Re: twitches and muscle discomfort

Posted By CCF Neurology MD:NT on December 08, 1998 at 01:05:20:

In Reply to: twitches and muscle discomfort posted by ian on December 07, 1998 at 18:41:07:






About 5 months ago I experienced twitching in 1 thigh for 24 hours or so.  The next event was 3 months later when my right eyelid started twitching along with my upper right arm.  The twitching then developed further, quite rapidly in my opinion over the next 4 weeks to encompass my whole body - legs, arms, feet, face, back, stomach and neck.  At the time the twitches were the only symptoms.  However, gradually the muscles in my upper legs and arms started to feel uncomfortable(mild pain) but without any signs of weakness.  Therefore, I consulted an experienced neuro and had a full neuro exam followed by an EMG.  From the clinical exam, the neuro felt it likely that I had suffered minor neck injury in the past as the reflexes in my right arm were difficult to get and that there was a 30% chance that I had disc disease, otherwise everything was normal.  The EMG was also normal apart from a slightly higher than normal amount of polyphasic responses (it was conducted by a neuro physiologist with 15 years experience).  The neuro put the whole thing down to being post-viral and said that I might not feel properly better until mid-2000.  My concern is that 2 weeks later, my muscles (across neck, quadriceps, biceps, triceps and behind both knees) feel as though they are getting worse not better.  Although I dont have any weakness I am still twitching somewhere every few minutes and dont feel as though I could run very far due to muscle discomfort although I have not tried.  Please can you help as I am beside myself with worry about ALS etc.




Dear Ian:
I invite you to search the archives of this forum for the numerous answers related to fasciculations and ALS. As a general rule, ALS almost always has abnormal findings on examination (weakness, atrophy, or upper motor neuron signs) when the presenting symptom is fasciculations. A normal exam in almost all cases rules out ALS, and this conclusion is further confirmed with a normal EMG.
It is relatively unlikely that you have ALS. If your symptoms, however, are progressing, I think it is very appropriate that you return to your neurologist for a re-evaluation, and even seek a second neurological opinion from a major academic center. Another EMG test may also not be out of place.
Good luck!