Twitching

[Mark Anthony]

What is the likely hood of identical twins coming down with sporadic Als if no familial history.  I am very scared as I am a identical twin.  I came down with twitching,  sporadic and migratory in nature,  while at the same time (three weeks later)twin brother came down with same twitching symptoms.  


We both are experiencing twithing, tremors,  internal vibrations feelings,  I had an emg on calf in March, of 99 due to accident where 1mm by 2mm of atrophy was found.  That has not increased nor is it visible to the naked eye.  Weeks later , twitching started .  NO weakness so to speak. Had emg done last week of entire left side of body.  All normal.  My twitching is felt and does affect all areas of bodyl. My left eye lid twitches constantly and I can command it to twitch if I squint hard and release.


My question are


1.  Do you think I dentical twins could come down with sporadic ALS within weeks of each other if not familial?

2.  If als,  would onset be so close in the time frame?
3.  Does this sound like possible ALS to you?
4.  Does denervation show up before twitching and since I had two
    emg's relatively close to another,  March and August,  of 99 both normal,  does this suggest benign or is it to early to tell.

5.  One more odd thing,  I had a low platelett count in march.
    WOuld this signify anything.  
6.  Tremors?  Are they part of ALS?  I am going thru a    
    blood work up now.   Please give me some advice on what I am reporting.
    My twin and I are very nervous and hope that we are going to
     be okay.

[CCF Neuro[P] MD, RPS]

Dear Mark Anthony:

"The vast majority of time,      tremor is not associated with ALS".  The word time is the object of this prepostional phrase and is not a modifier of tremor.  Time tremor does not exist.  

Sorry for the confusion.

Sincerely,


CCF Neuro MD

[Mark Anthony]

Do you mean time the tremors duration?  Time in intervals etc?
Is there a refferrence source you could suggest so I can understand "time tremors" in the context in which they are to be tested?


Thanks

[CCF Neuro[P] MD, RPS]

time, tremor.....

Sincerely,

CCF Neuro MD

[CCF Neuro[P] MD, RPS]

Dear Mark Anthony:

1) It is impossible to say never, but this would be very, very unlikely.
2)Same answer as 1.
3) Like I said in the posting, I do not think you or your twin have ALS.
4) Yes, motor signs usually show up before a patient realizes or notes that fasciculations are occurring.
5) No
6) No, tremors are a distinct entity and can co-exist with or without ALS.  The vast majority of time tremor is not associated with ALS.  However, someone with ALS can also have a tremor.

See your brothers posting.

Sincerely,

CCF Neuro MD

[Mark Anthony..............please define]

Please define time tremors. What if any tests you would suggest having upon my next visit.  Thanks for your imput

[Mark Anthony]

I had previously prepared these questions prior to seeing the nuero last week.  I am the only twin that has been subjected to tests.  I would appreciate the answers to the posed questions even though I am confident in the nuero exmaminer that I have had.  I prepared the post assuming that they would turn out normal.  But I would appreciate an answer to the questions posed Doctors as It took me months to get into this forum.  Thanks so much.


Mark Anthony/I appreciate this service very very much.

[CCF Neuro[P] MD, RPS]

Dear Mark Anthony:

Please see the identical posting of Mark.

Sincerely,

CCF Neuro MD