Welcome to icliniq.com.
I understand your concern.
I would like to know some details about your symptoms:
1. In which body parts, do you have twitching?
2. Are these twitching visible to the eyes? Or only felt inside?
3. Have you noticed any weakness or thinning of some part of arm or leg muscles? If yes, please describe.
4. Have you noticed any situations in which these twitching get increased? If yes, please tell.
5. How is your common mood today? Is it usually towards happy, toward sad or toward worried?
6. How is your sleep usually? Do you get sleepy quickly after laying in bed? Do you have frequent awakenings in night?
7. Have you undergone some investigations for this symptoms? If yes, please send as attachment.
Investigations to be done:
The investigations include T3, T4, thyroid stimulating hormone (TSH), serum vitamin B12, ECG (electrocardiogram), nerve conduction study all four limbs, serum calcium, and serum magnesium.Differential diagnosis:
The differential diagnosis include-Treatment plan:
1. Benign fasciculation syndrome.
2. Anxiety disorder.
Only twitching's cannot fulfill the diagnostic criteria for diagnosis of amyotrophic lateral sclerosis. There are many other possible etiology for twitching's.Regarding follow up:
Though ALS is progressive disease, with time more symptoms may appear.
Though no new symptoms in two years, make the possibility of ALS is lesser. Still, there are no tests or clinical methods to rule out ALS. ALS is diagnosed by clinical judgement and criteria supported by investigations.
Revert with above mentioned information for better understanding and further judgement.