Well, other than ALS there are many conditions which can cause internal tremors with thumb twitching. Tremors are often associated with drugs, alcohol, smoking, lack of sleep, poor sleep patterns, stress and fatigue. They can be seen in peripheral neuropathies of diabetes, in hyperthyroidism, parasomnia, multiple sclerosis, TIAs or transient ischemic attacks or mini strokes, hypoglycemia, disorders of calcium metabolism, hyperparathyroidism etc. Certain epilepsies too could be the cause. I would suggest you get the blood levels of the following checked if they have not already been checked: potassium, calcium, sodium, magnesium, vitamin B complex, or vitamins B1, B3, or B6 and Vitamin D. Get your kidney function, parathyroid gland function and adrenal function tests done because these affect the electrolyte balance in the body. Stress, alcohol, caffeine and fatigue all cause similar symptoms. Hence if you take alcohol or coffee then cut this down. Sleep at regular hours and see if it helps. Certain sleep disorders and peripheral nerve disorders due to diabetes, Lyme's, lupus or hypothyroidism can also be the cause. Please discuss these possibilities with your treating doctor. You will need blood sugar monitoring, MRI of brain and cervical spine, T3, T4, TSH, sleep studies, serum electrolytes, brain EEG, etc to reach a diagnosis. Since you have hyperglycemia, in all probability, your symptoms are due to diabetes. Hope this helps. Take care!
The medical advice given should not be considered a substitute for medical care provided by a doctor who can examine you. The advice may not be completely correct for you as the doctor cannot examine you and does not know your complete medical history. Hence this reply to your post should only be considered as a guiding line and you must consult your doctor at the earliest for your medical problem.
obrigado doutor por responder minha pergunta, eu to muito preocupado com als,eu não tenho fraqueza nem atrofia,mas tenho fasciculaçoes pele o corpo,ultimamente tenho tendo fasciculação no musculo thenar do polegar, que chegar a contrair e travar o polegar,a diabetes mal controlada pode dar espamos pelo corpo
Thank you doctor for answering my question, I'm very concerned about als, I have no weakness or atrophy, fasciculations but I skin the body, lately I've been having fasciculation in thenar muscle of thumb, you get the contract and lock the thumb, diabetes poorly spasms can give controlled by the body.