Twitching and Pulling Fingers

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np2001

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I am 33 years old/male----this started 10 months ago---had twitching in between my left index finger and thumb (constantly pulling my finger towards my thumb). This lasted for 2-3 weeks and then I got one between my right middle finger and index finger that would pull the middle towards the index. This lasted for 2 months. Accompanying this came the profuse random twitches---particularly calves/soles of feet after long day on them. During this time I had an EMG 3 weeks and 2 months into the twitching---all normal.After this was over I began to feel better again---still with random twitches everywhere but I was able to ignore them. 3 weeks ago my left thumb started going nuts---really strong and really hard pulling it in towards my palm/at my pinky finger. Accompanying this was an explosion of twitches/buzzing/a brief recurrence of my right middle finger twitch. To make matters worse the thumb stopped twitching for 2 days straight and I thought I was over it when low and behold it has come back stronger than ever tonight.I know I am going to ask all of the questions you have answered 1,000 times before but I really need some help right now---1) Do you guys get twitches like mine with such strong and recurrent hot spots? Fingers for some reason really freak me out and (for some non-rational reason) I am sure that my twitches are different/stronger and more ominious than any of yours. 2) What do you make of all of the talk on the other forums of people who have had twitches and then developed their weakness?3) Do I need another EMG?Thanks for your help---sorry for being so crazy.
 
Let me see if I can answer some of your questions.No, you do not need another EMG.I don't know what other forums say about twitching preceding weakness because I do not look at other forums. This is a deliberate decision in order to preserve my sanity.I always imagine that my symptoms are different and somehow worse than everyone here. I'm pretty sure most of us think we have the worst case or the first case that is going to turn out to be ALS. Considering that has never happened in the history of this board, it is safe to assume that you and all the rest of us are wrong.Take care.Becky
 
It is very hard for any of us to know how severe our symptoms are compared to others. It is a very subjective thing. But the fact that many have gone to many neuros and read and post on this board regularly indicates it is not a minor matter for most. Of course, there are some who may just have health anxiety and really no more twitching than the normal person but many really do have some sort of abnormal nerve thing going on and come here for reassurance that they will be ok despite the strangeness of it all. One of the more reassuring things I have been told about my symptoms from someone who has treated ALS patients for fifty plus years is that he has never seen an ALS patient whose symptoms started with random bodywide twitching. So if I read your post correctly, you had twitching all over within a very short period and this is more consistent with some other cause than ALS. I have no firm answer for myself but the best guess is that something triggered an immune response that resulted in antibodies that are irritating my nerves and making them hypersensitive. I had no obvious viral illness but you can have an immune system flare up without having typical viral symptoms and an immune flare up can also be caused from other things as well. There is a lot of support for this theory but it is just a theory. I hope you take comfort like I do that you are not alone in experiencing this phenomenon which can be frustrating, annoying, and concerning but not almost never debilitating unless you let the other things just listed get the best of you.
 
Oh no! Not the tip of the tongue!!! Please say it wasn't the tip of your tongue! (Just kidding. My favorite BFS joke) Your fine. BFS normal.
 
Here is a bit about tongue-twitching:"Usually the patients that we see who have tongue fasciculations have the typical signs and symptoms of ALS that has significantly progressed (prominent weakness and muscle wasting). The tongue fasciculations are NOT the presenting symptom unless they are accompanied by markedly slurred or even absent speech, difficulty moving the tongue due to atrophy and weakness, and profound difficulty swallowing. These patients are quite sick and many of them have had dramatic weight loss due to the inability to swallow.So you get tongue twitches? No big deal. Did you read what he said? ...tongue fasciculations are NOT the presenting symptom unless they are accompanied by markedly slurred or even absent speech, difficulty moving the tongue due to atrophy and weakness, and profound difficulty swallowing. Do you have any of those symptoms along with your tongue twitching? No. Not that Ive read from any of you..."In other words: If you are able to speak or eat, you really dont need to think about the tongue. If it wasnt benign, you would have lost several pounds before even thinking of a twitching tongue. I know how you feel, as I have several tongue-twitch evey day. But actually Im gaining in weight (simply love chocolate) and speak too much. Im sure its the same thing for you.
 
I have had daily tongue twitches for at least 16 months now. They came with the everywhere twitches all at once practically. They have not progressed or led to any weakness or speech problems. When I first got one I thought I was imagining it since it seemed too surreal. I teach middle school and talk nonstop all day. If I had any speech issues whatsoever, I'm sure one of my students would have pointed it out since they notice just about everything else and are not shy about telling me. Search my posts for the word "tongue" and you will find lots of info about how common this is. It scared me too and still does to some extent so I've solicited a lot of info about it and all has been very reassuring.
 
