Dr. Aida Abaz Quka
Neurology
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
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Patient's Query
Hello doctor,
For the last few days, I have had fasciculations in my calves and muscle cramps in my leg, especially after training. Sometimes, I feel some numbness in my right arm. I am really concerned about ALS, and my doctor says that I do not need EMG. What is your opinion about it?
Kindly suggest me.
Hello,
Welcome to icliniq.com.
I understand your concern and can explain that cramps in ALS (amyotrophic lateral sclerosis) usually occur at an advanced stage when there is muscle weakness and muscle wasting. So, I do not think that this is your case. Dehydration can lead to this clinical situation—caffeine intake and sleep deprivation too. For this reason, I recommend avoiding caffeine intake, taking plenty of fluids to stay well hydrated, and taking magnesium supplements (300 to 400 mg) daily. I hope this helps.
Thank you.
Patient's Query
Hello doctor,
Thanks for your answer. I am anxious and have panic attacks. Since I have that, I went to a chiropractor today, and he said my strength is normal, and my arm is not numb anymore. But I always have my calves twitching, and today one of my eyes too. So do you think I do not need EMG based on my symptoms?
Kindly help.
Hello,
Welcome back to icliniq.com.
I do not think that you need to perform an EMG as your symptoms are not suggestive of ALS. In my opinion your situation is related to benign fasciculation syndrome and there is no reason to panic. I recommend taking Magnesium supplements and plenty of water to stay well hydrated. Hope you find this information helpful.
Thank you.
Patient's Query
Hello doctor,
Thank you for your answer. I sent videos of my twitching to a neurologist, who said that it was myokymia, according to what he saw on my calf. What is the difference between myokymia and fasciculations? Is it possible to recognize it only by seeing it?
Kindly help.
Hello,
Welcome back to icliniq.com.
I read your query and undertsand your concern. Myokymia is abnormal twitching of a part of a muscle, while fasciculation involves a bigger part of the muscle.The underlying causes are similar, but we can exclude ALS. So just relax and do not worry about it. Hope you find this information helpful.
Thank you.
Patient's Query
Hello doctor,
Thank you for the response. Can I show you some videos of my twitch to say what you think about it? The thing is that the twitch is coming to my eyes sometimes too. What does that mean? Kindly help.
Hello,
Welcome back to icliniq.com.
Yes, please upload the related images.
Patient's Query
Hello doctor,
Thank you for the reply. I will send the related images and videos.
Hello,
Welcome back to icliniq.com.
I saw the videos (attachment removed to protect patient's identity) and I think this is myoclonus. I recommend checking vitamin D and vitamin B12 plasma levels for possible deficiency. I recommend taking Magnesium supplements 400 to 500 mg daily. If myoclonus persists I recommend performing nerve conduction studies. Hope you find this information helpful.
Thank you.
Patient's Query
Hello doctor,
Thank you for the answer. I will start it today and I will ask a doctor for these check. Is this symptom associated with ALS? Is that the same thing on my calves and legs ?
I would like to say that my father and uncle got the same symptoms too.
Hello,
Welcome back to icliniq.com.
I would exclude ALS based on the images (attachment removed to protect patient's identity). Hope you will find this information helpful.
Thank you.
Patient's Query
Hello doctor,
Thank you very much for the answers.
I was really concerned about that disease, and that my doctor said that I do not need EMG.
Hello,
Welcome back to icliniq.com.
Yes, you do not need an EMG. Just relax and do not worry about ALS.
Thank you.
Patient's Query
Hello doctor,
Thanks you for the response. I have some questions. I have a lot of these movements in my eyes, too. Does it mean something more? And I had the sensation of having difficulty swallowing and eating. Do you think it is psychological? Kindly suggest.
Hello,
Welcome back to icliniq.com.
I think that this is just a little stress and anxiety. Nothing serious. I recommend taking less coffee and more camomile tea. I hope you will find this information helpful.
Thank you.
Patient's Query
Hello doctor,
Thank you for the suggestion. I have started Magnesium supplements. I have also stopped drinking coffee. The fact that it is happening to my eyes too means it is due to stress ?
Hello,
Welcome back to icliniq.com.
Yes, it seems to be stress related. However, I do not think this is anything serious, including ALS. So relax and do not worry about it.
Thank you.
Patient's Query
Hello doctor,
Thank you for the answer. Is it common to have this for someone who does a lot of sport? Have you already seen ALS in the ’30s? Is it true that fasciculations happen after muscle loss or loss of strength?
Hello,
Welcome back to icliniq.com.
In ALS, you should have muscle wasting and weakness when fasciculations start. But, on the other hand, this is an exceptional diagnosis at this age. So, relax and do not worry about it! I hope you will find this information helpful.
Thank you.
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Neurology
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