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tabkb

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Does anyone who has ALS or have a relative with ALS know if the twitching is only in the weak limb. Let's say your right arm and hand and fingers are weak, can the twitching be only in the affected limb or can it be on the left side too? I have a weakness on my right side but no weakness on the left side, both sides twitch. Thanks for you help.
 

Nighthawk

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I think I have a combination of UMN damage coupled with LMN damage.
Only LMN damage produce muscle twitching (also known as fasciculations).

My muscle twitching in the upper limbs started with twitching in my dominant hand (left hand, by the way) but, by the time I did notice the twitching in that particular hand, I had weakness already, and it ended up with atrophy (the muscle between the thumb and the index finger is wasted and the pinky finger and the ring finger are curled under).
My right hand wasn't twitching simultaneously as the left hand was at that time.

Although, I have to clarify that the muscle fasciculations and wasting in my left hand were caused mainly by Ulnar Nerve Entrapment at elbow level as it was revealed on the EMG ordered by the neurologist.
I don't know how common is having nerve entrapments running alongside with ALS or if it is some unidentified underlying condition.

I, right now am having the same problem in the right hand (fasciculations and some weakness but no atrophy...just yet) and it is also being caused by the right Ulnar Nerve being trapped at elbow level.

Hope this helps.
 

hn7609

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In my case the twitching is present in most of my muscle groups. At certain times the twitching is more prominant in the weakest muscle groups but it still is present most everywhere.

I have a weakness on my right side but no weakness on the left side, both sides twitch.

You are twitching on the left because it is affected..........you just haven't lost enough strength there to realize it.
 

dbltree

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I have twitching everywhere, literally from my chin to my ankles but weakness only in right arm and minor weakness in right leg. Eventually weakness I am certain will spread to all areas as mentioned....
 

Nighthawk

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This is the way I see it and understand it.

In ALS, NOT all LMN die at the same time and same speed, they do die in stages.

Let’s say for example, when 60% of the LMN that nourish the muscles of your hand die, the rest of the LMN still “alive” try to do their own job and the job of the LMN that already died.

This causes a lot of stress to these motor neurons because they are OVERWORKING trying to make it up for the ones already dead.
This overwork then translates in muscle twitching [fasciculations] which we can see and feel.

Once the last of these motor neurons die, the group of affected muscles no longer receive any nourishment from the motor nerves and waste away (atrophy).

The speed on which all this happens is the one that determines how fast or how slow the ALS progress on people affected by it.

That’s why some PALS say this: “as long as you notice fasciculations, you still have life in those muscles”.

Hope this helps.

Regards,
 

mbmurray

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i agree with your statement. My right arm and shoulder have atrophy and twitch the most, but I also have twitches in my left arm and both thighs, just not as prominent (I guess I have weakness there that is what the EMG says, but it is not that evident to me right now).

I have noticed weakness in my right arm for 2+ years and atrophy for the last year, but I still am able to type and use the arm to a degree (have 54lbs hand strength)
 

bob_s

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I have twitching on both sides but only when I relax the muscles. Weakness was only on one side until recently.

Somebody mentioned ulnar entrapment. I have that too, but my neurologist thought it was unrelated to ALS.
 

Flyby

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-My fasciculations have moved up my body from my toes to the top of my torso on both sides. I agree that when there are on more in an area that area has no motor neurons left working.
 
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