twitching

[krue]

What other diseases cause twitching that does not stop besides als?

[chochmeh]

lots...check out:
http://neurologyminutiae.blogspot.com/2007/03/als-pearls-als-mimics.html

[chochmeh]

sorry, tried to go to the html that i gave you and couldn't!!! so i pasted and copied info for you...

Thursday, March 08, 2007
ALS pearls-- ALS mimics

spondylitic myelopathy -- limb fibs should go away within six months of fixing spine

inclusion body myositis pearl check finger flexors esp FPL FDP, forearm atrophy and check for absent fascics and symmetry

spinal cord AVM

heavy metal intoxication

lymphoproliferative disorder

multifocal motor neuropathy with conduction block (anti GM1 seen in about half) rsponds to IVIG

vasculitis

motor polyradiculopathy

infectious (polio, WNV)-- EMG shows poor recruitment, then fibs in 4-6 weeks

Bulbospinal mononeuropathy (Kennedy's syndrome) X linked, presents in men with symmetrical weakness, atrophy and fasciculations of bulbar and proximal limb muscles, testicular atrophy and gynecomastia.Occurs early, diagnosed by a CAG repeat, and is associated with a normal lifespan. Consider in males with slow course. Fascics are more pronounced in this disorder, but its all LMN.

Spinal muscular atrophy (Werdnig Hoffman, Kugelberg Welander)-- kids, young and old adults

Progressive lateral sclerosis (UMN variety) is associated with a normal lifespan

Benign fasciculations

cramp fasciculation syndrome-- easily treated with membrane stabilizers

Monomelic atrophy-- focal variant

frontotemporal dementia- identical path finding seen by Neumann ALS spectrun disorder?

Machado Jospeh disease= spinocerebellar atrophy tpe 3. See prominent anterior horn disorder plus ataxia and myelopathy

polyglucosan body disease-- rare UMN and LMN findings plus sensory changes and shite matter changes on MRI, with rare glucosan bodies seen on sural nerve biopsy.

Acid maltase deficiency may mimic PM abnormal respiratory muscles.

Syrinx

true neurologic TOS thoracic outlet syndrome -- shows decreased median CMAP, normal median SNAP, decreased ulnar SNAP, decreased medial antebrachial SNAP; needle shows median > ulnar hand involvement; lower trunk median/radial innervated forearm muscles (FPL, EIP)

myofibrillar myopathy-- = Desmond's myopathy-- mimics IBM. Get quad atrophy, medial gastroc, dysphagia, atrophy of VM/VL but rectus femoris is spared and is normal

[krue]

Thanks, So if you have twitching without muscle weakness or atrophy as I've heard some say it's probably not ALS. Is PLS much slower, worst fasic. I have are in the calves and feet [2 1/2 yrs and it never stops] have little over all endurance and twitching off and on in all other parts of the body, but no weight loss and cpk always normal? No amount of doctors can figure me out. I worked a lot with treated lumber [has arsenic in it] and levels of it did show up in 24 hr urine test, but not high levels, but by then I had done much detox treatments. Anyone have any ideas? Never had any trauma injuries to the head or spine.

[chochmeh]

Cramps and twitching without atrophy could be cramp/fasciculation syndrome, i think there are meds to control the twitches and pain...i have atrophy with cramps and fascics, and my neuro says it's peripheral neuropathy...my doctor put me on cymbalta which used to help the pain, but now, i am needing something more...

[krue]

I don't have cramping, which is another good sign. Doctors are sure then you don't have ALS? And you have pain with the cramping or something else? Havn't found anything that phases the twitching as far as meds. go. Have faint tickles in the face like some one drawing a feather across my face [really maddening]. Later

[chochmeh]

Diagnosing ALS is long drawn-out road...i went to OSU medical clinic and had a specialist in neuromuscular disease perform the test...many things can cause what i have...ALS is rare...and, of course, the longer i am not diagnosed, the better...of course, with all the classic symptoms i am scared...i had my neuro sign me up for physical therapy...if i don't grow muscle back, then i guess we will both know...
kill me or cure me

[krue]

I have been having symptoms for three yrs. or more. Have your cpk levels checked [test for muscle cell death] Get a cloth tape and measure biceps and thighs if over time they stay the same it is a very good sign. ALS is a tough thing to have in the back of your mind, to say the least. If you get foot drop that is a bad sign. Mainly ALS is wait and see. When did you start having problems? I was going to say don't be scared, but that is impossible with ALS lurking in the wings. Hang in there! Talk anytime!

[chochmeh]

My CPKs are fine...i am thinking of having Lyme testing redone as well as heavy metals...they checked for muscle metabolic disorders, auto-immune, diabetes and MS which i do not have...i did not have upper EMG, just lower...which i need to have done, becuase i am having bulbar symptoms now...i have had this with sudden (everything at once) onset...i don't have foot drop or hyperflexia which is good...not upper or lower...last time i went to the neuro he banged on my chin and checked for muscle loss in my hands...i have been measuring calves and ankles