Dr. Muhammad Zubayer Alam
Pulmonology (Asthma Doctors)
The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.
Answered by
Medically reviewed by
Patient's Query
Hi doctor,
I am a 51-year-old male who is 5.10 feet tall and weighs 248 pounds. I started having muscle twitching three months back that seemed to be in one leg but would roam to the other part of the leg, leave there and move to the other leg, then to my arms, hands and then return to where it started. After a few days, it seemed to stop; then, it seemed to be all over when it came back. Twitching can be felt all over, especially in the legs at rest, but seems to stop when moving, or I am not feeling them than one. Right now, I mostly have them in my legs and feet, but I also get them in my buttocks, abdomen, arms, hands, top of my head, and right eye, though these seem to come and go. The ones in my legs change in intensity and sometimes stop altogether. I have no other symptoms, and this has now been going on for almost four months.
My GP checked my blood, and all levels were normal, including magnesium, potassium, and calcium, with a slight elevation to my CPK of 201, but he ran that blood work again in two weeks, and it was back to normal at 147. He sent me to a neurologist who did a full physical exam, including strength and reflexes but did not see anything worrying as he scheduled me for a future examination in six months. A few nights later, of not being able to sleep, he sent me for an MRI of the brain and spine. Still, those results came back clean other than a small tumor between my C3 and C4 between my spine and throat that favors being benign according to the scan, but they are likely going to do a biopsy to be sure. My main concern at this point, of course, is, could this be early stages of ALS, or does it present this way with no clinical muscle weakness and no visible atrophy for this long. I am trying to determine if I should ask my neurologist to perform an EMG of one of my legs since that is where I feel them more often or is this unnecessary as this could not be ALS at this point? I am currently taking Atenolol 25 mg for high blood pressure, fish oil 1000 mg daily, align probiotic for IBS, Phenytoin Sodium extended 100 mg to help with the twitching at night can fall asleep.
Hi,
Welcome to icliniq.com.
Thanks for the query.
I can understand your concern.
According to your statement, you have been suffering from muscle twitching for three months, which has started in one leg, then gradually spread to the other leg, arms, hands, feet, buttocks, abdomen, head, and the eye felt especially during rest. Your MRI (magnetic resonance imaging) of the brain and spine has revealed a small tumor between C3 and C4. Your small tumor between C3 and C4 may cause such type of clinical features. It may be benign or malignant. So, a biopsy from the tumor should be done to detect the tumor's nature and then treat them accordingly. In the case of ALS (Amyotrophic lateral sclerosis), nerve conduction study and electromyography, etc., can help to detect if you want. In case of any other query, ask me.
Patient's Query
Hi doctor,
Thank you so much for your reply.
So there is a chance that a small tumor, which I understand is the size of a grape, could cause all of this twitching? Also, does ALS start with muscle twitching with no other symptoms?
Hi,
Welcome back to icliniq.com.
Thanks for joining us again.
Small tumor between C3 and C4 may cause such type of clinical features that I have already mentioned. If this small tumor compresses the nerve in the C3 and C4 region, such symptoms like weakness or tingling sensation in the lower limbs, then upper limbs, brain, and eye involvement may occur. Your tumor may increase in size soon, and other clinical features may develop. The initial stages may grow slowly for a few months to years, and then it may grow rapidly. Symptoms may occur according to the area of involvement in the case of nerves. So biopsy from the tumor is essential to detect the nature or type of the tumor. Your brain and spine MRI detect small tumors between C3 and C4 levels; you should prioritize this tumor. I have already mentioned that nerve conduction study and EMG (electromyography) can exclude other causes like ALS. Many other neurological causes may develop such types of symptoms, but as the tumor has been detected, so biopsy from it will predict the next step of approach towards the diagnosis and treatment. In case of any other query, knock me, and I will try to reply to you further.
Was this conversation helpful?
Same symptoms don't mean you have the same problem. Consult a doctor now!
Pulmonology (Asthma Doctors)
Related Questions
Kindly tell me whether the cramps I am experiencing are due to ALS or MND.
Can ALS cause muscle twitching?
I experience widespread muscle twitching with sudden tinnitus in ears. How to clear it?
Is ALS the only reason for continuous twitching?
Does tingling in my hands and legs mean carpal tunnel syndrome or ALS?
I have constant muscle twitching in feet and legs with no difficulty in walking. Is it ALS?
Disclaimer: No content published on this website is intended to be a substitute for professional medical diagnosis, advice or treatment by a trained physician. Seek advice from your physician or other qualified healthcare providers with questions you may have regarding your symptoms and medical condition for a complete medical diagnosis. Do not delay or disregard seeking professional medical advice because of something you have read on this website. Read our Editorial Process to know how we create content for health articles and queries.
This website uses cookies to ensure you get the best experience on our website. iCliniq privacy policy
