Hello. I have been looking at these boards for over a year and this is the first time I've written. I am 43 year old and female started getting sporadic twitching a year ago and sharp, quick cramping throughout my body about five months ago. Other symptoms are very tired jaw when chewing (past four months)tremor in left lower lip when I open jaw real wide that was discovered at a teeth cleaning, and all reflexes are hyper and I have a positive Hoffman reflex and negative Babinski. They ruled out MS with imaging. Had EMG in right leg and my neurologist said it was normal but noted reduced amplitude of right tibial (2.6). We did right leg/foot because I was experiencing constant twitching in right foot. As far as weakness, the only thing I notice is I can't do as many modified push ups as I used to (could never do regular ones). I would appreciate your input as if this sounds like ALS to you. Thank you for your time.
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Nikki J
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Hi
Your symptoms do not sound like ALS to me. As I am sure you know hyper reflexes are common and are often a normal variant. A positive hoffman can also be normal particularly if it is bilateral. Was yours?
Did you mean to say reduced amplitude was on the ncs portion of your ncs/ emg? Anyway your EMG did not show ALS. What does your neurologist say?
Your symptoms do not sound like ALS to me. As I am sure you know hyper reflexes are common and are often a normal variant. A positive hoffman can also be normal particularly if it is bilateral. Was yours?
Did you mean to say reduced amplitude was on the ncs portion of your ncs/ emg? Anyway your EMG did not show ALS. What does your neurologist say?
Thank you for your response. Yes, reduced amplitude of 2.6 on right tibial on nerve conduction, all other nerves within normal limits. I asked her what reduced amplitude meant and she told me nothing to be concerned about. All muscles examined showed no evidence of electrical instability in the right leg/foot tested back in November. I can't recall if hoffman was in one or two sides, but I think it was just left. My neurologist wants to do another EMG to rule out things since my left mouth tremor hasn't gone away and neck pain has gotten worse. He is a different neurologist than the one that did my EMG on right leg, we had moved.
Nikki J
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As you were told the ncs finding has nothing whatsoever to do with ALS
Neck pain as an early symptom does not fit either. When the muscles get weak and the head starts to drop it is another story
If you what you have in your lip area is tremor that is not part of ALS. Is it really tremor confirmed by the neuro? There is something called clonus but that is really different than tremor. It is like your teeth are chattering multiplied a 100 times and is not really your lip at all
Neck pain as an early symptom does not fit either. When the muscles get weak and the head starts to drop it is another story
If you what you have in your lip area is tremor that is not part of ALS. Is it really tremor confirmed by the neuro? There is something called clonus but that is really different than tremor. It is like your teeth are chattering multiplied a 100 times and is not really your lip at all
Nikki J
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My sources for saying tremor is not related to ALS are some famous ALS researchers who have seen a gene positive member of my family who has tremor. They all have sworn it is unrelated to ALS or our genetic defect
You asked if it was a real tremor confirmed by a neuro and I answered yes. If you are saying tremor is not associated with ALS, which I believe you are, that is good news. Also, I am sorry about your diagnosis and of the other members of your family and pray there are rapid advancements in treatment that will help you.
Nikki J
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Thank you for your kind wishesYes I understood you were confirming it was a tremor. That was why I told you what my family member was told and by whom. I hope you find it reassuring that it came from ALS experts and was not my unsubstantiated opinion. I am just repeating information. Good luck with you emg.
He may have called it a twitch, can't remember if he said twitch or tremor, but he definitely confirmed it and that is why he wants to do an EMG. If it is a twitch, not tremor, is that associated with ALS? That will be my last question, unless anyone has any for me.
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CJANAY: You might have missed Nikki's very first comment. It doesn't sound like ALS at all. She is quite knowledgeable, and I would take that to the bank.
Nothing you said describes ALS. The neuro's EMG cleared you, too.
Specifically, sporadic twitching is so common, it is not diagnostic of anything.
Cramping is also not indicative of ALS.
very tired jaw : In ALS, muscles don't get "tired," they just don't work at all.
can't do as many modified push ups as I used to: If a muscle is affected by ALS, you couldn't do ANY pushups.
So good luck with your doctors, but don't sweat ALS.
Nothing you said describes ALS. The neuro's EMG cleared you, too.
Specifically, sporadic twitching is so common, it is not diagnostic of anything.
Cramping is also not indicative of ALS.
very tired jaw : In ALS, muscles don't get "tired," they just don't work at all.
can't do as many modified push ups as I used to: If a muscle is affected by ALS, you couldn't do ANY pushups.
So good luck with your doctors, but don't sweat ALS.
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