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Distinguished member
Aug 30, 2008
Hi all

I have to say i am lost about all this UHM,LMN etc i have read the link from AL about it and i have just a few questions

I have really bad twitching in my calfs, is this LMN? and would this have shown up on the EMG if it was nasty?

I also have cramps and stiffness in the same calf, am i right in thinking that this would not show up on an EMG if it was nasty?

just worried as the pain / stifness / crampy feeling is always in my calf and it twitches 100+ a minute 24/7

HI Chris~

Lmn involvent is what shows up the emg. Lmn is atrophy and twitching. If you have lmn atrophy from als it will show on the emg. The UMN does not show on the emg but in phyiscal exam with nuero, like clonus, babinski, hyperflexia etc.

My calf twitches bad, last night I could not feel it but when I crossed my legs I felt it going crazy, then moved my other leg away and felt nothing. It did concern me, but I just have to let that go as I know that twitching alone will not tell me anything.
thats when my twitches are at there worst when i cross my legs, they go beserk and they go in mini cramps all the time when crossed
what do you mean by mini cramps? Real cramp or big twitch?
its like a twitch that holds for about 3 seconds and hurts

What I gather is twitching can be classified as either benign (not caused by lmn) or pathological (caused by lmn). If it is pathological (something that is doing damage), the EMG will pick up on it. If the twitches are benign, you can stick an EMG needle right in the little sucker and readings will be normal. At that point, you can stick smiley faces on them and have a happy day!

Others can explain this in more clear detail but this is a short version. Only your neuro can tell of what variety yours are.
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thanks, i went after 3 months of twitching for my EMG, would this be long enough for the EMG to pick up if the twitches were nasty?
Yes, that would be plenty of time. The EMG can even pick up on any movements not seen by the naked eye.
If EMG pick up JUST fasciculations, could it be consider a normal exam? Benign?

Thank you.
Yes fasiculations on emg can be benign. Other things that are picked up on emg help make a diagnosis.
OK, but an EMG just with fasciculatios (no fibs, no SW, no MPUs,...)? Would it be considered "clean"?

Best wishes.
The answer would be yes, clean. If you want great detail on EMG's and ALS, there is a thread that has been sticky'd in the "Is This ALS" forum. It is entitled, "Read this about EMG's and ALS".
Good. and advice guys, yep stuff is seen really early on the emg and like we have all said although pls says NO twitching, many a twitcher is also a plser. I always wonder in my mind if twitching is actually spasming in plsers? sounds like a slippery slope (I know), but you talk to many with pls or UMN dominant als and they say they had twitching and still have pls or umn dominant als. I myself am umn als and twitching was my first symptom, now undiagnosed. do not worry, I had super pathological reflexes, clonus, spasicity, weakness, and later included the atrophy and weakness. But the twitches were only umn symptom at the beginning. Zaphoon so true, make this living span longer. Wish they could make the connection why some progress slower, and can live a full life span with strictly pls.. If we figured out pls, and keep things either all lmn, pma, or umn pls, we could change this fatal diagnosed.
Just so i get this right, hopingforcure........was twitching your first symptom of ALS? Was this the first thing you noticed? i have 24/7 twitching in my calfs but i have had a clean (ish) EMG, as my nerves were slow in the first test.

when i walk i have crampy / Sore feeling in my calfs...have you experienced this? i do not think its weakness as i can still run upstairs etc.

Many Thanks

Chris, I had twitching, but I also had a flu like feeling, hyper pathological reflexes, had a lot of trouble going up the stairs, trust me, running has not been in my vocabulary since my first twitch. I was super fit, and exercised hours a day, it defined me. But not able to exercise or even walk without trouble from the very start. Relax I never ever had completely normal neuro exam, and I new tait I had something very bad fro m the start. Relax....
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