Fasciculations and clonus

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xavras

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Hello
I'm 40 years old male from Poland. These are my symptoms:
January 2019: Fasciculations in calves, 2 weeks later everywhere and 24/7 in calves. Neuro exam was ok, except some bilateral brisk reflexes.
April 2019: Second neuro exam also only brisk reflexes. Emg - 5 muscles tested, conclusions: without electrophysiological signs of neurogenic damage, fasciculations most likely benign.
September 2019: today neuro exam: brisk reflexes, bilateral Sterling sign and ankle clonus (3-4 beats L and 1-2 beats R). No Babinski, muscle strength ok, no other abnormalities. Control in six months.
I didn't notice any weaknesses. I can easily do all everyday activities. I'm worried about clonus and the intensity of fasciculations. I think this could be the beginning of ALS.
I will be greatful for your opinions. Thank you in advence and sorry for my poor english.
 

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affected

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I think everything you mention here is address by reading carefully through this link:

Nothing you describe suggests ALS, and twitching means nothing. This is great news! Your EMG supports this - ALS shows up clearly on an EMG in areas you don't even have symptoms in yet.

Maybe your general doctor can help you look at ways of working on your general help and stress to see if you can reduce your generalised symptoms and gain back some quality in your life?
 

KarenNWendyn

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I agree. Normal EMG, normal strength, no muscle function failure— this means no ALS!

Fasciculations are common, nonspecific, and meaningless in the absence of muscle function failure. Brisk symmetrical reflexes and non-sustained clonus can be a normal variant.
 

xavras

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Thank you for replies. My neurologist was a little concerned about clonus he had not noted a few months earlier. I have scheduled MRI of the cervical spine and head. I have had health anxiety for several years. I have been taking SSRI medications for several months and they help a lot, but I'm afraid I'm one of those cases where weakness appears after a long time from the beginning of twitching.
 

xavras

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I have one more qestion. How much time must pass without weakness so that i can be calm that my symptoms are not related to als? Thank you again for your help.
 

affected

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Pretty much right now - clinical weakness is the symptom that rings alarm bells - all the things you are reporting suggest nothing. ALS will show on an EMG in areas that you haven't even found weakness in - so it's not a matter of waiting for it to show up. You don't have ALS symptoms - this means you can work with your doctor to investigate what is going on and work on treating that. But you can set aside ALS - we are really happy for you on this one :)
 

xavras

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Thank you affected. I will update this thread (if i can?) after mri if there is any relevant information.
 
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