Seeking Advice: Foot Fasciculations

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WolfgirlWolfrider

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Hi all,This is my first time posting and would like some advice. I've been having fasciculations in the arches of my feet and calves for a couple months now following the most stressful 6 months of my life, and am going in for an EMG on monday. I have random twitches all over (eye, shoulder, butt ect.) that are not very frequent like a few times a day. My foot fascics are very frequent (every second or so) and my calf fascics are every 5 to 10 seconds. I have absolutely no weakness and passed my clinical exam with ease, but I'm still terrified of the worst. My Neuro didn't seem to think anything was wrong, but he didn't even look at my feet. When I called him and told him I didn't think I did a very good job of showing him my symptoms and explained to him the frequency of the fascics in my arches, he said he still thought it was all stress/anxiety because as he put it, people always present with weakness first in A#*, but he'd see me one more time and take a look. He said he wasn't sure he'd even do an emg but he'd let me know when he looked at me. My question for all of you is if he does do the emg, what do I need to know about it? What's the difference in results from BSF and A#*? Is there a possibility that there could be gray areas or false positives? Basically, I'm scared I'm going to walk out on monday with more worry and questions than I have now and I don't know how I could worry any more than I already am. I guess I should say I'm a 34 yo male with no medical history. thanks a buncg for your help in advance.
 
Hi Cboxer,Your symptoms are a lot like mine... Constant feet and calf twitching with random pops everywhere...After 6 months and at your age with no weakness or other abnormalities it is impossible that you have anything more than benign twitching. It is very scary and unsettling but It certainly wont affect you anymore than you ALLOW it to.There are no grey areas with emg regarding fasics if you are twitching due to als that means the muscle is already dead so a clean emg will rule als out 100% but your symptoms and presentation ( do you believe that all your muscles are dying at once?) already do that!!Be cool, it gets better welcome to twitchyland,Dar
 
thanks dar,when you say clean EMG, will the fascics i have show up, but the doc can tell the difference? are they looking for muscle death? If so, would super fine fascics sound like muscle death on an emg? I've heard the term fibrillations before. I's that what they are looking for in ALS? I'm concerned that because my foot twitching is so fine, that it could be interpreted as something worse than BFS. I guess I just don't understand what and EMG actually looks or listens for. thanks again
 
The feet and calves are by far the most common places to twitch. My neuro never even did an EMG on my feet. He said most normal people would have "traffic" on their EMG and the main leg nerve is responsible for the feet anyway. My legs were fine. They both had fasciculations on the EMG, so don't worry about that, if that shows up. The doctor kind of smiled at me when I asked if he saw fascics, like "duh!". Fasciculations are nothing to worry about. Many, many people have fasciculations show on the EMG, and others don't. It really depends if they decide to show up I guess during the EMG, or if the twitches are true fascics to begin with. Fascics are nothing to worry about.They will know whether your EMG is clean or not. In your case, I'm 99% sure it will be clean because you present just like the vast majority of people on this board, you don't have weakness, and your neuro did a clinical exam on you. You will hear many people say the clinical exam is the most important anyway.Take care and try not to be scared of this exam.Mitra
 
Thanks mitra,When you say "true fascics" what do you mean? I am positive he will be able to see my quivering arches. Different muscles fire off several times a second in my feet so that won't be an issue. whats the difference between true fascics and BSF? Sorry for being such a pain, but I'd like to go into this appointment with as much info as possible since my doc doesn't have any bed side manor and he seems bothered that I'm even seeing him. (but he's supposed to be a good neuro so I can put up with is attitude).
 
I understand your concern. My fasics are also "fine" i can see them but not feel them. Although i think its best to ask your doc for explanations of specific terms I can def stare that fasics alone are not an indicator of anything on emg!
 
As far as i know... They are looking for evidence of nerve damage( injuries etc) and nerve death( serious illness) fasics are concerning to us yes but are slmost always an irrelevant finding.
 
Hi cboxer,EMg actually records your spontaneous ans evoked muscle activity. Fascics are spontaneous but they are not distinctive - if you have them, it means noting. To be suspected for possible MND, EMG must show significan chanes in evoked activity - i.e., when you contract your muscles, neural signal runs down from the brain to the spinal cord and from the cord to the libm. If therer would be toooo long time between one part and another - so called elongated motor units, AND in case of several other specific changes MND could be suspected. Fascis on EMG mean really noting and in your case - fascics in the feet after clear sterss - I am pretty sure that nobody even would stuck a needle into your leg, because leg fascics are commonest in healhy people.
 
I agree with all previous answer, you present like a typical BFS. You have nothing to worry about your EMG. Please also keep in mind that even healthy people could have abnomalities in their emg, so don't freak out if you have some. An old injury somewhere could have damaged some nerves, it doesn't mean you have MND. Just focus on your neuro comments, what he tells you. If he says you are fine then you are, believe him and move on.
 
