Question about Fasciculations and BFS

While I'm waiting to see the neurology specialist at Penn on Mar 23 (you can find my situation in posts below), I wanted to ask a couple of questions about fasciculations that I'm confused on. I've read "BFS in a Nutshell" several times.

- Some things I read say that fasciculations that start in one place and then slowly radiate out to other areas are bad (ALS), while the opposite can be read in some places. Which is it?

- Along the same lines, some of the stuff I've looked at says that having fasciculations all over the body is good (no ALS) while others say it's bad (indicator of ALS). Any thoughts on which is correct?

- Many people on this board (and in "BFS in a Nutshell") say that you don't feel or notice fasciculations if it's ALS until there is noticable weakness and/or atrophy. However, when you read the ALS Forums or read about individual case histories, a measurable number of people with the disease will say that fasciculations were the first thing that they noticed (My comments assume that an EMG has not been done yet on the patient), and that they had fasciculations all over, not just in one place.

I apologize if these questions have been answered before. If they have, I'd be grateful if they can just be cut and pasted onto this thread. The feedback posters gave me before on my previous posts was a real sanity-saver. Here is my current situation over the last month. I continue to have soreness in both triceps and both quadriceps. I have shooting pains down the entire left leg into the toes. My calves twitch more than ever, literally non-stop for the past two months and even more after a workout. I have fasciculations in other areas on a regular basis (although MUCH less than in the calves), including thighs, butt, arms, abs, shoulders, upper back. I have no loss of strength or atrophy. All neuro test ( the ones you can do yourself) are normal.

Thanks very much in advance. I'm pretty stressed, which I know isn't helping the cause. Unlike most on this board, my EMGs were not clean, although the 4 herniated discs the MRI showed may certainly be causing some or all of the bad readings.

Most of the stuff I've read says that widespread twitching is not indicitive of ALS. How long have you been twitching?

I think it is a very positive sign that your clinical exam was completely normal after the twitching began. Plus you do not have any clinical weakness. I've been twitching for over 10 years and was just diagnosed with BFS in 2005. The anxiety is what will get you. I remember at my lowest point I could hardly even walk I felt so weak. Once I got that under control things gradually improved.

A few other comments after reading your initial post...

- You are still working out (positive)

- Muscle soreness (i and many others have this too)

- Shooting pain (from what I've read pain is not an early sign of ALS)

Have you ever been to a chiro?

No, I've never been to a chiropractor. Never had back pains or shoulder blade pain until now.

Hi,
whilst on als forums etc alot will say that twitching preceeded weakness, this is very uncommon in reality. There is a quote from principles of neurology a leading neurology textbook that says that it is a good rule to follow that in als weakness preceeds twitching.

Furthermore, on this site there are a few thousand people who twitch. NOt one has complained soley of twitching and gone on to develop als, not a single one. Only one person on here ever had it and she had some bad weakness problems initially i believe.
You just have boring old bfs im afraid.

Robert

Robert,

Your comments fit with most of the stuff I've seen as well. I appreciate your response, and I'll post after Mar 23 to let everyone know what the neuro specialist at the EMG lab at Univ of Penn has to say.

What is widespread fasciculations?i think when they talk about als widespread fasciculations they mean widespread across the muscles from one muscle to the next rippling none stop with weakness or atrophy,not widespread because they are popping off in different parts of the body.Has anyone saw the young boy who started having fascics after an accident on the youtube fasciculation link, we need not complaine when we see his, and he probably dosent have anything like you know what.Another thing fascics can be the first sign of als but when you searched the als forums i wonder what search word you used, was it weakness, atrophy of fasciculations.

I"ve been twitching for 12 years. I started twitching In my left ankle,it went up my left leg [feet too],then went to my left ankle,up my left leg,then my left arm,now to my right arm [hands too], and face. Just saw a new neuro, had another EMG, said everything is O.K., But with this condition I am anything but O.K. . It is very diffucult at times,and right now I am really having a tough time

Twitching all over or in one spot ....feeling them or not MEANS NOTHING. I have had every type in just about every location going on 2 1/2 years. Some I feel....the ones in my lower legs I don't.

If you were clinically weak or had crazy reflexes than yes your twitching might mean something.

Clinically weak = means you can't tie your shoes or lift your leg, not feelings of weakness.

Crazy reflexes = Seriously abnormal....most of us here have no idea what they look like. I saw a video on a neuro web site a couple of years ago showing a young guy that had a stroke and had serious damage to one side of his body. They tapped his knee...there was no doubt he had problems. His leg went straight out and rocked back and forth wildly 4 or 5 times. Thats abnormal...I would bet that no one on this site has anything close.

Remember, ITS NOT THE TWITCHES, ITS THE COMPANY THEY KEEP


Paul