36 yr old female... help with Symptoms.

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New member
Jan 5, 2023
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Thank you so much for taking the time to read this. You guys are all amazing as I have been reading other threads before posting. I am just one nervous mom of two daughters ages 10 and 8. I have read the read before posting thread. I have been having twitches since November. It started in my right thumb. Since then it has turned into facicualtions in my right arm and left leg (all through calf). I have noticed my hand locks and makes me unable to hold things.
Recently I have had faciculations through my neck. My face and mouth are twitching as well as feel numb.

Now I know twitching means nothing. I had an EMG yesterday which came back normal on both arms. He also did behind upper back.
My fear is that I could have bulbar als. Not sure if this would show up in the emg on both arms or the neck? The fasiculstions in my neck and under my chin really concern me, as well as my mouth and face twitching.

Thank you for reading. Any insight would be greatly appreciated. I am grateful for my clean emg of both arms but nervous because of my symptoms in my throat and face.
Sounds like they emged the upper trap which is one of the accepted sites for bulbar screening
The EMG tested all that was needed to test. Please discuss your continuing concerns with your doctor so you can get the bottom of what is going on. Hope it is solved soon.
Thank you for all your replies...

I have my lower EMG this Friday as I have twitching in my left toe and both calves.

A few questions:

Are fasiculations in your neck/throat (under chin) common with ALS. I also feel twitching in my lip. This concerns me the most, thinking could be Bulbar.

The neurologist did do the needles in my back near my spine (two). Not sure if that would show if bulbar?

I am super grateful my EMG in both arms were normal... but still concerned and value your input here. GodBless you all
Fasciculations are common. Period. Anyone can have them anywhere. Re your bulbar fears 1 you complained of fasciculations everywhere as well as other hand symptoms. Your upper extremity emg was negative and I don’t think your doctor found anything on clinical exam as you did not mention it 2 as I already told you you seemed to describe an emg of your upper trap which is a bulbar screening site.
please ask your doctor any more questions
Twitching means nothing, please refer to this post and read through really carefully to be ready for your next appointment. That way you will know a little about what is important and what they may talk to you about.

It is unusual to have 2 EMGs so close together.
At any rate, truly, the doctors know which muscles to test and it isn't necessarily the ones you may think should have been their foruc. They have lots of training to figure that out however.

Next step is to discuss all this with your doctor as the clinical examination is very important for interpreting everything else.
Thank you both for taking the time to answer. I think the concern is that it was both my right arm and left leg primarily the concern. They wanted to do two separate EMG for upper and lower. They never mentioned doing an EMG to test for bulbar. I hope we can figure it out soon as the fasiculations can cause a lot of anxiety especially feeling them through our neck.
No worries - if it were ALS you would have signs in at least upper or, if not and lower if it were bulbar onset. You are reporting symptoms body wide so it is not bulbar onset.
The EMG is just a tool that is used to help diagnosed a huge variety of disease and injury processes.
Hi everyone...
Had my lower emg done today. He said there were some small fasiculations during the emg, but everything else with my nerves looked normal. I have a follow up feb 9.

Question.... do some
Fasiculations even with a normal nerve study ever mean als? Made me very nervous
It sounds like they were simple fasciculations so they should not worry you. There is a difference between simple fasciculations and complex fasciculation potentials on emg. The latter IN COMBINATION with other findings MAY be suspicious but simple fasciculations? No. Please prepare your questions for your follow up so your doctor can address all your concerns
As suggested, prepare all your questions for when you see your doctor for the follow up as they can answer in context of your actual findings. I wish you a speedy return to health.
Do you think with the emg results both upper and lower, even though I had a few fasiculations in my right calf is enough to rule out als?
You are clear - twitching means nothing. Someone with ALS has a VERY different EMG.
Please let this go and work now with your doctors to ask all your questions on what is next as we only deal with ALS here.
Your doctor is the one who can help now. Great news!
Thank you all. Lastly here is the results of brain mri. Does any of this point to als?


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Did you ask your doctor to talk you through this MRI?
MRI alone would never diagnose ALS.
Your clinical exam is clear of ALS, your EMG is clear of ALS. Your MRI seems to be pretty much normal.

We can't do anything more. Please, only your doctor can help you on this.
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