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LookingForHope

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I have had constant twtiching in both calves for going on 3 months.
i also have twitching randomly all over my body including my tongue.

all the muscles twitch at rest and when i get up to walk or move around my calves stop twitching. i get radnom ones in arms, hands, tongue ( at rest ), butt, (arches of feet are also 24/7.)

i went and seen a neruo and he checked a few reflexes and ordered a emg..

the emg was dont on both calves and my right thigh and foot.
the emg was considered clean just showing fasiculations..

i went back to the neruo and asked for some strength test and for him to test babnski, hoffsmans, and clonus, he also checked my gait and looked at a few reflexes. he said i was strong and my gait was normal and no babnski, hoffsmans or clonus, he didint say anything about brisk reflexes or anything either but he did tell me the neruo that did my emg wants me to do a follow up emg in 4 months. i asked why if it was " Clean" and my exam was "Normal" he said the guy that did the emd test said he thinks i might have had a Positive sharp wave he couldnt tell during the test so i need a follow up. My main neruo Said he is leading towards a Neruomytonia or BFS dX.

My question is the psw? how can you think you see a psw? and also the emg said no neruopathy, radiopathy, and no active denervation.

oh just remembered the Neruo also said he didint notice any atrophy or hypertonia or hyperflexia

so its been a lil offer 3 months now and still have 0 weakness, atrophy so no Symptoms of Als as far as im concerned.

So what im askin should i be worried about the follow up or is the 1 semi exam and 2nd good exam and one Esssintail Clean emg Be good to rule out ALS?

or is this going to be one of those stories of of good clinical and emg 4 months later full blown ALS?

Sorry to bother but my anxiety and been really high lately.

Thank you all for your Responses
 

lgelb

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Sounds like wanting to dot the i's for risk management rather than any real concern -- 1+ PSW would not mean anything in one muscle. I don't see anything to worry about in terms of ALS.

As you will have read in the sticky, twitching without weakness or atrophy is a reason to check out your diet, hydration, stress and sleep, and do stretching. It's not a sign of ALS.

Best,
Laurie
 

LookingForHope

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Yeah atm they are doing alot of blood work testing for Myasthenia gravis, Lupus and diffrent KVG protiens i think there called in the blood and a few cancers i guess for the Neruomytonia.

they have had me on 300mg gabapentin for a month or so with no results on the twitching.

and wouldnt 1psw mean that BFS would be out of the dx cause a psw to my understanding means there is nerve damage?

I am a little bit concerned because I have read post on this site in where people had clean emgs and clinicals to months later getting a A diagnosis
and on mayo clinic and other various sites they say twitching is a Early sign of ALS.

I also stated above my tongue twitches which is new and scares me of Bulbar. My calves twitch 24/7 and arches of feet 24/7 but i do have bodywide random twitches in thighs,knee,hands,face,lips,tongue,back,arms etc... I understand you are saying No Weakness Or Atropy is good. But In Some Studies bodywide twitching isn't bfs and more of a Bulbar als Or even start of Limb Onset.

1 more thing. im also 30 years old does anyone know the statistics of my age with bulbar and limb? I read the sticky but from what ive gathered als is on the rise and its like 5/100000 now but idk about being 30 and how to do the math.

Thank you all again Much Appreciated.
 

KarenNWendyn

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A thorough history and physical exam (H and P) are the most important tools a physician uses to establish a diagnosis. Usually after doing the H and P, the physician has a pretty good idea of what’s going on.

Tests (including EMG, labs, imaging studies, biopsies, etc) are done, as indicated, to supplement the information from the H and P and help rule in or out a particular diagnosis.

If the tests raise possibilities that are not suggested by the H and P, they warrant follow up, but they are less credible.

So in your case, your presentation does not suggest ALS. The doc did an EMG just to be sure. One psw was found — not enough to sway the initial diagnostic impression, but something they wanted to follow up on just to cover their a$$. Many of these things found on tests are red herrings and usually normal variants and incidental findings. But that’s how it works in medicine.
 

KarenNWendyn

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To answer your questions:

“and wouldnt 1psw mean that BFS would be out of the dx cause a psw to my understanding means there is nerve damage?”

Not necessarily. A single psw in the context of normal strength and lack of other findings showing acute and chronic denervation and reinnervation means nothing .

“I am a little bit concerned because I have read post on this site in where people had clean emgs and clinicals to months later getting a A diagnosis
and on mayo clinic and other various sites they say twitching is a Early sign of ALS.”

EMG can not be done too early. If there are any signs of weakness, the EMG will be abnormal if it’s ALS. If there are no signs of weakness, then there’s no point in getting an EMG if ALS is a concern because you can’t diagnose ALS without weakness.

“I also stated above my tongue twitches which is new and scares me of Bulbar. My calves twitch 24/7 and arches of feet 24/7 but i do have bodywide random twitches in thighs,knee,hands,face,lips,tongue,back, arms etc...”

So? Twitching is common, nonspecific, and meaningless. Eventually you’ll learn to ignore it, for your own sanity.

“ I understand you are saying No Weakness Or Atropy is good. But In Some Studies bodywide twitching isn't bfs and more of a Bulbar als Or even start of Limb Onset.”

Which studies?

“1 more thing. im also 30 years old does anyone know the statistics of my age with bulbar and limb? I read the sticky but from what ive gathered als is on the rise and its like 5/100000 now but idk about being 30 and how to do the math.”

Your chances of getting struck by lightning outweigh your chances of getting ALS.
 

lgelb

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In the 2010-2011 period, 506 new ALS cases in ages 18-39 were noted in the US. We don't have bulbar/limb onset breakouts for them. It does not matter, because you're not showing signs of the disease.

As for ALS being on the rise, it's a disease of aging and so as we live longer, more cases are reported. Also, there is now a national registry that makes reporting more likely.

I guarantee that if you work on the anxiety about ALS and what underlies it, you will be less bothered by any/all twitches.
 

LookingForHope

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Yes im going to a therapy out patient place on monday to be evaluated to start cbt therapy and w.e. else they might think i need. Im trying to ignore the twitches it's just really hard like right now as im typing this to you my right temple and right eyebrow are twitching together kinda lifting on my forhead it's really hard to ignore .....

im trying to just spend time with the wife and kids and chill and relax but my mind keeps jumping to what if's like weakness is going to strike at any second and my family will lose there father/husband.

I really thank you all for the replys and taking your time to give me your answers and opinions. Im so greatful truly. Thank You Both
 

ShiftKicker

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The first thing you will be told by a therapist is to stop exposing yourself to triggers. This forum is a big one. Please, no more posting about your twitching here- as it means you are not actually chilling and relaxing with your family, you are engaging with people on a forum for people diagnosed with ALS.
 

LookingForHope

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So since i already had a emg with twitching in the muscles he stuck the needle in does that mean according to you all im fine?

he didint put the psw on the emg because he said he thinks he "Seen" a psw? it just shows fasics

so the follow up in 4 months is kinda pointless according to Karen because i already had a clean emg and i currently have 0 weakness
 

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ShiftKicker

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None, normal. It seems a bit odd that you would ask strangers on the internet to interpret this for you.

Please seek help for your anxiety and continue working with your doctor. This forum is not the place for you.

Thread closed. Please do not open another.
 
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