I think all you need to know is that if the neuro notes fasciculations, SO many of us had them noted on the EMG. I asked my neuro if he still considered my EMG "clean" and he said "yes". And, I think you'll get a clean EMG. And, please trust your neuro. Please.
 
thanks for all the info. It helps a ton. So if the doc had the needle in my calf for example, and my calf happens to twitch when the needle is there (guaranteed it will), that would show up as a fasciculation? But that really is nothing of significance? the issue would be if he had me flex my calf and it showed slow muscle response? Is that basically how it works? thanks again
 
Not sure with your other question, but rest assured that if they find fasciculations that they are fine. In fact, that's why we're all here: Benign Fasciculation Syndrome.I didn't feel my twitches but I'm sure they were there. I was all stunned by the NCT, which was awful in my opinion. That's where they zap you and measure your responses. The EMG portion was easy for me, but I felt so strange due to the NCT, so I'm guessing the electrical activity in my legs was at an all-time high.Mitra
 
Hi RaindogI was going to ask about Isaac's. I've looked up some videos of Isaac's and my calfs look very similar. my feet are constantly firing off and my calfs are almost at the same pass. Can BFS be that frequent? or is BFS typically less frequent? I know with Isaac's it can also have tightness and cramps associated with it. My calfs feel very tight today, but i could be from the 200 calf raises / walking on toes i did yesterday checking for weakness. If I get an EMG on Monday (and I assume the doc will do one when he sees my twitching) would it show something different between BFS and Isaac's? and can most neuros differentiate between the two? Does Isaac's look like ALS on an EMG? The last thing I want is my neuro to not be very familiar with Isaac's and think its ALS. I don't have any weakness so I'm leaning towards Isaac's rather than ALS. What do you guys think?Thanks.
 
Thanks Gracely,I really appreciate your response, and I know I'm being silly with the worry. I actually am not as concerned with als any more as much as Isaac's. I agree and think I've finally convinced myself that if I had als, Id be showing obvious weakness by now since I've been fasciculating for 2 month, plus as my neuro said, fascics ALWAYS come After weakness. Also, my legs and feet are the worst, but I get random twitches all over, which I think is a good sign since als "spreads" from one muscle group to the next..... it's not random all over. Is that correct? I guess my main concern is if I'm going to have an EMG tomorrow, could Isaac's show the same patterns on the emg machine as als? I will be feeling and seeing the twitches during the test for sure since they never stop in my legs and feet. Will the doc be able to see the difference between constant twitching and something associated with als? I'm almost not sure if I want the test at all if there is the chance that there could be similarities between what BFS/Isaac's looks like on the screen and what als looks like on the screen. Any info would be appreciated. Thanks again
 
I would not tell you how it looks on the screen because first, all what you could see on the screen would be a spikes and downs, and that is all. The difference is obvious only for trained and experienced medical person. Second, for practical purposes, you need to trust results even not being able to interpret them by themselve. Again, just because interpretation needs special training and learning which a simple board on the Net can not provide for you. it is a bit like X-ray scan. it LOOKS simple but to interpretate the situation correctly, one still needs to see dozens and hundreds of scans plus special education.Third, as I said, EMG is processed by special statistics program and after that you would have a final verdict pinted on your report. if it is "you are OK" - trust it.I understand your urge to decrease your anxiety by being able to judge on your own and maybe before the dcotor would do that. By it is not always when we can have our own qualified judgement. When you give your blood to the bloodwork, you have to trust the lab and wait few days for result. it is practically the same.I wish you good results of course, be patient and wise.
 
Well, I wanted to post what the results of my emg were. I went in a couple weeks ago and the doc decided to do a nerve conduction study and an emg. He said that it all looked normal. He also said that he'd be taking a look at it in slow motion later that day and that if he saw anything bad, he'd give me a call. Well it's been just over two weeks now so I'd like to assume he didn't see anything bad. It's relieving to know that it's BFS and not anything worse. I'm still twitching like crazy though. I feel lately that my feet and toes cramp very easily. Do any of you experience the same thing? If I point my toes, it's almost guaranteed to cause my toes to curl down and cramp until I stretch them the opposite way. Is there anything I can do to help with the cramping? I've tried bananas, and mag/potassium supplements and neither seemed to work. thanks again.
 
I am easy foot cramper. on my opinion, you need either VERY STRONG magnesium supplement (like Magne B6 forte, not regular one), or more waster, more good sleep, less overal tension. I need only mild nervous day to get my feet cramping even when I try to put a shoe on. last summer I was on vacations very far from home and i was cramping EVERYWHERE (even in my neck muscles, and it was so strong that I thought I had my clavicula bone broken!) every day of those 14, and cramps disappeared as on a magic spell when i landed back in Kyiv.
 
I also have cramps in both feet really easily for years, way before the twitches start. I am just like you, if I curl my toes it's almost guaranted they goes into cramp, and I can relieve it the same way, by stretching on the opposite way.I am 8 months in, I am currently feeling a lot better. I still twitch, a lot, but I am starting to "don't care at all about those twitches".
 

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