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Old 11-13-2012, 03:09 AM   #1 (permalink)
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Default Fasciculations symptoms

From reading up on ALS I understand that the logical and commonly path of it's process is weakness and abnormal reflexes followed by atrophy and fasciculations. However, I have also read that some people for notice fasciculations as their first symptom but usually still have something abnormal upon clinical examination. I was wondering from people who had fasciculations first or just if anyone knows, what sort of things would this be? Atrophy, weakness or abnormal reflexes?

Also, I have been following the thread on Atrophy Before Weakness before I signed registered up, and was wondering if you had fasciculations and atrophy but normal reflexes and strength tests would this show ALS or not possible?

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Old 11-13-2012, 03:10 AM   #2 (permalink)
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Default Re: Fasciculations symptoms

I forgot to add this sentence into it. Does anyone from UK know statistic of people those in UK with ALS?

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Old 11-13-2012, 03:52 AM   #3 (permalink)
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Default Re: Fasciculations symptoms

Bug,

Are you currently experiencing fasics with atrophy?

This has been said a thousand times before, ALS is insidious. It sneaks up on you and quietly goes to work without you having any idea that something is happening. Some people do notice fasics first, but they do have other things going on that maybe they attribute to a more common ailment, like weakness. They are having a hard time doing certain things that they could normally do, or their gait has changed, or they have atrophy and do not realize it. I think that the most important thing to understand with ALS twitching is that it is almost always confined to the area of weakness. It isn't usually global and it goes unnoticed. The things that get people to go to the doctor are various forms of weakness and upon clinical examination something is seen that prompts a referral to a Neuro, like abnormal reflexes.

If you have atrophy then you should without a doubt have weakness and you cannot pass a clinical strength test with true clinical weakness. Some reflexes can appear to be normal, but in an ALS workup you're going to see abnormalities during the initial examination, whether the fasics are there or not. Most neuros won't even acknowledge a twitching complaint because they are so common and usually benign. I read something from a neuro who specialized in MND that said EMGs are diagnostic tools that are not used to rule out ALS but to confirm it and fasics are never the reason for running an EMG.

As far as the statistics you're looking for... ALS is universal. It doesn't discriminate against anyone and the numbers are two per 100,000 people. Not sure on the number of people in the UK with the disease.

Hope that helps!

If anyone sees anything in there that isn't right, just let me know and I'll correct it!
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Old 11-13-2012, 04:18 AM   #4 (permalink)
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Default Re: Fasciculations symptoms

My twitching is mostly confined to lower limbs, especially one side and constant on bottom of foot. They are mostly unfelt but seen, very fine. I have had them for about 4/5 months now. Would this timeframe mean you would definately have weakness by now even if you did have Atrophy?. I have thought I have atrophy which is why I've been following that thread. I'm slightly confused of your post, as I've read it it contradicts itself. You say you would have weakness with Atrophy yet you said before 'or they have Atrophy and do not realise it', which would suggest no weakness?

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Originally Posted by MommyRissa View Post
Bug,

Are you currently experiencing fasics with atrophy?

This has been said a thousand times before, ALS is insidious. It sneaks up on you and quietly goes to work without you having any idea that something is happening. Some people do notice fasics first, but they do have other things going on that maybe they attribute to a more common ailment, like weakness. They are having a hard time doing certain things that they could normally do, or their gait has changed, or they have atrophy and do not realize it. I think that the most important thing to understand with ALS twitching is that it is almost always confined to the area of weakness. It isn't usually global and it goes unnoticed. The things that get people to go to the doctor are various forms of weakness and upon clinical examination something is seen that prompts a referral to a Neuro, like abnormal reflexes.

If you have atrophy then you should without a doubt have weakness and you cannot pass a clinical strength test with true clinical weakness. Some reflexes can appear to be normal, but in an ALS workup you're going to see abnormalities during the initial examination, whether the fasics are there or not. Most neuros won't even acknowledge a twitching complaint because they are so common and usually benign. I read something from a neuro who specialized in MND that said EMGs are diagnostic tools that are not used to rule out ALS but to confirm it and fasics are never the reason for running an EMG.

As far as the statistics you're looking for... ALS is universal. It doesn't discriminate against anyone and the numbers are two per 100,000 people. Not sure on the number of people in the UK with the disease.

Hope that helps!

If anyone sees anything in there that isn't right, just let me know and I'll correct it!
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Old 11-13-2012, 07:01 AM   #5 (permalink)
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Default Re: Fasciculations symptoms

Hi Bug

I'm assuming that you have been reading Ian's thread; I think you need to bear in mind that people lose muscle mass all the time for a very wide range of reasons, and people twitch all of the time, again for a very wide range of reasons.

If you want to learn about MND in the UK then the Motor Neuron Disease Association is the best place to start; the charity has a website with lots of information.

Obviously if you are worried about MND then you should visit your GP, but from what you say it is highly unlikely that you have MND. Best wishes for the future!
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Old 11-14-2012, 04:17 PM   #6 (permalink)
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Default Re: Fasciculations symptoms

I mean simply that you can have weakness and atrophy or have weakness with atrophy and not realize that you have the atrophy part. I may be incorrect in some way and if I am, I don't mean to misguide you or give you ill advice! ALS is complicated and rare, and Grateful is right. If you are worried about any of these things you should get to your GP.

I hope you get better soon! Sorry for any confusion!
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Old 12-01-2012, 06:38 AM   #7 (permalink)
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Default Re: Fasciculations symptoms

I just want to ask, if you had fasiculations and atrophy in your foot (no weakness) and then had twitches spread to your left arm and hnd, could you develop weakness and atrophy there before ALS had completely taken hold of that foot and had weakness in it? Or would that foot have to be fully weakness before it progressed to upper limbs?

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Old 12-02-2012, 01:28 PM   #8 (permalink)
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Default Re: Fasciculations symptoms

Please does anyone know the answer to this or not?

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Old 12-02-2012, 05:06 PM   #9 (permalink)
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Default Re: Fasciculations symptoms

Bug

In ALS the damage is to both upper and lower motor neurons, both of which are in the brain; it isn't about upper and lower limbs. The MND website which I suggested you read does explain that.

Obviously you are concerned and I think you need to go and see your GP and discuss your concerns with him/her; no-one here can substitute for that. I wish you the best of luck!
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