Fasciculations and UMN control

Status
Not open for further replies.
vmd,

In my case the symptom onset order was cramps, weakness, twitching.

First weakness was around June 2007. I didn't recognize it as weakness at first just a slight limp for unknown reason. First time I can recall any twitching was around November or so of the same year. But I never focused on them as I didn't cruise the internet until the neuro said possible ALS.

There's a new poster today who was just diagnosed with twitching preceding weakness. So I guess everyone is different. To really get an accurate answer you need a large sample size.

-Tom
 
Tom:

Yes, we need larger samples and representative samples as well. It seems that a good clinician who has seen many patients with benign and malignant fasciculations would develop a strategy for differentiating between the two types.
 
Hi VMD,
I would think as long as you have been dealing with this stuff, you should have some eal major changes in your physical status. How ar eyou doing? write and let us know.
 
I have had muscle twitching since March 1989. I can remember the night is started.

It was not until the last few years I experienced other "symptoms" of something, and only a few months since I have gotten really concerned about serious issues of subjective weakness, subjective coordination, etc. Nothing has been picked up clinically or diagnostically.

I am not diagnosed with anything, but something isn't totally right. I do know that.

I think you can stop the debate of fascics before weakness, weakness before atrophy, all that stuff. I've concluded there is no set pattern with neuromuscular stuff folks.

That should really muddy the water, huh?
 
Hmmmm

I find it interesting that nobody had a comment to judylyne's post in this thread. I find her comment directly related to the subject and very interesting.
 
I agree

I agree with you hopingforcure..if you dont have atrophy and clinical weakness then i wouldnt worry about it....Blinza always knows everything, so you should listen to him he knows a lot about als and has had plenty of emgs to prove he doesnt have it...I am so happy for you Blinza you dont have ALS!Happy new year everyone!Jenny benny
 
Hoping:

I'm still here struggling with my symptoms. Recently, I have developed the type of fasciculation that is quite worrying to me: the constant, 24/7 type with other characteristics that differ from the other fasciscs I have been experiencing.

ktmj:

I also have had bouts of fasciculations in the distant past, but none, apparently, as continuous as the ones I have been dealing with for the last year or so.

Kevin:

Yes, the issue is whether a good neurologist can pick up pathology with a good EMG workup once fasciculations are present. Again, there does not seem to be a consistent answer here that all will accept. I know Wright has dealt with this question before, however.
 
Kevinw,

She stated the twitching was the first symptom her husband had. My guess is, it was probably the first symptom that was obvious to him. If the doctor suggested he had probably had the disease for 2 years before then, that means there was other stuff going on in her husband's body prior to the twitching.

People will tend to dismiss things like minor weakness setting in due to age, exercise or the flu and not a motor neruon disease. We have all come to know that muscle twitching is not only visible but annoying and to more than a few, troubling (especially when Dr. Google is employed).

I'll bet twitching was just the first symptom to catch his eye and that could have been going on a while before he noticed it. I saw the twitching before I felt it.

Zaphoon
 
Can you elaborate on that, judylynne? What else happened? I need to check your profile and see if there is more information on your husband.

Thank you for posting.
 
what came first

My partner never complained about any twitching. His first symptom was weakness, followed by atrophy in his left hand/arm. There are slight fasciculations visible on that arm a year later. But nowhere else. I have read that the tongue (in a resting position, inside of the mouth) is a good indicator of presence of fasciculations (which are visible on the tongue).

Since my partner's diagnosis I have had random twitching EVERYWHERE, everyday. I know it is related to stress and nothing to do with ALS.

Danijela
 
Like Hopingforcure said, my neurologist told me that although they (the medical community) do not really understand why fasciculations happen, that one of the reasons may be nerve irritation.

In my own case, I've not ever been very twitchy. With bulbar onset I had clinical weakness noted by various medical professionals that I either was not consciously aware of, or did not realize the extent of, and had not felt any fasciculations in those areas. Now that there is limb involvement, my left hand has some visible muscle loss, also is weak (and my wrist) but only once was I aware of fasciculations there, and that one episode was one of an almost continual more intense movement, as opposed to the ongoing slower more gentle ones that I have in my feet and legs. But both places have atrophy.

Fasciculations in a specific muscle does not necessarily equal future atrophy in that spot. That place may end up with atrophy, but the fasciculations are not the cause. I've also had atrophy where I didn't have fasciculation that I was aware of. That's why its the weakness that matters, not the twitching. The type of twitching, and if there even is twitching needs to be taken out of the equation completely, if one is trying to evaluate the seriousness of what is happening.

As for clinical weakness versus subjective/perceived weakness; in the bulbar area, other than my voice, the growing weakness was so gradual that the professionals pointed it out (or found it through testing) before I noticed it. After they'd point it out, I'd realize they were right, but the weakness was noticed by them first.... Even with my voice, it was others, my family or friends who knew my voice well, that heard the change in it before I could.

But then, in my arms and legs, I noticed it before it could be measured by them. In September the PT at the clinic, and my neuro found weakness in my left hand and my feet, but they said before they would ever be able to detect it, I would have noticed it first. That statement was true of my limbs, but not really for the rest of me.

I agree with Caroline, that the weakness, and prospect of the loss of independence, is what has been hard for me to deal with.

The fact that its usually gradual may be why some are more advanced (like Judylyne's husband) before the person feels something is wrong, and it takes something unusual, like a muscle moving on its own, for them to take notice. Imagine, for an example, jumping into the pool on a hot summer day. The water feels cold when we first go in, because it was a sudden change of temperature, but after being in there for a while, it doesn't feel cold at all (unless it really is LOL)
 
Rose,
a very kind and informative post.
Wright gave a very informative explanation of the emg exam on another thread. He stated that fasiculations are not evident in UMN involvement, and this is true, but many have twitching with PLS, but it is not malignant twitching (so to speak), it is not the kind that show's up an emg, therefore leading to a "CLEAN" emg and a pls diagnosed. I know this is all so hard to explain. And like Wright said it can turn to a dirty emg and become dirty with lmn involvement.
 
Rose:

Good post. I have read research attempting to find clinical differences between malignant and benign fasciculations. Apparently, they feel they may be able to categorize such fasciculations as more likely to be malignant or benign.
 
Hoping-

Your comment that UMN people don't have fasiculations is not true. My husband has UMN symptoms only, including fasiculations.
 
Fasciculations are a lower motor neuron symptom not upper motor neuron.
 
Status
Not open for further replies.
Back
Top