Hello, I am a 28 year-old male who has been having random twitching for the past month or so. I am concerned about ALS. Below are what I consider to be the most relevant/important points. 1) The twitching at first was only in my left calf. It has now moved to the other calf, my thighs, and my back. All muscles do not always twitch; it's mostly my back and left thigh. 2) I have not fallen nor have I noticed any loss of strength. 3) I had an EMG performed last week. I am unsure as to the normal protocol and standard length of an EMG, but it seems like mine was very long. I was in there for 2 hours while they did the EMG and Nerve Conduction Study on both my calves, both thighs, my arms, and my back. 4) The results of the EMG and Nerve Conduction Study were normal. The doctor wrote "This is a normal electrodiagnostic examination. There is no electrodiagnostic evidence of a polyneuropathy." Also, no clinical weakness was found. 5) I am concerned that I continue to have NEW "hotspots" of fasciculations. For example, my other arm was twitching earlier. Also, earlier today my thighs were twitching. 6) Overall, I am afraid that the test missed something and may have been done too early. I am concerned that the fasciculations KEEP EXPANDING, and that the EMG is wrong. I really appreciate your advice!Happy Holidays!
Concerned about ALS Twitching
- Thread starter dslzuki
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Hello gonzo1,I was also concerned my emg was done too early. My symptoms started 11 months ago..( twitching and many sensory issues like tingling, burning and so on) and I had a negative emg in the way beginning, 3 weeks into my newly acquired symptoms. Well my symptoms have continued off and on (mostly on!) for the past year. I still have no diagnosis but my symptoms seem to be consistent with bfs. Anyhow, I just had another emg 3 weeks ago, and it was also negative. So in my opinion, if you ate symptomatic when you have your emg and its negative, then bottom line is, it's not too early. Also, as far as the length of time it takes for the test to be completed... Both of my emgs took 2 hours each. So I think that's normal also.Good luck!
Hi gonzo, welcome on board.Your story seem ot be typical - twitches in several locations, mostly legs, nornal EMG and even NCV.Practically because you do not have clinical weakness, I suppose your clinical exam is normal too (strenght, reflexes, coordination). This prcatically excludes MND for now and means you do not have any sign which may suggest that in the near future you may deveopl something sinister. So with this medical story you really should say to yourself^ bye bye thoughts about ALS.as for BFS typical pcture - clearing for ALS or other MND does not mean your twitches would stop. They appeared not becasue you were not diagnosed, but becasue (most probably, as your nerves seem to be intact by EMG/NCV test results) you have your muscle cells membranes damaged by ine or several common stress factors, including (but not limited to. of course) emotional stress, food stress or viral infection. Those three are most common. Plus, probably. inherited predisposition for development of twitches exists, if you have hypermobility syndrome (maybe I say, becasue many of fellows are hypermobile but not all of course).Same as for any disease: if you get a cold, saying - holy crap, I got a flu! - does not relieve you from a week of running noze, fever and coughing. Having been diagnosed with benign twitched does not stop a process kciked in your body.usually reduction of food stress and emotionsl stress (like elimination diet, decrease of caffeine, alcohol, increase in schedule, mediatation, moderate physical activities, antianxiety medication and speaking therapy, if required, in specifically hard or acute cases) helps a lot. Nothing to do with viral stress however, because there is no specific virus is known to cause BFS, so no speicifc magic pill exists.By the way I had my own EMG in about a 4 weeks after tqithcing onset, and it is already 26 month I am in, still twitching a bit, cramping, having muscle pains and tunnel-like syndrome in my hands (which I am working quite hard with) but alive and defintely not dsiabled.
And just for some encouragement, my twitching has also expanded overTime. It started in the arches of my feet and now basically all my muscles twitch. This has been going on for a year and I have developed no weakness. just try to keep doing what your doing. You can't ignore the twitches but you can learn to live through them.
Thanks for your input! 1) From your experience, in ALS, when do people start to see weakness vis-à-vis twitching? 2) From your experience, what are the odds of having had the EMG done too early?3) From your experience, what are the odds that the EMG missed the twitching in a body part? For example, let's say that my right calf just didn't happen to twitch during the few minutes they were scanning it and, because of this, the test came back as being clean.Happy Holidays!!!
Gonzo, fortunately I do not have such experience. But medical consensus is that if a person has unexplained twitch (no electrolyte deficiences, no major neurological deficites at the exam, etc., no adrenal, pituitray or thyroid pathology,, no clear Guillean-Barre sysndrome, etc.), and nothing bad happens in 4 to 6 month, then the twitches are benign.But as the top medical specialists say, usually people with malignant twitches preceding ALS have already sertain signs on EMG suggesting for specific underlying process (damage of anterior horns) causing twitches in their case.As I said, I had my own in about 4-6 weeks from twitching onset. it showed some minor twitching activity bit no signs of MND.Nope it is not significant if your leg twitches or not during the EMG. For having ALS, a person must have degenerative process in both central brain motor zone and in the anterior horns of spine. It is usually noted on EMG (and NCV) even if the process is still subtle and does not manifest by twithing. Moreover, looks like central brain damage might be spotted regardless to where the needle is incerted, as this is related to central processor damage.becasue our twitches seem ot be very local. they usually do not give those specific waves and delays common for ALS-related damages.i see you had entered in typical EMG doubt stage 
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))Thanks for your answer!!I understand that statistically it's very unlikely that I have ALS considering a) that I have no weakness b) that I'm 29, and c) that I have a clean two-week-old EMG. Nonetheless, I also have seen that there are a few people who have posted about initially having a clean EMG and then, not long from that point, having a dirty EMG. Have you talked to these people, or do you know about these scenarios? I wonder what's going on with them. It scares me that the same thing could be happening to me. Again, I really appreciate your input and I hope you're enjoying the holidays.