Question on Nerve Conductivity Study and Twitching

[Twitchydude99]

Hi all, thank you first and foremost for reading my post and providing any insight.

My story is probably similar to others here, 43M I started twitching my my tricep back in late February localized to that one area. The only thing that could stop it was flexing my muscle, but it calmed down and moved also to another muscle. Both twitched but less frequently. Fast forward to May. My son’s best friend took his own life and after that (I assume stress) my body started twitching all over. Today it will still twitch all over at times, like popcorn twitches, but my right foot is constant. It’s like a twitch that’s building up for a larger twitch but never happens (usually) more like a quiver.

I went to a general neuro in July to get an EEG/NCS/EMG. They only tested my right limbs (is that normal to not test them all?) and was told all were normal. However yesterday I went to get my records because they’re far too busy to see me each time (months wait) so I decided to go to another neuro. The NCS said “the right fibular motor nerve showed reduced amplitude” 1.9 (>2.5 is normal) it appeared to be near the ankle. The EMG was normal is all respects.

I don't notice any weakness in my ankle. Should I be worried about this reduced amplitude even though the neuro didn’t mention it to me? I read it’s from a loss of axons, and als is when you lose axons too right? Wouldn’t that show on the EMG though? Just hoping this isn’t a beginning of something more sinister. I can attach the files of my report if you’d like. Thank you again.

 

[Twitchydude99]

I went ahead and attached my results in case you’d like to take a closer look.

 

[Nikki J]

Yes it is normal to test only one side. No that one finding is not worrisome at all for ALS. In isolation it isn’t worrisome for anything which is why it is deemed a normal study. If it were worse / more diffuse/ other findings it could have been an indication of a nerve disease but not ALS. Anything on the ncs points away from ALS

 

[Twitchydude99]

Hi sorry for the late response, I had to wait to post again. Thank you for your reply.

On the NCS, do you know why anything on the results points away from als?

I’ve seen videos where they test only one side and the person develops it beginning on the side that wasn’t tested, which is what had me worried. I tried to get the neuro to do both sides but he said there’s no need to.

Lately my legs around my kneecaps have been feeling weaker, kind of like a softer feeling like they don’t engage as well, it’s hard to explain. However I can still walk as many steps as I can before, lift my legs, walk on heels and toes, etc. I know it’s a progressive disease though. I’m twitching all over and the Dr doesn’t seem concerned, but I’d love to know the cause!

Thank you again for taking time out of your day!

 

[Nikki J]

You were tested in an area where you had symptoms. In fact you implied the right was worse. But anyway it isn’t logical to think all your right sided symptoms are benign and the same type of thing on the left something else.

Abnormalities on ncs are not related to als. If someone has ncs findings they have a non als explanation for their symptoms

 

[Twitchydude99]

Thank you for the kind explanation. My neuro agreed to test the other side of my body just to give me the reassurance and wants me to test for celiac and a few autoimmune disorders. He says most likely just bfs though as my clinical was good. Well thank you again, hope you have a great week!