Neurology Forum
This expert forum is not accepting new questions. Please post your question in one of our medical support communities.
Avatar universal

Generalized Twitches, Stiff Muscles and Cramps in Left Hand

Thank you for considering my question.

I've been having generalized muscle twitches and stiffness in my right calf and left arm (since mid 2001, age 29).  I perceived this stiffness as weakness, and finally saw a neuro towards the end of 2002 (lots of anxiety due to the wait due to ALS concerns).

He ran NCV, EMG, reflexes, blood work, etc.  All were normal.  He insisted everything was fine.  I even saw another Neuro who did another examination (but no EMG) and he said I was fine.  The twitches continued, but I never "progressed" over the next year, so I finally dropped the possible-ALS ideal.  

Unfortunately, the past month or so, I have been getting a strange "cramp" and massive twitches in the muscle between my thumb and forefinger on left hand.  I also notice a stiffness in my fingers, and grabbing things with that hand doesnt feel right.  Typing causes the hand to go into a semicramp with visible twitches.  Generalized body twitches continue.

I went back to my neuro a few days ago, and he tested my strength and reflexes (most of body and affected hand), and says everything looks great - but did no EMG.  However, he had a concerned look on his face and stated "this is something we need to watch - see me in 3 months".  

I am now anxious about ALS again.  The EMG in 2002 was 'normal'.  My current neuro examination was 'normal'.  Are the odds still low on ALS?  
11 Responses
Avatar universal
First of all, keep in mind that I am unable to diagnose you because I am unable to examine you, this forum is for educational purposes.    
   Fasiculations (tiny muscle twitches) are a frequent cause of anxiety.  Most fasciculations are not associated with ALS.  Fasiculations often start after a viral infection, with exercise, in normal people, and in electrolyte disturbances. Fasiculations are also associated with some muscle diseases (myopathies) and in motor neuron disease (ALS).  They are not an "early sign" of the disease and are generally associated with weakness and atrophy in ALS.  From your description I do not suspect that you have ALS.  I do think your symptoms should be taken seriously, and a thorough exam for weakness and atrophy should be conducted, in addition to a repeat EMG.  Keep in mind that anxiety will increase your awareness of each twitch.  I would also suggest a comprehensive electrolyte testing and CPK, aldolase (muscle enzymes).
I hope this has been helpful.
Avatar universal
Some people appear to be able to post a question even when they say the limit has been reached.  I don't understand this.  I have been trying to post for 4 months.
Avatar universal
Hi Aub,

It's not easy to post here, but also it's not impossible.

They usually allow 2 new questions per day, unless there are a lot of non answered questions (what has been the case lately).

Usually the "open" space for a new question during the morning. I'd suggest you to have your question already typed, read to go. Open the website and keep trying to post (would say every 10-15 minute).

You might have to try for a couple of days.

Good luck!
Avatar universal
it sounds to me like you need to stretch your hand muscles. i had the same type of cramping where the thumb gets "locked" under my index finger. strecth your thumb palm muscle by bbending your thumb backwards and see if it helpe. do it for a few weeks, 4-5 times a day. hold the thumb back for a full minute
Avatar universal
Sorry for your problems...

You know, there is something about "3 months". I myself have a bunch of unespecific neurological symptoms. I am seeing my third neurologist (and another doctors as well, trying to cover all possibilities).

I really like my neuro, and she doesn't really know what is going on with me. But she wants to see me for a complete neuro exam each 3 months. I think they don't know what you (and me) have, and these follow ups can tell them if things are getting worse, better, or are the same, and see if they can get more "clues".

I know how frustating it can be, and also stressful. If you don't really trust your neuro, change doctors. I learned that the most important thing is trust on your doctor...

Hang in there and hope you feel better soon!

Avatar universal
Thanks for the concern.  I can't wait until they come out with that test that can determine if one has ALS right off the bat (which I've read is 95% accurate).  Not sure what the holdup is, but this could save people tons of anxiety and grief.  Most other tragic diseases can be diagnosed quickly, so atleast one 'knows' if they have it or not.

The idea of "not knowing" causes more anxiety than "knowing".  I spent a solid year of massive worry and anxiety before I started to accept it and then realized I hadn't gotten any worse.  Since ALS is progressive, I concluded it had to be BFS.  I am hoping this is still the case.
Avatar universal
Yea the only thing that has me worried is:  the muscles in my left hand between thumb and fore-finger are stiff, as well as part of the forearm, and hasn't gotten any better.  I can feel it even at night while I sleep.  And of course those muscles twitch significantly as part of the stiffness, not including the whole-body twitches.

When I use the muscles (like typing) within a few seconds they semi cramp up and then visibly twitch.  Even my wife has seen it.  This makes it 'feel' awkward to type, or even grab things.  I tested my strength (like holding weight plates between each finger and my thumb) and its still there compared to the unaffected hand.  I don't see any visible atrophy in the muscles at this point.

My neuro seems to think things are fine since he hasn't noticed any reflex abnormalities, strength loss, or atrophy (and of course a clean EMG 3 years ago when I had similar symptoms).  However, I am not clear on if a disease like ALS can hide under the radar for a while, with symptoms for the patient, but no clinical abnormalities...  Thats the part I am nervous about.
Avatar universal
a test that would be easy for your doctor to perform would be the HLA 27B for anylosing spondylitis, this could be an answer to your problems, it is a dieases that effects the spinal column, affects joints ligaments and muscles throughout the body. the tests costs $150. the disease affects each person differently, it depends on where the damge is in your spine. good luck!
Avatar universal
Alright, I am severly freaked out here. I have had twitches in my muscles for a few years but very infrequently. They are usually contained to the calf or eye lid. A few weeks ago they started everywhere. I have been seeing a chiropractor and a few weeks after the first visit I started getting a tingling sensation in the heel of one of my feet (not sure if connected to chiropractor). I have also been (past 2 days) experiencing muscle fatigue in my arms. Now, the twitches have subsided a bit and the tingling in my foot is gone, but the fatigue in the muscles remain. I also feel like I am not holding onto things as well as I used to but I am unsure. My fear is that these are the developing signs of ALS. I have been told by my chiro and regular doc that this is not the case, but I cannot shake it. Any help here would be appreciated. Also, I am under an intense amount of stress right now since I work full time, attend school full time, found out my home owners insurance is dropping me, and I am now selling my house. Any advice would be appreciated.
537220 tn?1214512887
A related discussion, FEELING OLD AT 35 was started.
Avatar universal
A related discussion, finger stiffness was started.
Popular Resources
Find out how beta-blocker eye drops show promising results for acute migraine relief.
In this special Missouri Medicine report, doctors examine advances in diagnosis and treatment of this devastating and costly neurodegenerative disease.
Here are 12 simple – and fun! – ways to boost your brainpower.
Discover some of the causes of dizziness and how to treat it.
Discover the common causes of headaches and how to treat headache pain.
Two of the largest studies on Alzheimer’s have yielded new clues about the disease