Hi,I wouldn't be worrying about ALS in your case, especially since your twitching has been going on for so long now, coupled with the fact that you've had a clean EMG.Also, I've read that twitches like the ones you're experiencing in your fingers and hands that are strong enough to move joints, are not associated with ALS. I've read that the twitching in ALS is rarely strong enough to move joints, as it is with BFS.BFS is all about hot spots, and you sound like you're experiencing these to a T, so that's another positive sign. Hot spots are not associated with ALS.I'm thankful for every month that passes by where I'm not developing weakness or losing my motor skills. I'm about 5.5 months into this, and if I can get to where you are at 11 months I think I'll be sittin' pretty and be able to put this nasty mess behind me!
 
Hi there Nervous In Queens (or is 'Nervousin Queen?' not that there is anything wrong with being a queen even if you are a 33 year old male... you'd be far from the first in our proession to be a queen!!!To answer your questions;1) Do you guys get twitches like mine with such strong and recurrent hot spots? YESFingers for some reason really freak me out DON'T KNOW WHY BUT ME TOO... I WILL BE IN THE MIDDLE OF CONSULTING WITH A PATIENT, I LEAN FORWARD TO BLOW UP THE SPHYG WITH MY L HAND, I SEE THE 1ST INTEROSSEOUS MUSCLE TWITCHING AWAY AND I SUDDENLY GET A WAVE OF ANXIETY. TAKES ME A COUPLE OF SECS TO SHAKE OFF THE PANIC (THANKFULLY THE PATIENT DOESN'T NOTICE AS i AM CHECKING THEIR RADIAL PULSE AT THIS POINT, LOOKING INTENTLY AT MY WATCH! BUT THEN AGAIN I CAN BLOW THE SPHYG UP WITHOUT DIFFICULTY SO THE HAND CAN'T REALLY BE WEAKand (for some non-rational reason) I am sure that my twitches are different/stronger and more ominious than any of yours. NO SORRY I'M THE ONE WITH DIFFERENT, STRONGER, MORE OMINOUS TWITCHES, I SOMETIME BELIEVE THAT IT WILL BE ME WHO IS THE EXEPTION THAT PROVES THE RULE THAT BFS TRULY IS BENIGN!!! BUT ACTUALLY, IF YOU WANT TO BE THE ONE WHO IS THE EXCEPTION I REALLY REALLY DON'T MIND... IT'S ALL YOURS!2) What do you make of all of the talk on the other forums of people who have had twitches and then developed their weakness?I DO'NT LOOK AT OTHER SITES. BEING IN THE PROFESSION YOURSELF YOU CAN PRESUMABLY ACCESS THE SAME RANGE OF PAPERS ETC THAT I DID FROM MY LOCAL MEDICAL LIBRARY. DID YOU FIND THE ONE WHERE A COHORT OF ALS PATIENTS WERE INTEREVIEWED AFTER DIAGNOSIS ABOUT THE PRESENCE OF ABSENCE OF FASCICS BEFORE DIAGNOSIS? I THINK IT AS ONLY 7% WHO NOTICED FASCICS BEFORE WEAKNESS AND THE MEAN INTERVAL BETWEEN THIS AND WEAKNESS WAS SOMETHING LIKE 7 MONTHS AND THE MAXIMUM WAS SOMETHING LIKE 12-13 MONTHS. NONE OF THESE PATIENTS WERE EXAMINED BY A NEUROLOGIST IN THE INTERVAL BETWEEN FASCISC AND WEAKNESS AND NONE HAD AN EMG AT THIS STAGE. I THINK ANY SELF RESPECTING NEUROLOGIST WOULD TELL YOU THAT THEY WOULD HAVE ALMOST CERTAINLY ELICITED SOME POSITIVE SIGNS ON EXAMINATION DURING THI INTERVAL AND THERE WOULD PROBABLY HAVE BEEN EMG FINDINGS TOO. THE PAPER DOESN'T DESCRIBE WHAT THE FASCICS WERE LIKE BUT I WOULD RECKON THAT THEY WOULD HAVE BEEN FOCAL NOT GENERALISED, VISIBLE BUT NOT PALPABLE AND CERTAINLY THEY WOULD NOT HAVE BEEN STRONG ENOUGH TO MOVE A DIGIT.I ASSUME THAT PEOPLE ON OTHER FORUMS (WHICH I WOULD NOT LOOK AT IF I WERE YOU ) ARE DESCRIBING THAT THEY ARE PART OF THAT 7% REFERRED TO ABOVE OR ARE DESCRIBING NORMAL PHYSIOLOGICAL FASCISC THAT EVERYONE FEELS (WHICH IN MY OPINION ARE COMPLETELY DIFFERENT FROM THE FORCEFUL REPETITIVE GENERALISED AND SEVERE FASCICS THAT FOLK LIKE US FEEL)3) Do I need another EMG?NO WAY. SEE MY SEPARATE POST
 

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