Neck Fasciculations

[trish23]

I am a 42 year old female who has been experiencing fasciculations at the back of my neck(right side)for almost 2 years.  They have only recently become more pronouned.  I have had an MRI which indicated a protruding disc at C5/C6.  No other tests have been performed to date.  I had an appt. with a neurosurgeon last week who said he did not feel the disc was causing the fasciculations.  I realize I don't have much info but could you give me some idea as to what might be causing the fasciculations?  I am not in any pain, just some occasional soreness in the neck.

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

The differential diagnosis of fasciculations includes Lou Gehrig's disease (you don't report any progressive weakness, difficulty swallowing, or ominous symptoms), polio (same type of thing and rare in the U.S. at this time), thyroid problems (would be more generalized rather than focused on your neck), benign fasciculation syndrome (same explanation)and chronic root compression which could be a cause. The protruding disc could be pushing on a root and not the spinal cord which is more difficult to appreciate on the MRI. But the lack of pain makes this less likely. Keep in mind, the neurosurgeon has had the luxury of personally reviewing your films unlike me. Consider taking your films to see a neurologist, get a full exam, and an EMG to see if there is really something going on back there. Best of luck.

[Bovard]

I think you answered the question but can you please clarify anyway. Could muscle fasciculations continue for as long as 2 years without the presentation of other ALS symptoms appearing much earlier?  Maybe another way to ask the question is could someone have focal muscle fasciculations for two years and still develop other ALS symptoms after such a long time?  I thought that once ALS symptoms begin, the disease progresses fairly rapidly.  Thanks.

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

ALS is a slow chronic progressive destruction of the motor cells in the spinal cord with a mean duration of 4-6 years from onset. Fasciculations are an early sign in many patients and are usually followed by clinical weakness. In many patients, you would expect to see something else besides fascics in a matter of 2 years, but nothing in medicine is 100%.

Your question in the comments(as well as those of others on the website) are thoughtful and important especially to people who have the symptoms. Unfortunately, because of time constraints and different screen-setup I don't always get a chance to see any comments, just the initial questions. So please try to ask them as an official question if you can get through, otherwise I may miss them.