Re: Twitching Question

Posted By CCF MD mdf on November 29, 1998 at 23:15:48:

In Reply to: Twitching Question posted by Suzette on November 29, 1998 at 20:16:56:






I have been twitching in my legs for almost 4 months. I have read here that this could be a sign of ALS. I have no noticible weakness. My question is, how soon after twitching begins would one see significant weakness in that muscle? Could stress be causing these?? Thank you.
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Twitching may be one of several phenomena. Usually, though, people notice twitching of just a part of a muscle without force-generating contraction of the entire muscle. That is, the limb doesn't move about the joint, and the twitches are painless. Often, the twitching muscles can be seen on the surface of the skin and appear to be like a bag of worms.
If that matches your twitches, then you are observing fasciculations. These may be a result of damage to the nerve or motor neuron, but also may be benign. There is a well-described syndrome of benign fasciculations, which imply absolutely no damage to the nervous system.
Of course, fasciculations can also appear in neuropathy (affecting just one nerve, as in a compression injury, or affecting a group of nerves) or in radiculopathy (pinched nerve root as it's exiting the spine) or in motor neuron disease (the prototype is ALS).
But don't jump to ALS at the first sign of fasciculations. There are definite criteria for the diagnosis of ALS, involving clinical signs and symptoms as well as systematic diagnostic EMG and nerve conduction studies.
The way to get peace of mind is to see an experienced neurologist. You may wish in fact to see a neuromuscular specialist, one who has seen enough people with ALS to know what it looks like and what it doesn't.
You are welcome to call 800 223-2273 and ask for neurology appointments at 4-5559. Tell them you want to see a neuromuscular specialist.
I hope this helps. As you know, this forum can't substitute for medical advice given from your doctor after appropriate evaluation. CCF MD mdf.