twitching all over the body , neck spasm, tongue twitches and atrophy

[eva]

Hello all,

First of all, I apologize for my English. My symptoms started 14 months ago with random twitches ( thumb, back, left eye) , it was random , few times a week. After six months these twitches intensified . They started in my arms and calfs , face. When I was at dentist ,my mouth started to tremble when they were opened for longer time.

Few months later my twitches spread to the places where they were't before- thighs, abdomen, ass, neck, tongue, lip. My tongue is weaker, I cannot touch tip of my nose anymore ( I could do it year ago), sometimes I have problem with pronunciation of s,z. I feel weakness in my left hand where I have cramps and twitches. If I do exercise my body starts shaking. I show my tongue to neurologist and she wasn't sure with atrophy so she sent me to ALS specialist ( I have appointment on September).

I had 2 EMG of my thighs, calfs and arms. They also checked masseter , both EMG were clean. One in beg of June, another one in the end of July.

I heard that for bulbar onset, EMG can be clean at the beginning, but I am confused, because I have widespread twitches and weakness for 6 months, I can see atrophy in my left hand ( trenar ), I feel weakness , but EMG was clean. However, they did just emg of arm - my neurologist said they are not checking hand, only arms.

What are your experiences , I there is already weakness and hand atrophy, can EMG of arm detect some problem?

Many thanks for your opinions

 

[lgelb]

The two EMGs combined tested multiple regions, including bulbar (the masseter muscle). So given the issues you are concerned about, I have no doubt that if there were primary muscle damage (myopathy) or nerve damage that would raise concern for neuromuscular diseases such as ALS, these tests would have revealed it.

Atrophy can be caused by many things, and diet/exercise/stress/sleep can have a big effect on shaking, feelings of weakness, and twitching.

I would return to primary care and ask to be evaluated for a possible postviral syndrome or rheumatological disorder.

I see no reason to continue to worry about ALS.