fasiculations and other symptoms

I have posted before in July about fasiculations.  I appreciate your comments.  My husband has been to nuero now and has had another MRI this time of his low back.  He does have pain in his low back that occasionally is shooting and short in frequency.  To refresh you, he went to the dr initially for fasiculations that started in his left shoulder and weakness in both shoulders, fatigue, and a general feeling of ill health.  He does not routinely go to dr's nor complain, so I knew he did not feel well.  The cervical MRI shows spondylosis, rather severe for 52.  He has reduced his caffeine intake and still has fasiculations which are more widespread and diffuse.  The neuro, kept saying the degree of spondylosis was what was causing his pain...my husband has no pain in his shoulders, only his low back, thus the 2nd MRI was ordered.  He continues to have great weakness, the emg and ncs were abnormal but I am not sure in what regards.  The neuro is convinced that he should be in lots of pain.  He has also ordered ANA, CPK, T4, CBC with diff, and sed rate.  I am concerned about ALS.  What is your opinoin from these vague symptoms.  He has been in very good health and is not overweight.  He has enough fatigue that he does not want to play golf or hunt like he used to, and after a day at his office, he is in bed by 8 for the night.  Any other tests that we should wait for,,,or ask for if they are not ordered...?  Thank you..

[CCF Neuro[P] MD, RPS]

Dear Elaine:

ALS does not give a patient pain, so I would not think he has ALS.  Muscle weakness, fatigue, cramping, without sensory changes, an abnormal EMG that shows positive sharp waves, fasciculations and maybe fibrillations are the hallmark of ALS, so I would think that your neurologist based on his/her exam and EMG would have given your father the diagnosis of ALS.  The symptoms are too vague without doing the neurological examination and seeing the lab results to give you somesort of diagnosis over the internet.  Many patients with spinal problems have fasciculations, fatigue, pain, weakness etc.  Most of the time there are other reasons for the spinal problems, such as arthritis, lupus, diabetes, etc that compound the spinal problem and give vague symptoms.  Give your father's neurologist a chance to view the labs, follow the neurological exam, and see if a good diagnosis doesn't follow.  I hope that it is something simple and fixable.

Sincerely,

CCF Neuro MD

[One year]

I have been twitching for 14 months without any other symptoms (maye be sensory ones of creepy crawliness and tingling here and there)....after 2 normal neuro exams - one after 4 months of fasc. and one after 7 months of fasci... would you rule out ALS as a possibility? I woudl think weakness would have shown up long ago.

[C Joe]

SJF,

You should not worry about your ailments.  I think you answered your own question.  If you look for posts around this forum, very credible, you will find that your situation most likely suggests a benign condition.  The worry will affect you much more than your twiches will!  

Take care,  

Joe