Aa
SOME SPECIFIC FASCICULATION QUESTIONS
HI
I know neuros Do not like to make the distinction between ALS TWITCHES AND BENIGN FASCICULATIONS, yet PLEASE try to answer my questions even if the answers will be relevant only for the most part of cases:
1.What pattern is more typical for the initial twitching of als(initial!): A. Random twitches that do not seem to settle in a specific muscle (RANDOM POPPING - "a twitch here a twitch there but many of them...
or.. B. specific areass/spots of fasciculations that are widespread, but every muscle have specific spots where ONLY there , you find twitches.
*I never get a twitch again in a plcace where It has twitched
never 2 twitches in the same spots for a long time. there are many of them, but each time, different spot, different muscle
MINE IS A.
* based on your clinical experience, which pattern is more typical for the inital twitches of als (A OR B), when you examine the patient first time. (I read somewhere that in als , each muscle has specific spots/areas of twitching, and these spots of recrurtent fasciculatins ARE found in clinical exam - so B is more appropriate. IS it?
2.I know that als has assymetric onset by definition. well, are there cases of Benign fasciculation you have seen of assymetric pattern also? How common is that?
I was diagnosed with benign fasciculations, yet 80% of my twitches are left sided (left leg and arm) so I would like to know ,base on your experience, how common is assymetric pattern of benign fasciculations (more twitches in one side or limb)???
ARE most benign fasciculation patients symmetric or assymetric?
**** DEAR NEURO, I KNOW THAT MOST NEUROLOGISTS DISLIKE THESE DISTINCTIONS, BUT PLEASE , TRY TO RELATE TO THESE 2 POINTS as specifically as you can, especially to PATTERN A,B , PATTERN YOU FIND MOSTLY IN ALS AND MY PATTERN(A), PLEASE!
BEST REGARDS, DAN!
I know neuros Do not like to make the distinction between ALS TWITCHES AND BENIGN FASCICULATIONS, yet PLEASE try to answer my questions even if the answers will be relevant only for the most part of cases:
1.What pattern is more typical for the initial twitching of als(initial!): A. Random twitches that do not seem to settle in a specific muscle (RANDOM POPPING - "a twitch here a twitch there but many of them...
or.. B. specific areass/spots of fasciculations that are widespread, but every muscle have specific spots where ONLY there , you find twitches.
*I never get a twitch again in a plcace where It has twitched
never 2 twitches in the same spots for a long time. there are many of them, but each time, different spot, different muscle
MINE IS A.
* based on your clinical experience, which pattern is more typical for the inital twitches of als (A OR B), when you examine the patient first time. (I read somewhere that in als , each muscle has specific spots/areas of twitching, and these spots of recrurtent fasciculatins ARE found in clinical exam - so B is more appropriate. IS it?
2.I know that als has assymetric onset by definition. well, are there cases of Benign fasciculation you have seen of assymetric pattern also? How common is that?
I was diagnosed with benign fasciculations, yet 80% of my twitches are left sided (left leg and arm) so I would like to know ,base on your experience, how common is assymetric pattern of benign fasciculations (more twitches in one side or limb)???
ARE most benign fasciculation patients symmetric or assymetric?
**** DEAR NEURO, I KNOW THAT MOST NEUROLOGISTS DISLIKE THESE DISTINCTIONS, BUT PLEASE , TRY TO RELATE TO THESE 2 POINTS as specifically as you can, especially to PATTERN A,B , PATTERN YOU FIND MOSTLY IN ALS AND MY PATTERN(A), PLEASE!
BEST REGARDS, DAN!
That is just a piece of ****!
OK, that is dan's question for today. Be expecting the same questions over and over. He is determined to dx himself with ALS.
Why don't you just ignore the question yourselves if you are tired of the same ole thing. Maybe Dan has an anxiety disorder that needs to be addressed by a psychiatrist. Make positive suggestions rather than criticisms and you will get farther along in life.
It was nice of the doctor to be so polite as to answer everyones questions on this forum even the ones on ohter peoples threads. You all out to be thankful not criticcal!
Gee Whiz the majority of you should be ashamed of yourself. You say Dan is determined to diagnoise himself with ALS. Maybe he is just scared and looking for reassurance..Since you seem to know Dan so well. I assume he visits the ALS message Boards, which means to see him there you must be there too..Right????
Do you or have you been told you have ALS, Do you twitch? Hvae you ever been scared? I know the ALS fear very well and how it will eat at you. There are many Docs that will push a patients fears aside and never address them in any way..Maybe all Dan needs is a Good reliable Neuro/Psych to help he to understand what he does and does not have and why. And help him to stop worrying about it..Because worry will change nothing..
You pay a doctor to take care of you..very good money I might add, they should be willing to take the time to address your fears and if not I would seek a new Doctor....
Dan Please do something to calm your fears because they will make you worse and you really don't want to be sick DO YOU? So get some help and as for the rest of you I sure hope people are more receptive and concerned and helpful to you should you ever have an irrational fear of a deadly disease or even a deadly disease because all of the responses i see here except for a choice few are just plain rude and disgusting and I pray would never have to depend on any of you for comfort if needed.
Just my opinion...Betty
Do you or have you been told you have ALS, Do you twitch? Hvae you ever been scared? I know the ALS fear very well and how it will eat at you. There are many Docs that will push a patients fears aside and never address them in any way..Maybe all Dan needs is a Good reliable Neuro/Psych to help he to understand what he does and does not have and why. And help him to stop worrying about it..Because worry will change nothing..
You pay a doctor to take care of you..very good money I might add, they should be willing to take the time to address your fears and if not I would seek a new Doctor....
