Normal Muscle Twitching When Tired

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T

twilightkickball

Member
Pam,

if you can induce your twiching by hiting a muscle it's not a bad sign. I can also do it sometimes but only in my calves. When I hit the muscle few times my calf "answers" with one or two twiches. This kind of reaction is normal, especially in calves and when muscle is tired. I tested it on my wife's calves and a few times her reaction was exactly the same like mine (she has no ALS, I'm sure :)

During my neuro examination doc hit my muscles and looked at them very carfully. I asked him what is he waiting for and he answered "fine muscle twiching, looking like crawling worms". I know that many of you have also "crawling bugs" feeling and it is benign. But I tell you what I was told.

Grym,
does your calf twich really non-stop at one and the same point for 5 years? I don't believe. Non-stop is not even 100 twiches every day, but is really non-stop. In July the edge of my palm was twiching non-stop for 3 days. It was really constant. No breaks. Every second. 3 days. Now I will never say that my calves are twiching non-stop although before this palm twiching I used to say so.

regards
Marcin
 
Marion & everyone,

I've done a ton of research on this and from what I read ALS twitches are concentrated in one area, at first, and are constant, (they don't come and go) and persist for more than days or a few weeks. Later in the disease, as more muscles are involved, fascics bcome more widespread.

Here's something I copied from one of the forums last year. Hope it helps some of you. I found it reassuring when I first read it....especially the bit about benign fascics occurring in bursts of activity.


Twyla

I emailed a neurologist at my local university which I attended some years ago and her answers may be of interest, they certainly describe me and probably others here too. This is meant to put minds at ease, not to worry! "Fasciculations are not unique to ALS, and many ALS patients don't have fasciculations. However, typical benign (i.e. not ALS) fasciculations are big movements, often VERY symptomatic (they drive the sufferer nuts) and even uncomfortable. They can be anywhere and often seem to jump around - hand for a few days, calves for a few days and so on, but have a predilection for the calf muscles. ALS fasciculations can also be all over, but are often "regional' i.e. more in one part of the body and persistently so, and also frequently aren't noticed except by an observer - a spouse, or a doctor seeing the person for another reason. They are usually smaller and less well organized, more wriggly and less jerky. They are less rhythmic - more disorganized and flickery. Benign fasciculations are often quite prominent and the same movement again and again in the same muscle. ALS fasciculations don't seem to occur in the bursts of activity that benign ones do. They are more continuously present, and tend to decrease as a muscle atrophies and gets weaker. I have been working in this specialty area for over 10 years.
 
That article didn't mention anything about real weakness. Just the style of twitching. sometimes I have big twitches, sometimes little jumps. Nothing constant. Today I'm not twitching much, but after reading this I probably will!
Jen said that if you feel your twitches, that's a good sign. I feel them, it's just not real strong all the time.
There are other things that cause twitching though...
 
The reason the article didn't mention anything about weakness is because the person who wrote to her neurologist asked specifically and only about fasciculations as they occur in BFS.

T.
 
Twyla, great post and great info.
I think we are still with the same question: is it possible to distinguish benign fascics and ALS fascics based on their look only?

If what you wrote is truth it's a good news for me I guess. My fascics are exactly like you described benign: quite strong, rhythmic - the same movement in the same muscle few times in a row and so on.

Unfortunetelly I also have an expierence with fascics looking more like ALS fasciculations. There were 3 days in July when one muscle in my hand (between my wrist and the smallest finger) has been twiching non-stop. It was very fine twiching, hardly visible, wriggly and not rhythmic. There were no breaks in twiching - even when I didn't feel it the muscle was twiching. Really scared believe me.

But it has gone after 3 days. It was around 10th of July so it's almost a month with only ocasional twiching in that muscle.

regards
Marcin
 
Grym,

thanks for keeping us on task. I beginning to understand one of the main functions of this site if not the function of this site is to get people to stay calm. It is reassuring to know and be constently reminded that ALS has weakness attached to it.

short and sweet
 
Pole : Where did you find this info. about PNH being superposed with the disease ??

If what you are saying is true that PNH is an early sign in *** patients then a clean EMG on the twitching muscles should show nothing since it is just PNH and the disease process has not yet started in these muscles ??

Also, from what TheTrex's post says - it seems fasciculations do not have to be a finding in the EMG in early cases ??
 
The poster that mentioned the company that fascis keep is correct, without weakness, atrophy or reflex change it is highly highly unlikely it is ALS.

My calves have been twitching constantly for 17 months now. When my neuro saw my my calf muscles (which have increased 1 inch in 1 year due to weight lifting), and heard I was running 16+ miles while training for a marathon, he laughed when I asked if he was going to perform an EMG. As he said, if you are twitching that often, for that long, there would be profound weakness in the muscle, no ifs ands or buts! Also, calf muscle twitching can have a "malignant" appearance more so than any other muscle.

