Questions about ALS

[EJEB]

This is my first time writing on this website. Two months ago I noticed twitching on my right forearm. This lasted for a couple of weaks and accept for an occasional twitch has stopped. I also have twitching in my right calf and thigh which has also been happening for the last couple of months. I went to my GP in August who told me that he does not believe it is ALS because there is no weakness associated with the twitching. I asked him to send me to a neurologist who has had ALS patients. I went to the neurologist about a month after the twitching first started. He gave me a Neuro exam and told me there is no weakness in my limbs and all my reflexes were normal. I was given an EMG and nerve conduction test that was administered by another neurologist on my entire right side. He tested the muscles from my feet to my neck and the exam lasted about an hour. He and my neurologist confirmed that I did not have ALS on September 6, 2008. I still have constant twitching in my right leg and occassional twitching in other areas of the body. I noticed my right calf muscle is smaller on my right leg compared to my left. I still have no weakness in my limbs and I'm still able to climb stairs and walk a couple of miles a day. I'm concerned about the atrophy in my calf. I did lose an uncle to this incidious disease. I'm concerned that I had the EMG to early in the process.

 

[wright]

If your calf was truly atrophic . . . and the atrophy was due to ALS . . . it would be weak. Weakness precedes atrophy, too. Furthermore, twitching is continuous with ALS and does not stop as you have indicated.

Listen, you were just examined by two physicians . . . one of whom is an ALS specialist. If he/she told you that you don't have ALS, then please believe him/her. Congratulations . . . but please don't forget about the people who actually have ALS.

 

[EJEB]

Thanks, but I was told that other muscles will take over for the one that is lost. The other concern is that my uncle had familial ALS with a defective chromosone. I also saw on a website that atrophy can be the first symptom of ALS. I'm just so scared.

 

[wright]

You would still feel weakness in the affected area because there would be less muscle there producing tension. Furhermore, weakness precedes muscle atrophy in ALS. That is a fact, so I'm not sure where you read what you read, but it is wrong.

Most of the muscle atrophy with ALS is due to denervation (some is due to disuse after the muscle is very weak and cannot generate tension) . . . and as soon as the muscle is denervated, it is weakened. The muscle atrophy will follow that weakness. By the time you have atrophy, the weakness will be very evident.

Please relax.

 

[EJEB]

Thank You for your help

 

[EJEB]

Neuro Followup

I had my follow up visit with my neurologist last Friday to go over the EMG done on September 6, 2008. I was told that I have a L-5 Radiculopathy and some neuropathy but not ALS. I beleive this means I didn't have a clean EMG. I don't think I have a radiculopathy because I do not have any pain radiating down my leg. The only pain I have is in my lower left back and not all the time. Two Fasics were detected on EMG. He said that they are Non ALS specific. What is the difference in detecting ALS and a radiculopathy on an EMG. I am a Type 1 diabetic for 21 years. I said back in September I had atrophy in my right calf. I had him measure my calf muscles and there is a 2 centimeter difference between right and left leg but he doesn't think there is a problem. I have constant twitching in my lower right leg and I now have what I beleive is atrophy in my right calf. The only thing I don't have is any clinical weakness in my leg. I can still do everything that I want to do. My reflexes are also normal. I'm confused and scared.

 

[Boo Boo 621]

ME too EJEB

Hi EJEB,

I totally understand your concerns and worries. I have not actually been to the neurologist yet - I got this Tueday. I do have the same thing - right calf twitching with what I think is slight atrophy. The muscle doesn't ball up as much as the other calf and it has me very worried. I also have no weakness and am about to head out on a 4 mile walk with my baby girl. I try and get some exercise here and here - sometimes it's tough with a 6 month old baby - which is why I'm hoping my actual lack of exercise lately may be contributing to the difference in my calf muscles. Before my daughter came along, I used to be way more consistent with running, walking and biking. Let me know how you're doing!