Dan Please do something to calm your fears because they will make you worse and you really don't want to be sick DO YOU? So get some help and as for the rest of you I sure hope people are more receptive and concerned and helpful to you should you ever have an irrational fear of a deadly disease or even a deadly disease because all of the responses i see here except for a choice few are just plain rude and disgusting and I pray would never have to depend on any of you for comfort if needed.
Just my opinion...Betty
I never can get here early enough to post a question, but you folks seem to be very knowledgeable, so maybe you can help me. Here's my case history, tell me what you think:
I am a 23yo male second-year medical student. I first started experiencing muscle fasciculations 4 1/2 weeks ago. The onset was incredibly sudden: I was sitting in a restaurant feeling fine when I started having a forceful twitch in my left index finger (yes, it was the muscle between it and the thumb that was twitching). By that night I had profuse and widespread fasciculations all over my body. Like an idiot, I consulted my pathology book which put the idea of ALS in my head. I subsequently did not eat for a week. I went to the student health service and was worked up for possible hyperthyroidism (my patellar reflexes were 3+ and my pulse was 104) but labs came back normal. I returned three days later and was seen by an attending physician who spent 45 minutes with me (kudos to him!)trying to calm my fears. He prescribed low-dose Ativan, which worked admirably for two weeks. The twitches mostly subsided, or at least I stopped noticing them if they were still there.
Then my anxiety returned. My appetite once again vanished, and the fasciculations became more profuse. I am by nature a raging hypochondriac, and I have been imagining (I hope) all manner of relevant symptoms since then (stiffness, weakness, etc.) but all pass when I quit obsessing about them. Rationally, I tell myself that I must obviously have benign fasciculation syndrome. But fears about ALS can make one a bit irrational. I do have a postural tremor in my right thumb when I hold it in certain positions, but no functional impairments there or anywhere else in my body. I don't know if the tremor was present before or not. I don't have weakness or obvious atrophyin any specific limbs. I do have general, subjective weakness, but I can still lift the same weights, etc. My fiance' says that I "shake" in my sleep sometimes (like shivering when cold). I often wake up with my heart racing (>100 b/m). I have lost about ten pounds in the past six months, but I hardly ever exercise and my nutrition isn't good. I have buttloads of stress in my life, including med school, upcoming board exams (which I should be studying for instead of typing this), I'm getting married in five weeks, and I just bought a house seven weeks ago. (All of this and the persistent, gnawing fear that I shouldn't have gone to med school in the first place). Oh, and I had an awful viral infection one week prior to the initial onset of symptoms. I do have generalized anxiety disorder as well as intermittent major depression, for which I just started taking paxil--too soon to see if it helps or not.
Sorry about the long post, but thanks for reading and thanks also in advance for any comments, advice, or reassurances you may give me. Who knows, maybe someday I'll be your doctor (BE AFRAID!) J/K :)
I am a 23yo male second-year medical student. I first started experiencing muscle fasciculations 4 1/2 weeks ago. The onset was incredibly sudden: I was sitting in a restaurant feeling fine when I started having a forceful twitch in my left index finger (yes, it was the muscle between it and the thumb that was twitching). By that night I had profuse and widespread fasciculations all over my body. Like an idiot, I consulted my pathology book which put the idea of ALS in my head. I subsequently did not eat for a week. I went to the student health service and was worked up for possible hyperthyroidism (my patellar reflexes were 3+ and my pulse was 104) but labs came back normal. I returned three days later and was seen by an attending physician who spent 45 minutes with me (kudos to him!)trying to calm my fears. He prescribed low-dose Ativan, which worked admirably for two weeks. The twitches mostly subsided, or at least I stopped noticing them if they were still there.
Then my anxiety returned. My appetite once again vanished, and the fasciculations became more profuse. I am by nature a raging hypochondriac, and I have been imagining (I hope) all manner of relevant symptoms since then (stiffness, weakness, etc.) but all pass when I quit obsessing about them. Rationally, I tell myself that I must obviously have benign fasciculation syndrome. But fears about ALS can make one a bit irrational. I do have a postural tremor in my right thumb when I hold it in certain positions, but no functional impairments there or anywhere else in my body. I don't know if the tremor was present before or not. I don't have weakness or obvious atrophyin any specific limbs. I do have general, subjective weakness, but I can still lift the same weights, etc. My fiance' says that I "shake" in my sleep sometimes (like shivering when cold). I often wake up with my heart racing (>100 b/m). I have lost about ten pounds in the past six months, but I hardly ever exercise and my nutrition isn't good. I have buttloads of stress in my life, including med school, upcoming board exams (which I should be studying for instead of typing this), I'm getting married in five weeks, and I just bought a house seven weeks ago. (All of this and the persistent, gnawing fear that I shouldn't have gone to med school in the first place). Oh, and I had an awful viral infection one week prior to the initial onset of symptoms. I do have generalized anxiety disorder as well as intermittent major depression, for which I just started taking paxil--too soon to see if it helps or not.
Sorry about the long post, but thanks for reading and thanks also in advance for any comments, advice, or reassurances you may give me. Who knows, maybe someday I'll be your doctor (BE AFRAID!) J/K :)
Dear Reader,
My understanding is that the gold seal on benign fasiculations is an EMG. Since your situation bothers you so much, why not get an EMG to put it out of your mind? If the EMG shows no fibrillations or other indicator of neurological disease, you will basically be in the clear. See
http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=8215252&dopt=Abstract
for more info.
Good luck,
Paul
My understanding is that the gold seal on benign fasiculations is an EMG. Since your situation bothers you so much, why not get an EMG to put it out of your mind? If the EMG shows no fibrillations or other indicator of neurological disease, you will basically be in the clear. See
http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=8215252&dopt=Abstract
for more info.
Good luck,
Paul
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