Fasciculations and probable atrophy

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Jun 6, 2023
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First I want to say thank you for this forum!
I'm 29 years old, a full-time student currently living abroad.

For about 8 months (more or less) I've been suffering from fasciculations all over my body. It's possible that I had fasciculations before, but I didn't pay attention to it, and it didn't bother me much. In the last month and a half , about two weeks before an exam I started to feel the fasciculations very frequently, all over my body - feet, palms, arms, legs, buttocks and even in the face (sometimes feels like weakness in the face on the left side including the tongue, I see no evidence of fasciculation in the tongue, but it really feels like that), shoulders, back and belly. The phenomenon continues even after I passed the test successfully and it bothers me a lot. I should note that the fasciculations are mainly at rest, and when walking for example I don't feel them at all (but I do feel them sometimes in the lip area).

About two weeks ago I went to a rehabilitation and sports doctor who performed a physical neurological examination which turned out to be normal - preserved gross strength, normal reflexes, negative Babinski, etc. In general, I do not feel weakness in my limbs, although in the last few days I started to feel a strange sensation in my right foot when walking (not at rest), which is often felt. I will note that It now feels like pain so I'm afraid it's a sign of plantar fat pad atrophy.

In addition, I measured the circumference of the claves muscles and discovered that there is a difference of about 0.5 cm between the right muscle (strong leg which is the smaller one) and the left (another measurement showed a difference of 1 cm and another of 0.4 cm, so my measurement may not be accurate but There is definitely a difference, also in the area of the heel joint). In addition, sometimes I feel a feeling of muscle pain as if they are tight, especially in the legs and the palm of the hand (but it is not a cramping sensation accompanied by pain, but only a tight feeling).

I am very worried and anxious about the situation to the level that I cannot Stop thinking about it, and even when I try, the fasciculations appear and the anxiety increases. I take a magnesium supplement on the doctor's recommendation, but without improvement. I should note that my lifestyle at the moment is mostly sedentary due to my studies.
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Hello there- sorry you find yourself here. Likely because you searched for "twitching" online. Please make sure to read here: Read Before Posting to reassure yourself. You have been very thoroughly examined by a specialist been given a clear neurological examination. We would not contradict that. As you will read in the link provided, sensory issues point away from ALS. Twitching absent any other symptom, especially no clinical weakness, associated with ALS means no ALS.

If you are struggling with believing your doctor and the information provided here, and are absolutely unable to function due to the worry about ALS, you must address that anxiety. We are not dismissing your symptoms here, only stating it does not sound like ALS. Your doctors appear to have told you the same.

Please take care
Pain in one foot while walking is not a sign of ALS.

You can always take a walk, listening to course material if necessary, so don't just sit there and obsess. And +1 ShiftKicker -- if this is obsession, it's time to nip it in the bud.
Thank you very much for your replay!
Unfortunately the doctor who checked my is not neurologist, and he didn’t checked for atrophy, now it’s I mentioned I can see differences between my legs and after measuring the diameters of Boths legs I noticed that there is a difference pu approximately 1 cm. I can’t sleep and the fasciculation are getting worse.
Hi there-

It's not clear why you're posting here then- we stand by what is in the link. We can not help diagnose you, nor does it seem like you believe the doctor or the link provided here. If you wish to discuss your concerns with another doctor, then that is what you must do.

Please take care
Many people have a 1cm difference between legs, arms, hands, feet.

Do talk to someone about this. It can make all the difference.
I do believe the link, and the doctor, sorry if it’s sounds like I don’t. Yet I went to neurologist who agreed that one leg is smaller than the other, and the fasciculations are not stopping, I feel it after almost every single move. I’m really worried. By now I’m waiting for EMG, but it will take a while and I can live normally. Can fasciculations and muscle wasting can indicate something else then als? About that pain that I felt I don’t fell it so I guess it was psychological,so now I’m even more concerned.
Please review my last comment, is it possible that I’ll have all over constant fasciculations at rest right after any movement and atrophy of calf and it’s not Als? Please I can’t live normally now
Yes. Fasciculations are more often benign than not. One leg being smaller is not necessarily atrophy. Everyone is asymmetrical. Even if it is atrophy there are many causes
I’m sorry for bothering , but now I cannot be optimistic anymore. I had blood tests that all came normal but the cpk. The normal range of the lab is 150-200 U/L, I had 283. Also fasiculations are not stopping and they are everywhere all over the day, every day. Still have no weakness at the moment but as mentioned I have differences of ~1cm between my right and left calves. An emg will be made in August, but I’m really afraid that there are no other explanations for my symptoms. Please let me know your opinion, I’m really afraid and 😞
My opinion has not changed and I doubt whether anyone here will say differently. The only new thing you report is cpk which is such a general test we can not ascribe any meaning to your result. There are many reasons for a mild elevation and no one is going to take that number and say oh yes ALS or even worry about it. Please let us know after the emg. August is just over a month away
Thank you very much for your quick response, I really appreciate it!
Tomorrow I have an appointment for my pcp, I’ll let you know her opinion as well. I’m just worrying because of the combination of non stop all over fasciculations, possible atrophy (also I can feel differences in my neck), and rhe elevated cpk results (because I had no physical activity the day of the blood tests or the day before).
So after visiting my pcp, she noticed that I also have elevated levels of uric acid (apparently it was elevated two year ago as well, but somehow we missed it). She checked for atrophy, she did see the differences but said she don't think it's atrophy. I'm still waiting for my EMG in August but for now, she recommends a specific diet for the uric acid issue, also I have to repeat the blood tests, she gave my blood test for detection of EBV as well. For now, my symptoms are the same and I'm losing weight, even though I'm eating regularly. I'm not sure if the high uric acid levels might be related to the increased cpk and the fasciculations, but I'm trying to do my best and stay calm as much as it possible.
Great news! High uric acid is protective against ALS and the doctor said not atrophy. Please no posting until after your August appointment
Hi Eddi-

This forum can only provide you with the info and advice you've already given. You must wait til your appointment in August. Again, you were asked to not post til you had more information from a medical provider. It is very clear you are anxious about this. If you feel there are changes, please go back to your doctor so they can observe what you are concerned about.

Take care
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