Was asked a good question...

[Clearwater AL]

I was asked a good question (I thought) last night. What is the difference between a benign fasciculation and an ALS fasciculation? As he queried, "physically, mechanically, frequency (as in time space between each) is there a difference indicated on an EMG monitor?" Why would they be titled the same? Best I could answer was, "Good question... I don't know."

He has fasciculations occasionally but is very healthy, somewhat unconcerned with them and hasn't been to a Neurologist. But, like so many he went to the Internet but like so few he is still somewhat unconcerned with them... for now.

 

[Nikki J]

It is not the fasciculations themselves but the company they keep on EMG. If you just have fasciculations without fibrillations positive sharp waves and motor unit remodeling they call it benign. I was told EVERYONE shows fasciculations on EMG if you wait long enough ( this from the head of EMGs at a major medical center) it is when the other stuff shows up they get concerned

 

[Clearwater AL]

Thank you for that answer Nikki. That should be one of the first notations on the DIHALS Stickie.

I'm guessing his question may have really been round about, "Their occurrence/presence without ALS/MND but yet a predominate occurrence/presence in ALS.

Anyway, your answer is suffice so this Thread doesn't ramble on. Now I'm not sure I'll tell him or he'll be running off to see a Neurologist.

 

[Atsugi]

Excellent insight, Nikki.

Without reference to an EMG, I always think of fasciculations in context with the whole picture. If a normally healthy person has twitches, he has twitches just like I do--no ALS. If a person has other signs of ALS, then it's time to see the doctor.

It's the whole horses versus zebras thing.

I view twitches, bounces, restless legs, and occasional spasms as just being a sign of imperfection, usually brought on by age.

Twitches are so commonly caused by stress--even unknown stress--that they can be anything or nothing at all.

 

[Clearwater AL]

Hey Mike, I believe the question he was asking was, "What is the difference between a benign fasciculation and an ALS fasciculation?" Even though they may feel the same is there an actual physical/neurological difference that would be noticed on an EMG read out. It has been written that ALS fasciculations are the nerves trying to reconnect with the dying muscle. So, if the muscle isn't dying and the lower motor neuron isn't dysfunctional would the benign fasciculation be a different fasciculation than that of an ALS fasciculation? It isn't horses versus zebras... it's - is the horse an Appaloosa or a Mustang? Or, is it a confusing coincidence that benign fasciculations and ALS fasciculations are the same neurological notation but are more collaboratively/evidentially predominate in ALS?