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Neurology (Expert Forum)
Scared of ALS
Answered by
Joanna Fong, MD - Stroke/NICU, multiple sclerosis, sleep, EEG, General Neurology
Cleveland Clinic
Cleveland - OH
This forum is for questions and support regarding neurology issues such as: Alzheimer's Disease, ALS, Autism, Brain Cancer, Cerebral Palsy, Chronic Pain, Epilepsy, Fibromyalgia, Headaches, MS, Neuralgia, Neuropathy, Parkinson's Disease, RSD, Sleep Disorders, Stroke, Traumatic Brain Injury
Scared of ALS
by stategirl, Dec 13, 2007 09:06AM
Okay, I have been twitching widespread now for about 3 months. I had a normal EMG only 2 weeks into the twitching, that I feel was too early to pick anything up. No true weakness or atrophy, I don't think. But recently I have had a twitch in my hand (between my thumb and index finger) that has gone on for over 3 weeks. It usually comes an goes over a couple of days, but this time it has been nonstop since Saturday (five days ago). Is this worriesome?? Please help! Also, I am a 29 year old female, no family history of ALS. I also get very fatigued quickly. Thank you for your help!
Doctor's Answer
by Joanna Fong, MD, Dec 20, 2007 04:17PM
, Dec 20, 2007 04:17PM
To: stategirl
Hi stategirl,
ALS is also known as Lou Gehrig's disease. It's a disease of degeneration of both upper and lower motor neurons manifest by lower motor neuron signs (weakness, wasting, fasciculation) and upper motor neuron signs (hyperactive tendon reflexes, Hoffmann's sign, Babinski sign, clonus). Its prevalence if about 5 in 100,000 in population. It has increased frequency after age 40; 10% begin before age 40; 5% before age 30.
Clinical features of ALS:
Onset symptoms: weak legs (footdrop), hands (painless difficulty with buttons), proximal arms, slurred speech, dysarthria, dysphagia; spastic gait disorder. Ultimately all skeletal muscle affected except sphincters (bladder and bowel control), eye movement.
Course of disease: progressive, no remissions, relapses.
Diagnostic testings:
-EMG, neurological examination (requires to see both upper and lower motor neuron signs).
From the description of your symptoms listed above, gross twitching is not a typical signs of ALS. However, fasciculations is part of the lower motor neuron signs; they are small muscle twitching underneath the skin, frequently described as "moving snake underneath the skin". You can see fasciculations in any muscle groups, including the tongue.
You may want to have your neurologist to recheck EMG to see if there is any changes in the exam, as you have progression or persistent of symptoms.
Another possible diagnosis of your "twitching":
- seizure (diagnostic testing: EEG)
- stress
- muscle fatigue
Good luck. Thanks for using MedHelp Forum.
THIS INFORMATION IS PROVIDED FOR GENERAL MEDICAL EDUCATION PURPOSE ONLY. PLEASE CONTACT YOU PHYSICIAN FOR DIAGNOSTIC AND TREATMENT OPTIONS OF YOUR SPECIFIC MEDICAL CONDITIONS.
ALS is also known as Lou Gehrig's disease. It's a disease of degeneration of both upper and lower motor neurons manifest by lower motor neuron signs (weakness, wasting, fasciculation) and upper motor neuron signs (hyperactive tendon reflexes, Hoffmann's sign, Babinski sign, clonus). Its prevalence if about 5 in 100,000 in population. It has increased frequency after age 40; 10% begin before age 40; 5% before age 30.
Clinical features of ALS:
Onset symptoms: weak legs (footdrop), hands (painless difficulty with buttons), proximal arms, slurred speech, dysarthria, dysphagia; spastic gait disorder. Ultimately all skeletal muscle affected except sphincters (bladder and bowel control), eye movement.
Course of disease: progressive, no remissions, relapses.
Diagnostic testings:
-EMG, neurological examination (requires to see both upper and lower motor neuron signs).
From the description of your symptoms listed above, gross twitching is not a typical signs of ALS. However, fasciculations is part of the lower motor neuron signs; they are small muscle twitching underneath the skin, frequently described as "moving snake underneath the skin". You can see fasciculations in any muscle groups, including the tongue.
You may want to have your neurologist to recheck EMG to see if there is any changes in the exam, as you have progression or persistent of symptoms.
Another possible diagnosis of your "twitching":
- seizure (diagnostic testing: EEG)
- stress
- muscle fatigue
Good luck. Thanks for using MedHelp Forum.
THIS INFORMATION IS PROVIDED FOR GENERAL MEDICAL EDUCATION PURPOSE ONLY. PLEASE CONTACT YOU PHYSICIAN FOR DIAGNOSTIC AND TREATMENT OPTIONS OF YOUR SPECIFIC MEDICAL CONDITIONS.