Textbook of Clinical Neurology, Goetz/Pappert 1999
Fasciculations are a feature of disorders of the anterior horn cell or root compression. Therefore fasciculations are often viewed as an ominous sign. They need not be because they are commonly experienced as a benign phenomenon in the absence of any disorder of the motor neuron or spinal nerve roots. Fasciculations of a benign nature can generally be distinguisshed from fasciculation secondary to lower motor neuron disease by several features. They have a predilation for males and for certain muscle groups, especially in the calves and thighs. When they occur in the arm muscles they they tend to be seen as repetitive twitches in the same muscle fascicle as opposed to random non stereotyped twitches of many parts of the muscle seen in patients with anterior horn cell disease. Benign fasciculations in the calves are more difficult to distinguish clinically because they may be frequent or multiple and have a malignant appearance. However, there is no associated weakness or atrophy of the affected muscle with benign fasciculations.

If you don't have atrophy or weakness, you don't have ALS (the CCF forum repeats this ad nauseam.

Ginny
 
Ginny,

Thanks for replying to my post but you missed the point.

Could PNH be an early sign in *** patients ? This means that all over twitching has started and there is no EMG finding in those muscles when it is done (since clearly if there is an EMG finding in the twitching muscles then it is not PNH since by definition PNH is benign ?)

If the above is not true then if there is an EMG done in twitching muscles and there is no finding then it may or may not be a disease (?)

Best Regards.
 
According to my neuro at Baylor, if you are twitching because of als, you will not have a normal emg. In regards to PNH being a precursor to als, that goes against commonly accepted science. Go look at the mayo clinic study, it show absolutely no correlation between bfs and als. Another bit of evidence that there is no link between our condition and bfs is that not one person that I'm aware from this board has gone on to develop als, not one. If this was the first step to als, it would have happened by now.

Don't worry about als if your neuro has said bfs (I know it is easier said than done :( ).

Take care,

Gary
 
Dear Gary,
Thanks for replying to my post but I did not mean that PNH or BFS develops into any disease. Please look at Pole's post - where he says PNH is also there with some *** patients otherwise why would some patients present with widespread twitching.
I guess what I am trying to find out is if some *** patient has widespread twitching but weak in only one place (or even no weakness anywhere) then would EMG in those muscles always reveal an abnormality or could it be that EMG turns abnormal only after detectable weakness (which is also detectable by EMG as reduced recruitment) is present ?
Thanks and Regards.
 
When I had my EMG, my neuro told me that I did not have to present with any clinical weakness or even fasciculations for that matter, that the EMG would be able to pick up issues before I even noticed them because in most cases of ***, the twitching/fasciculations is not even felt by the patient. As soon as my test was done, he looked at me and said "regardless of all those internet articles and by the way pull the plug on your internet", the EMG would have picked up an abnormality even if I did not notice one. Hope that helps.
 
I posted this last week, but let me share what my neuro told me last week regarding fascics. CONSTANT fascics in one area -- at least the ones you can feel and clearly see -- are not consistent with ***. Also, big "thumping" fascics that stick in an area for awhile and then go away are not consistent with ***.

And, while that may not cover everyone's fascics here, she also said that in "99.9%" of *** cases, a patient who notices the fascics has accompanying weakness and atrophy. She also said that she's never heard or seen any *** patient without weakness or atrophy, so I got the sense the 99.9% was actually conservative.

For what it's worth, this was a neuro with a top-notch reputation at one of the world's best-respected hospitals in Boston.

Hope this helps alleviate some concern.

Doug
 
I use to post on this board well over a year ago. About 6mths ago i saw fasciculations in someone with ALS/MND. The difference i observed was that in ALS/MND the fasciculations only visibly occured in the dying muscles, i could not see any fasciculations in muscles unaffected with the disease (his other arm). I did not know the person, i only sat next to the person at a seminar and spoke for about 5mins. I could only observe his arms which were visible due to him wearing a short sleeve shirt. But the twitching was not as violent as i have had with benign fasciculations, it was weak in comparism. But even then the type of fascics he had present, have been similar to the ones i have had in the past. I do not think you can make a visible difference between ALS/MND twitching and BFS, only that in ALS/MND it only seemed to occur in muscles becoming atrophied.
 
bb4life, you're not alone. Just read some of these posts on here, we all have twitching that won't go away, and many of us twitch in th ecalves. by all means, get checked out, but chances are very good that you have BFS, expesially since you say that you have normal strength. We have all been there, yes it's scary, but don't let it run away with your mind.
 

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