Fasciculations now in neck

[JohnMakar]

I stared having fasiculations Feb 15,
2022, between thumb and index finger. Also noticed bilateral both calf muscles. These are persistent areas but recently some started in the side of my neck muscle. No loss of strength.

I will be seeing neurologist next month. My question is specific: Are fasiculations in the neck muscle more sinister than fasiculations in other muscles?
> Can benign fasiculation syndrome affect neck?

Ty

 

[Nikki J]

No.
Yes
Relax and don’t worry

 

[JohnMakar]

Would really appreciate any feedback on what is going on with me. I’m 59 years old recovered from a stroke but otherwise in good health. All blood normal. February 15, 2022 noticed what a neurologist said was high amplitude Fasiculations between my index finger and thumb. Fasiculations also apparent on calf muscle at that time. June 23, 2023 normal EMG everywhere except abnormal EMG on right tricep - “a few fiblerations but normal motor units.” Normal neurophysiology exam in regards to strength. Muscle atrophy/ weakness not present anywhere. At that time no Fasiculations were noted on triceps.

Now large Fasiculations are happening on right tricep- firing off as I write this note. That’s new since last EMG. MRI in June cervical spine C7 noted “ C6-7: Moderate degenerative disc disease with disc height loss, degenerative endplate signal changes and circumferential disc/osteophyte complex. These changes do not result in any significant spinal canal stenosis. Moderate bilateral neural foraminal stenosis, more on the right, is also present. Mild bilateral facet join. degenerative changes.”

One neurologist said c7 stenosis caused fibs. Other neurologist seemed skeptical.

Question - Is this how ALS develops- (without weakness I know it’s not clinically manifest but concerned that it’s heading in that direction). Also interest if anyone has had moderate C7 Forminal stenosis as something that caused Fibs on EMG?

 

[lgelb]

As mentioned in this review, the answer to your question is yes. I would circle back to whoever ordered your MRI to see if they want to follow up.

 

[JohnMakar]

- Re: Fiblerations - article says ‘significant’ canal narrowing will show fibs. Unfortunately my MRI says changes do not result in any significant spinal canal stenosis. Raises concern in my mind fibs are result of denervation in local tricep muscles which are now coupled with fasiculations in that muscle area. However no weakness in tricep atm. Dr that ordered MRI basically not concerned unless weakness. Guess nothing to do but wait. Wondering if u can have fibs and fasiculations w/o weakness as a precursor to the disease or would one expect weakness already?

 

[lgelb]

Bear in mind that the article is a review and not all scenarios can be covered. Just because the article says "significant" (not a quantified term and MRIs don't see everything) doesn't mean "mild" can't cause the same phenomenon.

Yes, by the time EMG changes can be seen that are due to ALS, if it's an area that you've already noticed, we'd certainly expect weakness or stiffness that impaired movement (and not because of pain) since motor neurons would have died. So don't sweat that at all. You might try therapeutic massage (with someone who has a neuromuscular specialty since you do have spine issues) to see if you can calm things done.

In ALS onset, there is not an EMG-only, no-functional -issues prelim stage. I'd reread the diagnosis sticky.