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Do Twitching Of Muscles On Left Foot And Shin Suggest ALS?

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Posted on Mon, 13 Jul 2015
Question: Hi. i am a 40 year old male. i suffer from fairly severe hypochondria. over the past 2 months ive worried excessively about several serious illnesses i dont have. lately ive been having muscle twitches. they started in my left foot, calf, shoulder. i started to really worry about them. i mainly experience them in my left foot calf and shin. but also in shoulder, tricep, elbow on left side. occasionaly in my right leg, stomach, arm butt. but mostly left side. i have now also got twitching at tip of my tounge. im terrified it might be als. i do not have any weakness at all. ive been told it sounds like bfs and or stress. could this all be from the severe anxiety it has brought on? ive been doing the stand on top of toes and heels drill every day. the twitching is visible. my toes actually move with it.
doctor
Answered by Dr. Dr. Erion Spaho (28 minutes later)
Brief Answer:
ALS very unlikely.

Detailed Answer:
Hello and thanks for using HCM.

I have read your question and understand your concerns.

Just muscles twitching is not enough to diagnose ALS, so ALS in your case is very unlikely, because early symptoms include: difficulty walking, or doing normal activities, weakness of hands and feet, difficulty keeping a correct posture, problems with speech and swallowing.

Conditions related to muscles twitching in your case may be: benign fasciculations syndrome, if you use any drugs (fluorquinolones eg.) may be a side effect, anxiety as well as imbalances of electrolytes in blood.

Other less likely conditions may be muscles dystrophies.

You should have tests such EMG and nerve conduction, blood tests about electrolytes, done in orders to narrow the causes of your symptoms.

Hope this helps. I remain at your disposal for further questions and clarifications.

Take care.


Above answer was peer-reviewed by : Dr. Yogesh D
doctor
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Follow up: Dr. Dr. Erion Spaho (11 minutes later)
Thank you for your reply. So twitching all over without weakness doesnt indicate als? Als doesnt start with twitching? im sorry for the repeated questions but im trying to ease my fears. also as fara as electrolyes i was told to do a mineral tlblood test foe magnesium and potassium and not blood serum as blood serum levels are low only once you are already depleated. what is your opinion.
doctor
Answered by Dr. Dr. Erion Spaho (27 minutes later)
Brief Answer:
ALS is a multi symptoms condition.

Detailed Answer:
Welcome back.

ALS is a multi symptoms condition. Twitching could be one of early symptoms of ALS. But I would not diagnose ALS when the history is only twitching. You should get necessary tests ( those I've mentioned too) in order to arrive at a conclusion.

Hope this helps.

Best regards
Above answer was peer-reviewed by : Dr. Prasad
doctor
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Follow up: Dr. Dr. Erion Spaho (35 minutes later)
if i had a normal neurolgic exam with my symptoms would i need emg?
doctor
Answered by Dr. Dr. Erion Spaho (8 hours later)
Brief Answer:
EMG is needed to assess the nature of twitching.

Detailed Answer:
Hi again XXXXXXX

Normal neurologic examination is a very good point against ALS, however EMG is needed to assess the nature of muscles twitching, since (as you report) twitching is obvious.

Hope I helped you understand better your condition.

I remain at your disposal for further questions and clarifications.


Above answer was peer-reviewed by : Dr. Shanthi.E
doctor
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Follow up: Dr. Dr. Erion Spaho (19 minutes later)
One last question. Sorry. My anxiety over this is through the roof. I have notices that first thing in the morning in bed if i flex my calves ( point toes down hard) my calves cramp up. This of course scared me more. It doesnt cramp on its own. i have to induce it by flexing. Im worried this is another sign of possible als along with the twitching. Can anxiety cause all this twitching?? I have a 4 year old and am just terrified of the possibility of als. thank you for understanding
doctor
Answered by Dr. Dr. Erion Spaho (3 hours later)
Brief Answer:
ALS is not a single symptom condition.

Detailed Answer:
Welcome back.

Once more time, ALS is not a single symptom disease, furthermore muscles twitching and cramps usually occur spontaneously and in your arms, shoulders and tongue.

Anxiety is a possible explanation of your symptoms.

Wishing you good health.
Note: For further follow up on related General & Family Physician Click here.

Above answer was peer-reviewed by : Dr. Vaishalee Punj
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Answered by
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Dr. Dr. Erion Spaho

Neurologist, Surgical

Practicing since :2004

Answered : 4500 Questions

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Do Twitching Of Muscles On Left Foot And Shin Suggest ALS?

Brief Answer: ALS very unlikely. Detailed Answer: Hello and thanks for using HCM. I have read your question and understand your concerns. Just muscles twitching is not enough to diagnose ALS, so ALS in your case is very unlikely, because early symptoms include: difficulty walking, or doing normal activities, weakness of hands and feet, difficulty keeping a correct posture, problems with speech and swallowing. Conditions related to muscles twitching in your case may be: benign fasciculations syndrome, if you use any drugs (fluorquinolones eg.) may be a side effect, anxiety as well as imbalances of electrolytes in blood. Other less likely conditions may be muscles dystrophies. You should have tests such EMG and nerve conduction, blood tests about electrolytes, done in orders to narrow the causes of your symptoms. Hope this helps. I remain at your disposal for further questions and clarifications. Take care.