Dr. Hitesh Kumar
Neurology
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Patient's Query
Hello doctor,
I have fasciculations that occur a few times a day which lasts from a few seconds up to a few hours. It stops when I move the muscle. I have no weakness, but recently a neurologist diagnosed me with ulnar mononeuropathy in my elbow. What could this be? Please help.
Thank you.
Hello,
Welcome to icliniq.com.
I understand your concern.
Fasciculations have so many etiologies which include -
Any denervation of muscles such as neuropathy, nerve injury, spinal cord injury, or nerve root injury.
Anxiety.
Motor neuron disease or ALS (amyotrophic lateral sclerosis).
Extreme cold.
Hyperthyroidism.
Benign fasciculation syndrome.
Fasciculation cramp syndrome.
Also few more rare diseases. It is difficult to conclude any particular disease by your given information. I would like to know some details about your symptoms such as -
In which part of the body you are getting fasciculations?
Are these twitches visible to your eyes? Or only felt?
Do you have any weakness while doing hand, wrist, or finger movements?
Do you have any thinning of muscles in the forearm or hand?
Do you have an impairment of sensation or some tingling sensation in the forearm or hand?
Though physical examination is also very important for making conclusions about your details.
Thank you for consulting me.
You can always come back and reach me at icliniq.com.
Patient's Query
Hi doctor,
Thank you for the reply,
Fasciculations appear in the calves, thighs, arms, back, face, and buttocks. They are visible and there is no thinning of muscles in the forearm or hand, but have pain in my forearm. But, when I was diagnosed with ulnar neuropathy at the elbow by undergoing a nerve conduction test, three weeks ago, I had normal reflexes and strength, the only weakness was in my pinky finger and my neurologist said that if my condition gets worse, muscle wastage could occur and should undergo surgery. But I have to wait three months before re-evaluation. I have been getting numbness and tingling sensation in my fourth and fifth fingers but reduces as time goes on. Due to my anxiety from researching, I asked my neurologist three weeks ago about MND (motor neuron disease), and he has advised based on my neuron exam and nerve conduction studies, that he could not see any evidence of this or any neurological disease. However, the fasciculations were not present when I saw him as my physician.
Hello,
Welcome back to icliniq.com.
Ulnar neuropathy will not cause fasciculation in the calf, thigh, buttocks, face, or back. If there is no weakness in those areas and no thinning of muscles, and as per your information on neurological examination showing weakness in the pinky finger, and nerve conduction studies are normal, It is not fulfilling the criteria for diagnosis of MND as of now. Fasciculations can be due to anxiety. Though there is no test available to rule out MND. Being a progressive disease, some clinical symptoms or signs appear with time. It is suggestible to have observation and follow-up consultation. Meanwhile, other evaluations (if required by examining neurologists), can be considered to rule out or try to find out a few other possibilities. If you feel some anxiety, you can consult a psychologist or psychiatrist.
Thank you for consulting me.
You can always come back and reach me at icliniq.com.
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