Waiting for EMG

[Viilajwv]

Thanks you all for your information and time. I will try to include all information below.

I’m a 51 year old female. Started having eyelid twitches Jan 2019 that progressed to random thigh, calf and upper back fasciculations. By July 2019 fasciculations were more consistent and spread also to abdomen. Now they are also in buttocks and upper arms. PCP did all bloodwork in July and it was normal. She referred me to a Neurologist.

I had that visit 9/24/19. Neurologist did a exam, commented that I had nystagmus on exam but I’ve never had problem with blurred or double vision. That’s all she told me. She ordered a brain MRI and told me to come back after MRI for an EMG. MRI was last week and it was completely normal. EMG appt isn’t until 10/17.

The MRI was for what she saw in my eyes. I wish I had asked her what she saw in her exam that wanted her to do the EMG. I’m assuming she saw something and didn’t think the fasciculations were benign. I didn’t report to her any muscle weakness because I haven’t noticed that since this all began. The thing I feel is pretty bad fatigue. Legs feel tired like I ran a marathon and I don’t have energy to exercise. If I do any exercise the fasciculations get worse. I have steadily lost all energy to do basic tasks.

Question:

1. doctor has to see clinical weakness on exam, so did she see weakness I’m not aware of yet? I know it takes time for the muscle to completely die. So could I have enough strength still to not understand it as weakness yet to me. When the doctor did the strength test I felt like I was strong in all the tests. She really didn’t give me any information after her exam but to follow up with the MRI and EMG.

I’m anxious waiting for the EMG and to talk to her again. I don’t feel I have all the information to understand what is going on after her exam. She didn’t tell me what she was looking for. She just said lots of people have fasciculations.

I read the stickies and I know you say fasciculations don’t come without weakness.

2. Since it takes awhile for the muscle to die could the fasciculations be the start of ALS? I’ve read that it can come first in some patients.

3. Do fasciculations in ALS come and go? Some days I have many more fasciculations then others. Some days just calf or calf and thigh, other days they are all over legs, stomach, back and upper arms. And they move so I might feel some in right calf then that stops and I feel them in left calf or upper thigh. Feels like popping corn under the skin.

Thank you for taking time to read all this. I appreciate any insight you can provide.

 

[Vincent]

First things first. Fasciculations in the absence of muscle failure are not indicative of anything. As a matter of fact, 70% of healthy people have fasciculations making them normal. Muscle failure isn't necessarily like cutting a nerve. The muscle has to lose about 70% innervation before you have failure. THis is graded on a 0-5 scale, 5 being normal exam,0 being no movement. On diagnosis my left dorsiflexors were graded a 3-,meaning i could still lift my forefoot weakly against gravity. So I don't see ALS in your future. By all means get the EMG done, but don't worry about ALS
Vincent

 

[affected]

As Vincent says, twitching, or fasciculations mean nothing on their own. Doctors order tests to build a picture of what is going on and you have had two very common tests ordered. Both these tests are used to look for signs of a huge range of diseases.
Contact your doctor again if you need to know what she is thinking.
If you can however, it will really help you if you can stay calm, hydrated and exercise normally and get as much good sleep as you can.

Until you have more results we can't really do or say much I'm afraid. Please do let us know the results. I also don't see anything indicating ALS in your history so far. All the best.