EMG and throat questions...........

[kaytee]

I am a 32 year old female with thump like fasiculations that have been present for approximately 1 1/2 months.  I experienced pain and cramping/spasms prior to the on set of twitching.  This all began with fatigue and tingling/numbness in my arms,wrists and lower legs. The twitching started in the calves of both legs and soon spread all over at random. I have recently began having throat irriation and soreness. I did see a Neurologist who did an MRI of head and neck (since I had been in a car accident in Oct98), an NCV, an EMG of my left arm and a Spinal Tap.  All tests came back fine.  My concern is that the EMG was done 2 1/2 weeks before the thump like twitches began.  My Neurologist explained that the EMG would have still found a problem even though the twitching began after the fact.  He said that by the time a person twitches with ALS they have had the disease for some time and the denervation would be there.

My questions are:

Would an EMG done 2 1/2 weeks prior to twitching find a problem such as ALS?

Is it true that ALS twitches are different then benign twitches?  Mine are thumps like twitches usually singular or just a couple at a time.

My throat feels irritated and sore. When my doctor pushed on my throat muscles they were very tender and it was painful.  The doctor said it was not a sore throat such as a cold, that it was muscular in origin.  I get a twitch in my throat muscle every now and then.  My tongue is sore at the tip.  

Would the throat problems I am having be indicative of ALS or any other Neurological disorders?  How does ALS present itself with Bulbar symptoms?

I read something on the internet about an anxiety induced throat irritation, is there such a thing?

Finally, my Neurologist saw no reason for a follow up visit or EMG.  He feels that my symptoms are benign.  Can benign fasiculation syndrome involve all of these symptoms and does anyone know the cause of BFS?


Thanks so much for your time,
This service is wonderful!

Kaytee

[CCF neuro MD MM]

Subclinical manifeatations of ALS, that is changes on the EMG would have been present 3 weeks before the onset of clinical symptoms so the neurologists reassurance on the EMG fingings is correct.
Clinically ALS twitches are not individually different from benign twitches.
ALS is a purely motor disease , it does not present with pain in the trhoat or anywhere else.
Bulbar ALS present with difficulty speaking and swallowing, which progresses.
Anxiety can produce subjective throat irritation, the condition is sometimes called " globus hystericus ".
You throat problems do not suggest bulbar ALS or any other neurological disease to me.
Benign fasiculation would not cause your throat symptoms, just random fasiculations.
The underlying cause is not known although it may involve instability of channels in the cell membrances which allow salts to enter and leave muscle cells.

[L.]

Are there any MD's who specialize in ALS in the Balto. Washington area that you might recommend?

[kaytee]

Thank you for the quick and thorough response.  This is by far the best site for this type of service.

Keep up the great work!

Kaytee