Spasticity vs twitching?

[Mt7705]

My mother is complaining of spasticity and sudden twitches in both of her legs. I’m having a hard time telling the difference between fasciculations and twitches. She is saying they started in one leg and have gotten worse and progressed to the other. She currently has a PLS diagnosis. She will have another EMG/nerve conduction test in a couple weeks, but I’m wondering if this would point more towards ALS? Also is there anything that has helped you with this? She was prescribed baclofen but it hasn’t been helpful so far.

She had also lost control of her bladder, she was given medication but it hasn’t helped. She is wearing diapers, but is getting very irritated and is unable to sleep through the night. Should we look into catheters? Is that too uncomfortable to make it worth it?

 

[Nikki J]

All fasciculations are twitches. People with pls do twitch. even though some people say it is more an ALS thing experience of actual pls people says differently

Spasticity is an upper motor sign so definitely consistent with pls though people with als get it too because als affects upper and lower motor neurons. If the baclofen isn’t helping she may need a dose adjustment or a different med but spasticity is worse when cold and sometimes light stretching and or a warm bath can help too

Catheters do come with risks of infection. Is it really loss of control or inability to get to the bathroom in time?

 

[Mt7705]

Ok this is very helpful, thank you.

She says it’s worse at night because she can’t get to the bathroom in time, but also notes sometimes if feels like it’s twitching and she loses control. I guess the bladder is a muscle, so that could be why?

I’ll suggest warm compresses, she uses heating pads because her feet get very cold and lose sensation so I’m sure she has some.

 

[Nikki J]

Bladder spasticity is pretty common in pls I think. Definitely discuss the spasticity issue for limbs and bladder with her neurologist. I suspect a catheter would make her bladder more irritable so really look for other solutions. Some people have used the purewick system. Maybe even a female urinal for night?