HomeAnswersNeurologyamyotrophic lateral sclerosisI am experiencing body muscle twitches. Could it be ALS?

Can ALS lead to burning sensations in the back and feet with muscle twitches throughout the body?

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The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.

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Published At February 6, 2023
Reviewed AtOctober 10, 2023

Patient's Query

Hello doctor,

I am worried that I have ALS (amyotrophic lateral sclerosis). Three weeks ago, I had an episode of nerve pain. Burning in the back, feet, etc. Sometimes it feels like I have ice on my back. I also had shooting pain in several areas of my body, like an electrical shock. A couple of days after that, I developed muscle twitching all over my body, which persisted for ten days. It is especially prevalent as I fall asleep. I have not noticed muscle weakness, but my body generally feels weak, though I can still do daily activities. My vitamin D was low at 18 ng/mL. Currently, I am taking Lamotrigine and Hydroxyzine.

Kindly help.

Thank you.

Hello,

Welcome to icliniq.com.

I reassure you that your symptoms do not suggest ALS (amyotrophic lateral sclerosis). ALS is a motor disease that does not cause any sensory problems. Moreover, it is a slowly progressive disease that almost always initiates from one limb and slowly progresses to another limb. Finally, it starts with the weaknesses, followed by atrophy, and then muscle twitches. Therefore, you do not have ALS. Just let me know why you are consuming Lamotrigine and Hydroxyzine.

Thank you.

Patient's Query

Hello doctor,

I am consuming Hydroxyzine for allergies and Lamotrigine for bipolar disorder.

Thank you.

Hello,

Welcome back to icliniq.com.

Benign fasciculation syndrome is the most prevalent cause of muscle twitching, especially all over the body. The underlying causes include electrolyte disturbances like calcium, magnesium, phosphorus, etc., and psychological issues like stress or lack of sleep. So, considering your low vitamin D, I recommend you consume vitamin D, calcium, and magnesium supplements after consulting your specialist doctor. Sleep well and if you feel anxiety, consult with your psychiatrist.

Thank you.

Patient's Query

Hello doctor,

My laboratory results confirmed everything else was normal. So do people experience all of these twitches before the beginning of amyotrophic lateral sclerosis?

Thank you.

Hello,

Welcome back to icliniq.com.

Your symptoms are not suggestive of ALS (amyotrophic lateral sclerosis). A muscle twitch is not a matter of concern unless it is accompanied by weakness and muscle atrophy.

Hope this helps.

Thank you.

Patient's Query

Hello doctor,

What could cause muscle twitching in every part of my body for this long?

Thank you.

Hello,

Welcome back to icliniq.com.

Based on your description of the problem, my most probable diagnosis for your complaint is benign fasciculation syndrome (BFS). In theory, anything that causes overactivity of motor nerves may result in BFS. It includes some reasons like electrolyte disturbances, hyperthyroidism, high consumption of alcohol or caffeine, sleep deprivation, and high level of anxiety or stress. Nevertheless, the real cause in many cases is idiopathic (unknown). Regarding your low vitamin D level, as I recommended previously, consume vitamin D, calcium, and magnesium supplements. Sleep well, avoid alcohol, smoking, and caffeine, and consult with your psychiatrist if you feel a high level of stress or anxiety.

Hope this helps.

Thank you.

Patient's Query

Hello doctor,

I worked out today and tested my strength; everything was fine, and I did not feel weak. However, having twitches for two weeks, I could notice some clinical weakness.

Thank you.

Hello,

Welcome back to icliniq.com.

It is good and supportive evidence that your problem is BFS (benign fasciculation syndrome). You like regular exercise and workouts. In that case, my recommendation is a very light aerobic activity. Yoga, meditation, and relaxation are better than that, mainly because heavy workouts may exacerbate the BFS by increasing muscle hyperactivity.

Thank you.

Patient's Query

Hello doctor,

Does BFS also explain my jerks at night as I am falling asleep?

Thank you.

Hello,

Welcome back to icliniq.com.

There is a normal phenomenon in sleep initiation called hypnagogic myoclonus or hypnic jerks, involuntary muscle twitches that occur in the early stages of sleep. Sometimes they may be accompanied by a sense of falling or may cause a small jump or sudden awakening. These jerks are normal and are not related to BFS (benign fasciculation syndrome).

Thank you.

Patient's Query

Hello doctor,

Are they related to ALS in any way?

Thank you.

Hello,

Welcome back to icliniq.com.

Not at all. As I explained, hypnic jerks are normal. Around 70 % of all persons experience them at least one time in their life, and around 10 % of the population experience them almost always in their life. Therefore, hypnic jerks are benign and normal physiologic phenomena.

Thank you.

Patient's Query

Hello doctor,

Can it affect anything from my head to my shoulders and hands?

Thank you.

Hello,

Welcome back to icliniq.com.

Yes, as I mentioned, it may cause even a small jump. It means that the jerk may occur in a generalized form and cause a simultaneous myoclonic jerk in a large group of muscles of the body, including the head, shoulder, arm, etc.

Thank you.

Same symptoms don't mean you have the same problem. Consult a doctor now!

Dr. Seyedaidin Sajedi
Dr. Seyedaidin Sajedi

Neurology

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