it requires treatment, there are a few medication options though this condition is not very common, and the research that has been done on its treatment is limited. Minimizing caffeine and stress, and treating anxiety if it is present, will improve symptoms.
In regards to ALS, when fasciculations occur in the setting of associated symptoms such as progressive loss of sensation, tingling or numbness, weakness, trouble swallowing and other symptoms, the cause may be due to a peripheral nervous system problem. In general the symptoms would not be episodic and triggered by certain things but would be more constant/frequent without consistent triggers. The location of the problem could be the anterior horn cells, the area where the nerves that supply motor innervation to our body comes from. These are the cells that give off the nerves that allow us to voluntarily contract our muscles. The diseases that might affect the anterior horn cells include ALS (also called Lou Gherig's disease), a condition called spinal muscular atrophy, polio-like viruses, west nile virus, and other infections.
Another nervous system problem, neuropathy, may also lead to fasciculations. There will again be associated weakness or sensory changes. Metabolic abnormalities, such as with calcium, can cause muscle twitches. Also, thyroid disorders may lead to twitches as well.
Lastly, these symptoms may reflect emotional/psychiatric problems related to stress (what is called somatization disorder). The latter is a true medical condition whereby instead of a patient experiencing depression or anxiety, they experience physical symptoms, and once the stress is addressed, the symptoms resolve.
I agree that you should continue following up with your physicians. It is difficult to provide much information without the ability to exam you. If you continue to worry about this, you should have an EMG/NCS if agreed upon by your physicians. Also, routine blood work also including a TSH (for thyroid) would be helpful.
Thank you for this opportunity to answer your questions, I hope you find the information I have provided useful, good luck.
Without the ability to examine and obtain a history, I can not tell you what the exact cause of the symptoms is. However I will try to provide you with some useful information.
It must be emphasized that in the majority of cases of muscle twitches are benign meaning that they are of no consequence and are not resulting from a serious cause. In such cases, the twitches may be related to anxiety/stress, caffeine, and often occur after recent strenuous activity or muscle over-use. It is important in such cases to reduce stress/anxiety levels and to reduce caffeine intake. Tremors of the hands can be physiological that is exacerbated by stress/anxiety and caffeine.
Benign fasciculation syndrome (BFS) is a condition in which there are involuntary twitches of various muscle groups, most commonly the legs but also the face, arms, eyes, and tongue. If the diagnosis is confirmed and other causes are excluded, it can be safely said that the likelihood of progression or occurrence of a serious neurologic condition is low.
When BFS is present but not particularly bothersome or disabling, treatment is not necessary. If severe and it requires treatment, there are a few medication options though this condition is not very common, and the research that has been done on its treatment is limited. Minimizing caffeine and stress, and treating anxiety if it is present, will improve symptoms.
In regards to ALS, when fasciculations occur in the setting of associated symptoms such as progressive loss of sensation, tingling or numbness, weakness, trouble swallowing and other symptoms, the cause may be due to a peripheral nervous system problem. In general the symptoms would not be episodic and triggered by certain things but would be more constant/frequent without consistent triggers. The location of the problem could be the anterior horn cells, the area where the nerves that supply motor innervation to our body comes from. These are the cells that give off the nerves that allow us to voluntarily contract our muscles. The diseases that might affect the anterior horn cells include ALS (also called Lou Gherig's disease), a condition called spinal muscular atrophy, polio-like viruses, west nile virus, and other infections.
Another nervous system problem, neuropathy, may also lead to fasciculations. There will again be associated weakness or sensory changes. Metabolic abnormalities, such as with calcium, can cause muscle twitches. Also, thyroid disorders may lead to twitches as well.
Lastly, these symptoms may reflect emotional/psychiatric problems related to stress (what is called somatization disorder). The latter is a true medical condition whereby instead of a patient experiencing depression or anxiety, they experience physical symptoms, and once the stress is addressed, the symptoms resolve.
I agree that you should continue following up with your physicians. It is difficult to provide much information without the ability to exam you. If you continue to worry about this, you should have an EMG/NCS if agreed upon by your physicians. Also, routine blood work also including a TSH (for thyroid) would be helpful.
Thank you for this opportunity to answer your questions, I hope you find the information I have provided useful, good luck.
another think sorry for posting too much i hope you can still answer..i know it is impossible to tell from a photo but does this picture of my left hand looks atrophies to you???theres a dent and it is wrinkled
here is a picture of my left hand
http://www.medhelp.org/user_photos/show/159852?personal_page_id=1739121
and another one
http://www.medhelp.org/user_photos/show/159851
and also my left hand to compare
http://www.medhelp.org/user_photos/show/159850
sorry for posting too much im just trying to make the whole picture as clear as possible...Thank you...
here is a picture of my left hand
http://www.medhelp.org/user_photos/show/159852?personal_page_id=1739121
and another one
http://www.medhelp.org/user_photos/show/159851
and also my left hand to compare
http://www.medhelp.org/user_photos/show/159850
sorry for posting too much im just trying to make the whole picture as clear as possible...Thank you...
Oh and another thing..i forgot to mention maybe helpfull
a month ago i went to a neurologist who just did a neurological exam and reffered me to another one in the institute of neurology..she wrote on her report ''no objective findings'' ..then i went to another neuro ..First i got examined by a lady who also wrote down my symptoms etc...then the doctor came...he examined me and i think my knee reflexes were kind of exaggerated ...because the knee went in a 60 angle..i dont knoe whether that is normal....I didnt ask but i looked worried and the lady said mine are worse...Anyway the doctor didnt say anything....He just said ok we will do an EMG AND NVC before we do an MRI....He said ''i think there isnothing to worry''..I think he was kind of reluctant maybe he just said it to ease my worries..He didnt say tho if my exam was normal and stupid me i didnt ask...
sorry for my mumbling...i know you cant dx me but i would appreciate any info...
a month ago i went to a neurologist who just did a neurological exam and reffered me to another one in the institute of neurology..she wrote on her report ''no objective findings'' ..then i went to another neuro ..First i got examined by a lady who also wrote down my symptoms etc...then the doctor came...he examined me and i think my knee reflexes were kind of exaggerated ...because the knee went in a 60 angle..i dont knoe whether that is normal....I didnt ask but i looked worried and the lady said mine are worse...Anyway the doctor didnt say anything....He just said ok we will do an EMG AND NVC before we do an MRI....He said ''i think there isnothing to worry''..I think he was kind of reluctant maybe he just said it to ease my worries..He didnt say tho if my exam was normal and stupid me i didnt ask...
sorry for my mumbling...i know you cant dx me but i would appreciate any info...
i would al;so like to add tha once i had a back fasciculation and an arm one at the same time (left arm left side of back)
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