muscle fasciculation (calf)

[ga1687]

I'm a 31 y.o. white male.  Over the past month or so I have began to notice a cramp like feeling in my right calf.  I also noticed fasciculations in the calf over the past 2 or 3 weeks.  No real muscle weakness noticed.  Neuro exam is clear.  Measurement of calves are equal.  No EMG or labs taken.  Doc says most likely benign fasciculations but is a symptom of ALS (which freaks me out a bit).  I workout very hard and I've been under a lot of stress studying over the past 2 months for a national license exam and hope stress and exercise are the cause.  However, nothing has helped the symptoms.  Are ALS sympoms generally weakness and atrophy prior to fasciculations?  I need a little info here.  Thanks.

GA

[BhumikaMD]

Hi,

Try to rule out the following causes of similar symptoms and see if you can reach a diagnosis in your case in consulattion with your doctor -

'The origin of most cases is at present unknown and has therefore been given the title benign fasciculation syndrome.
Lower motor neuron lesions
Werdnig-Hoffman disease
Amyotrophic lateral sclerosis (rare)
Kennedy disease
Organophosphate poisoning
Benzodiazepine withdrawal
Magnesium deficiency (which can be caused by stress)
Multiple Sclerosis
Dehydration
Fatigue
Lyme Disease

Medications
Other risk factors may include the use of anticholinergic drugs over long periods, in particular ethanolamines such as Benadryl, used as an antihistamine and sleep aid, and Dramamine for nausea and motion sickness. Persons with Benign fasciculation syndrome (BFS) may experience paraesthesia shortly after taking such medication; hours later as it wears off (especially upon awaking), fasciculation episodes begin.'

The onset of ALS may be so subtle that the symptoms are frequently overlooked. The earliest symptoms are obvious weakness and/or muscle atrophy. This is followed by twitching, cramping, or stiffness of affected muscles; muscle weakness affecting an arm or a leg; and/or slurred and nasal speech. The twitching, cramping, etc. associated with ALS is a result of the dying muscle, therefore these symptoms without clinical weakness or atrophy of affected muscle is likely not ALS.

You could read more about this at the following link -
http://en.wikipedia.org/wiki/Fasciculation

and

http://en.wikipedia.org/wiki/Amyotrophic_lateral_sclerosis

Let us know if you need any opther information.

Regards.