Worried about ALS, twitching

[Onemore]

Hi. I write from Spain. Sorry for my bad english.

From some years I have been experiencing twitching in diferent areas of my body. Six months ago i noticed fatigue in my right arm, and pain in my right arm and my shoulder. I went to a neuro that, after making usual test, walking, touch nose, etc, told me that he thinks all was related to stress. He didn't think that a EMG was neccesary.

The pain continued, so I went to a traumatologyst. He ordered an cervical MRI that show important foraminal narrowing in right side of C3-C4 due to arthrosis and osteophites, and mild foraminal narrowing in both sides of C6-C7 due to osteophites.

He thinks that my problem can't be caused for this, so he thinks too that it is related to stress.

I went to a phisio that told me that my right arm (biceps) was with less muscular mass than the left, but he thinks that it is related to a non use of this arm due to the pain. After that, i went to the gym to test my biceps. If I take 20 pounds with left arm, i can lift it aprox. 20 times. When I use right arm I can only lift it 17 times.

But lately, I have observed a change in the twitching. It only last for a second of two, once in an hour or in two hours, but only in my right arm (sometimes in triceps, sometimes in elbow, sometimes in forearm), but mainly in the triceps. Other times only stayed in a place for two or three days, but this twitching in the arm I am now coming for my 5th week.

Besides this twitching there are a few in other part of my body, but less frecuent.

Do you think I have to worry about ALS?

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

First of all, keep in mind that I am unable to diagnose you because I am unable to examine you, this forum is for educational purposes. The symptoms that you describe, pain in the shoulder/arm, weakness in the arm and muscle twitches are non-specific and could represent several disorders.  ALS is often difficult to diagnose, because the presenting symptoms can be found in other disorders.  It is typical for ALS to present with hand atrophy/incoordination, and foot weakness/often as a foot drop.  There may also be twitches (fasiculations) and painful cramps/stiffness.  
   That being said, it is uncommon for ALS to present with pain that is not related to cramps and stiffness.  Other diagnoses that may be considered include neuralgic amyotrophy (immune related disorder), radiculopathy(nerve root compression), and CIDP (chronic inflammatory demyelinating polyneuropathy).  The twitches that you describe, are not specific for ALS, but are often seen in a benign syndrome, due to electrolyte imbalance, or after a viral infection.
   I would recommend that you get an EMG to evaluate for the above diagnoses.  Also ask your neurologist if there is any sign of atrophy in your hands.  I would recommned a neurologist that has expertise in the ALS/neuromuscular disease (EMG is subjective, and should be done by an expert).
   I hope this has been helpful.

[johnflox]

Have you taken any medicine up to one and a half years prior to the onset of your symptoms?
There are many drugs that cause the symptoms that you describe and you should rule out first that you are not suffering a toxic effect of a drug.

Many of those drugs cause the symptoms normally 6 months after taking them, but it is not uncommon that the symptoms appear in force up to 18 months after discontinuing the treatment.

So, there is no wonder that almost all patients start years of search for a solution, without knowing the real cause behind their health problems.

Just as an example, fluoroquinolone antibiotics (ciprofloxacin, marketed in Spain as Baycip and with more names, levaquin, floxin, tequin) cause permanent and irreversible neuropathies in severe cases, and very systemic neuropathies that mimick Lyme, Multiple Sclerosis, Gulf War Syndrome, Sjögren`s, Reactive Arthritis and others.

Other medicines with similar toxic profiles are those taken for rheumatic conditions, cancer treatments, and others.

Suerte y le deseo que sus molestias curen pronto y no se trate de una reacción tóxica.

[Onemore]

Thx for your answer.
The thing that scares me is that those new twitching in my right arm are completely diferent from others I had in the past.

First, others had last for two or three days, and the ones in the arm has no end.

And the fact that are in my right arm scares me more... because even the doctors didn't found me clinical weakness, i have muscular pain, and feel it sore after a little exercise.

[Onemore]

Thank you for your post.

I can´t remember taking any pills. Only last september i had a flu vaccine. Is the only medicine i can remember.

[Onemore]

I forgot to tell:

After the phisio told me about less muscular mass in my arm, I started to use it more (I have a little baby that I used to carry with my left arm) and I think i improved in muscular mass in my right biceps.

A patient with ALS can improve in muscular mass?

[mike1105]

you may have something as simple as myofascial issues with trigger points, which can cause ALL the symptoms you describe, especially the soreness, stiffness and pain. I would suggest purchasing a book by Clair Davies on trigger point release. At the same time, you'll need to learn how to properly stretch associated muscles. For instance, the scalene muscles in the neck, if tight and shortened, can cause weird symptoms of pain, numbness and twiches in the shoulder all the way down the arm and even into the hand.....

[Onemore]

Thank you for your advise.

I will try to find this book.

[Onemore]

Thank you

[agabriel]

I have been having all over body twitching for four months.  I don't know if it's twitching actually because everyone describes it differently.  But I get tics and fluttering if that makes any sense.  I also get muscle spasms in my arms upon awakening in the morning.  But this only occurs about once a month.  Does anyone think this is my anxiety that's out of control, or do you think it may be ALS?

[momofana]

Hello, I am 30 year old female.  My twitching started about 5 weeks ago.  My twitches are widespread and are barely noticable some days and others days twitch all day long.  My get them in my feet at night also.  I have also noticed some muscle pain in my right thigh and right bicep this past week. I have two small children and am scared to think about have something serious like als.  Please anyone give some advice, or if anyone has the same symptoms and fears please email at ***@**** so we can get our frustrations out.

[Ms.Divvie]

i wanted to get into this chat .I am under a lot of stress.. i have 3 kids- inlaws- an a husband who recently cheated on me .  
  That stated . I am over weight . but no real bad health problems ... other then being treated for stress and depression ..  and menstral problems ... female type stuff !
Last spring my Eye began twitching .. off an on . then my upper right arm .. recently my left thumb and fore finger started as well... but these things do not twitch all the time ..
could this be the same thing everyone is talking about ?

[DET]

I have had multiple twitches as well all over.  The most recent is thumb twitching and fore finger as described by Ms.Divvie.  If possible please describe your twitching Ms Divvie.

[cros12]

Alright, I am severly freaked out here. I have had twitches in my muscles for a few years but very infrequently. They are usually contained to the calf or eye lid. A few weeks ago they started everywhere. I have been seeing a chiropractor and a few weeks after the first visit I started getting a tingling sensation in the heel of one of my feet (not sure if connected to chiropractor). I have also been (past 2 days) experiencing muscle fatigue in my arms. Now, the twitches have subsided a bit and the tingling in my foot is gone, but the fatigue in the muscles remain. I also feel like I am not holding onto things as well as I used to but I am unsure. My fear is that these are the developing signs of ALS. I have been told by my chiro and regular doc that this is not the case, but I cannot shake it. Any help here would be appreciated. Also, I am under an intense amount of stress right now since I work full time, attend school full time, found out my home owners insurance is dropping me, and I am now selling my house.

[kidcoconut]

Hey, how did you guys make out? Still twitching? Any confirmed diagnosis. I've got it in both arms, tight shoulders, ( which I've always had ), and get really bad after even a light shoulder or arm workout. The Chiro  thinks it's in my neck and is working on. ( pinched nerve of some sort. ) He's also working on a rotator cuff problem with ultra-sound. would be curious how you guys made out, any imporvement or worse?

thanks !

Kid