Is it true that ALS fasciculations only happen when the muscle is at rest and that these are very different in character to the standard muscle twitch?
I had a follow up with my Neuro yesterday and I was telling him the muscle twitches in my calf, biceps etc. have eased off but still happen quite often but the twitch in my little toe which twitched almost constantly has spread to a couple of toes next to it now and got worse. Yesterday my toes cramped pretty bad and also felt painful. Also when I spread out my toes and try and stretch them out then my little toe really goes for it and the muscles from the side of my little toe to the top upper side of my foot just fasciculate constantly.
He said "Well of course they will do if you stretch the muscle like your doing! and ALS is motor based not sensory, pain is not usually associated with it" He then said "You have no muscle wastage at all and even though you say your right leg and bicep feel weak, in all my tests I have performed on you they appear symmetrical in shape and I can detect no weakness at all, actually your a strong chap and your reflexes are also good, no Hoffmans, Babinski. Trust me you do not have ALS." He concluded by saying "Andy trust me I know an ALS twitch when I see one, I was just at the hospital this morning seeing an ALS patient. What most people don't realize is that ALS fasciculations 99.9% of time ONLY occur after there is evidence of atrophy - They can also easily be triggered most of the time by the examining Doctor by just flicking the skin with their finger and I cant trigger any on you. Finally they move up and down the muscle, normally the bigger ones like thigh, calfs etc quite distinctly, almost in a wave like motion that travels the entire muscle, kind of like if a worm was crawling just under your skin and all your symptoms have appeared in 3 weeks, way too fast in my opinion for ALS"
I was kind of satisfied with his answer but then I read where a few people who had ALS said they had intermittent fasciculations early on at rest and when they stretched the muscle and they just looked like normal twitches. Also that they got symptoms very quickly?
Cheers
Andy
I had a follow up with my Neuro yesterday and I was telling him the muscle twitches in my calf, biceps etc. have eased off but still happen quite often but the twitch in my little toe which twitched almost constantly has spread to a couple of toes next to it now and got worse. Yesterday my toes cramped pretty bad and also felt painful. Also when I spread out my toes and try and stretch them out then my little toe really goes for it and the muscles from the side of my little toe to the top upper side of my foot just fasciculate constantly.
He said "Well of course they will do if you stretch the muscle like your doing! and ALS is motor based not sensory, pain is not usually associated with it" He then said "You have no muscle wastage at all and even though you say your right leg and bicep feel weak, in all my tests I have performed on you they appear symmetrical in shape and I can detect no weakness at all, actually your a strong chap and your reflexes are also good, no Hoffmans, Babinski. Trust me you do not have ALS." He concluded by saying "Andy trust me I know an ALS twitch when I see one, I was just at the hospital this morning seeing an ALS patient. What most people don't realize is that ALS fasciculations 99.9% of time ONLY occur after there is evidence of atrophy - They can also easily be triggered most of the time by the examining Doctor by just flicking the skin with their finger and I cant trigger any on you. Finally they move up and down the muscle, normally the bigger ones like thigh, calfs etc quite distinctly, almost in a wave like motion that travels the entire muscle, kind of like if a worm was crawling just under your skin and all your symptoms have appeared in 3 weeks, way too fast in my opinion for ALS"
I was kind of satisfied with his answer but then I read where a few people who had ALS said they had intermittent fasciculations early on at rest and when they stretched the muscle and they just looked like normal twitches. Also that they got symptoms very quickly?
Cheers
Andy