Proof that widespread twitching is related to ALS

[Sheelee6]

I recently came across this article and I'm freaking out now:

https://www.ncbi.nlm.nih.gov/pubmed/11464925

Everything I've read on here says that widespread twitching is not indicative of ALS, but this article states otherwise.

The worst part is that I had an emg last year that the neuro told me was clean then I found out I actually had 1+ fib in my upper paraspinal muscle. All other muscles tested (both legs, right arm, right hand) were all normal. Had a second emg (did not include paraspinal muscles) that was normal. I also had a cervical MRI that found bulging discs at c3-4 and c6-7.

My symptoms are widespread twitching for a year which has lessened a lot since starting magnesium supplements but hasn't completely gone away. A feeling in my arm that I thought was weakness but have since been told by multiple drs is not. It's on and off, it almost makes my right hand feel uncoordinated. I do have carpal tunnel though. I have also been getting pins and needles feeling in my feet and burning, prickling sensations in my legs. I have read on this forum that PALS get tingling, pain.


So why does everyone on this forum and everywhere else say that widespread twitching does not indicate ALS? I'm absolutely freaking out now because I have the denervation (although other drs have brushed it off as no big deal) and the bodywide twitching. I'm female in mid 30's so I know I fit the age group for als. Should I get a third emg? I know sometimes people get clean emg's and still end up having als. I'm so scared right now.

 

[Nikki J]

One paper published 19 years ago? Really?

Do some people with widespead twitching, clinical weakness and a pattern of denervation on emg in one area have ALS as stated in the article. Yes.

The the vast majority of twitchers have anything to worry about? No v

Do you have clinical weakness? The doctors say no.
One fib is not pattern of denervation

People with widespread twitching normal EMGs and normal clinical exams are not the ones that end up with ALS

We just went through this here. Again.

If you are worried see your doctor

 

[Sheelee6]

1+ fib is still denervation. And I dont think it really matters how long ago the article was from. They said people with widespread twitching and denervation (fib) are HIGHLY SUSPECTED of having ALS. To me that is alarming. I have both of those things.


The article did not mention clinical weakness so I'm not sure why you mentioned that. My doctors dont take me seriously, I've seen several now. They keep telling me I dont have ALS but according to that article I should be very worried.

 

[Nikki J]

Some ALS patients with fatigue and mild weakness can have profuse fasciculations at an early phase in the evolution of the disease

That is in the abstract of the article. Read more carefully

No -one fib is not what was meant by denervation pattern Not here to argue more. Believe what you want.

Good luck

 

[Sheelee6]

Ok, I see what you mean. I was specifically talking about the last sentence in the article that says widespread twitching and denervation in one location should be highly suspect of als. Since they didn't mention weakness there I assumed they meant just denervation and twitching were the main indicators of als.


Is 1+ fib anything to worry about? I've asked two other doctors (not the one that performed that emg) and one said maybe a pinched nerve and one said the needle could have too close to the bone (hes trained in electrodiagnostics).

 

[KarenNWendyn]

One fib is nothing to worry about. If you had ALS, EMG would have shown fibs, fasciculations, positive sharp waves, increased insertional activity in multiple regions. EMG changes in ALS are widespread.

You have had 2 clean EMGs and you have been cleared of ALS by a neurologist. Believe your doctors. There’s not much more we can tell you.

Also, just to clarify, pins and needles and prickly sensations are sensory signs and not part of ALS.

 

[Bestfriends14]

How terribly, terribly sad that you are arguing to try and get diagnosed with a disease you do not evidence having, as per doctors, clean clinical exams and clean EMGs.

Please do not come to a forum for terminally ill people trying to argue a case that does not exist. Go live your life, get a hobby or help those who are less fortunate. Again, it is terribly sad that you are choosing to spend your time chasing a disease rather than opt for celebrating the fact that you are healthy (physically) and leading a full life. A life that anyone on this forum would love to have.

Good luck to you in your life.

 

[Sheelee6]

My emg wasn't exactly clean, it had 1+ fib.

I understand that normally emg shows changes in multiple locations but that article is saying denervation in one location is highly suspect for ALS. That's what scares me.

 

[KarenNWendyn]

And we’re saying not to be scared of that. For all intents and purposes, one fib on an EMG is considered clean.

 

[Atsugi]

The most important thing to remember about twitching (and fasiculations--there are several different kinds for the scientists who study twitching) is that twitching is ALSO related to many diseases, some of which are not problems at all.


Twitching is so common to so many diseases that it is not diagnostic of anything.


For instance, I have been twitching all over my body for 20 years, and I do not have any disease that I can name--my body just pops and it seems to be meaningless.

 

[Vincent]

Based on el Escorial standards for diagnosis you would need chronic/active denervation with renervation in 3 areas of the body to meet criteria for an ALS diagnosis. 1 positive sharp wave could be written off as artifact, a glitch in the test. The fact that you have been told you do not have ALS and come here to be diagnosed by random strangers who lack the 15 years training to be a neurologist, should give you a hint as to what the real issue is. You have a software issue we only do hardware.
Vincent