Twitching Thumb: What Could It Be?

[Alonzo]

Hi again,

Sorry I posted twice, as I didn't ask these questions in my first post! To recap, I have a twitch in my thumb, you can see a little muscle move in the fleshy part of my plam and my thumb will twitch. If I rest and watch my hand, it may twitch, then ten minutes later I'll look at it again, and it won't twitch, so it comes and goes, but has been "coming and going" for a week now. So here are my questions:

Would it be unusual for an 18 yr old to get ALS with no symptoms or weakness other than a twitching thumb that comes and goes throughout the day?

Is the thumb a "normal" place to get a benign twitch?

Finally, I have a routine physical coming up, and will ask the doctor about this twitch, what do you think will likely happen, will I have to go to a neuro, or will he be able to say what it is and send me home? Basically, what can I expect a GP to do with this?

Awaiting a response.
Thanks,
GREG

 

[Alonzo]

Greg, you asked; "Would it be unusual for an 18 yr old to get ALS with no symptoms or weakness other than a twitching thumb that comes and goes throughout the day?"
ALS is VERY uncommon, especially in young people, but as with anything in life, there are always exceptions to any rule. ALS usually hits people in their 50's and beyond and it ALWAYS has weakness. I mean, that's what ALS is, right? Dying muscle tissue and nerve connections??? So it is literally impossible to have ALS without some kind of weakness or loss of muscle control, and obviously, if your brain can't command muscles to do their job anymore, that would mean weakness.

Your other question; "Is the thumb a "normal" place to get a benign twitch?"
Absolutely...

And your last question: "what can I expect a GP to do with this?"
That depends on your doctor's experience with twitches and his knowledge on the subject of benign twitches vs. twitches caused by a more sinister problem. It is very common for "good" doctors to have never heard of "BFS", so don't be surprised if he says nothing about it, and with that, also don't be surprised if he sends you to a neurologist for further testing. It is an individual thing based on their knowledge and experience, so obviously there is no "one" answer I, or anyone else, can give you on this question.

In a nutshell, yes, ALS does usually start in a hand or an outer extremity, but against that in your favor is; it is common for BFS to start in a hand as well and it does come and go. ALS doesn't uaually come and go and it always has weakness or loss of muscle control associated with the twitching, simply because that's what it going on with ALS... dying muscles and nerve connections, and as they die... they twitch. There is ALWAYS weakness associated with ALS twitches, period.