Is this ALS?

[Bart1]

Hi,

I'm 30 years old and I've been twitching widespread for 22.5 months now and been given dx BCFS by 2 neuro's.
However I've got this fine localized NON STOP twitch going on in my upper back for 8 days now. I even can't see it always but I can feel it. I always heard this kind of twitching was more related to ALS.  Also my jaws  hurt

Could this be ALS afterall?

thank you

[Bart1]

HI Dr,

I've been to my neuro on  18th of August who dx me with BCFS earlier.  On the 18th he did a clinical and saw nothing wrong . the clinical as normal. (he already had an emg done in dec 07 when the twitching started)  
But a couple of days after this neuro visit I started having a fine localized twitch in my upper back and this is why I'm scared. Now I think this kind of twitch could be the onset?

[Dr Rajgopal]

Hi Bart,
If you are very scared about ALS, please consult your doctor to determine if you have ALS. Diagnosis is based on physical exam, medical history and lab tests such as blood and urine tests. Electromyography (EMG) may also be used. This diagnostic test is very sensitive in detecting lower motor neuron disease. But specific signs of ALS such as spasticity, a specific type of stiffness, abnormally brisk tendon reflexes and Babinski's sign(an unusual flexing of the toes during examination; and diminished fine motor coordination) must be present. Take care!

[Bart1]

Hi Dr,

I had an MRI done when the twitching started in Oct 2007 that was fine.
But is it possible that this kind of fine localized twitching is the onset of ALS however I've been twitching widespread for 22.5 months?

[Dr Rajgopal]

Hi,
Muscle twitching not associated with other symptoms may not be suggestive of ALS. ALS is manifested as loss of control over muscles, difficulty swallowing, uncontrolled laughing or crying, difficulty breathing, slurred speech, muscle weakness or other serious disabilities. Muscle twitching may be a symptom of Benign Fasciculation Syndrome, Anxiety, Electrolyte imbalance, vitamin deficiencies or other causes. Did you have an MRI of the spine? Localised twitching in the back may be a result of spinal nerve compression. Please do not panic. Please discuss the management plan with the neurologist. Hope this helps you. Take care and regards!