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What Causes Twitching In Lower Leg And Tricep Muscles?
Question: HI I have a lot of twitching in my lower leg and my tricep muscles, I had a visual auditory and nerve test all in the same day last week and I am going to have an emg test this Thursday do you think it has anything to do with als. I can still walk run and eat normally or are these just other symptoms that I should not be so concerned because I read that sometimes the twitching starts before the atrophy.
Thanks
Very anxious
Thanks
Very anxious
Brief Answer:
ALS unlikely
Detailed Answer:
I read your question carefully as well as some of the exchanges you have had with my fellow colleagues.
Fasciculations (twitching) are a very common phenomenon. In the overwhelming part they are benign, without a particular cause, often related to anxiety (which you obviously suffer from). So it is never having fasciculations alone which makes a diagnosis of any kind. It is always the combination of symptoms which does. In the case of ALS there are other symptoms as well. It is true that visible atrophy can manifest in later stages, but however there has to be some weakness, as the fasciculations are due to muscles losing their innervation and that would cause weakness of those muscles as well.
I mention only weakness as it is a symptom you'd notice, but there are also signs seen on neurological exam (altered reflexes, pathological reflexes, brainstem involvement etc). Now I don't have reports of your consults but since you have undergone tests like MRI and evoked potentials I assume the neurologist has examined you and found no such signs. The fact alone that he has started with head MRI and evoked potentials (not done for ALS) mean that the exam doesn't hint in that direction at all.
So to conclude, while I can not perhaps mathematically exclude ALS without the exam findings, the lack of accompanying symptoms and neurological signs, makes me feel quite confident in saying that the EMG will show no ALS findings.
I remain at your disposal for other questions
ALS unlikely
Detailed Answer:
I read your question carefully as well as some of the exchanges you have had with my fellow colleagues.
Fasciculations (twitching) are a very common phenomenon. In the overwhelming part they are benign, without a particular cause, often related to anxiety (which you obviously suffer from). So it is never having fasciculations alone which makes a diagnosis of any kind. It is always the combination of symptoms which does. In the case of ALS there are other symptoms as well. It is true that visible atrophy can manifest in later stages, but however there has to be some weakness, as the fasciculations are due to muscles losing their innervation and that would cause weakness of those muscles as well.
I mention only weakness as it is a symptom you'd notice, but there are also signs seen on neurological exam (altered reflexes, pathological reflexes, brainstem involvement etc). Now I don't have reports of your consults but since you have undergone tests like MRI and evoked potentials I assume the neurologist has examined you and found no such signs. The fact alone that he has started with head MRI and evoked potentials (not done for ALS) mean that the exam doesn't hint in that direction at all.
So to conclude, while I can not perhaps mathematically exclude ALS without the exam findings, the lack of accompanying symptoms and neurological signs, makes me feel quite confident in saying that the EMG will show no ALS findings.
I remain at your disposal for other questions
Note: For further queries, consult a joint and bone specialist, an Orthopaedic surgeon. Book a Call now.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Answered by
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