Q. I have twitching in my forearm. Could it be ALS?

Answered by
Dr. Ashok Kumar Choudhary
and medically reviewed by iCliniq medical review team.
Published on Jul 04, 2017 and last reviewed on: Aug 02, 2019

Hello doctor,

Since the past week, I have had a twitch in my forearm area. I do not know if it was because I had to lift a three-gallon bottle for a long stance, or due to my anxiety issues. There is no weakness or atrophy as could be the case with ALS. Also, the movement of the twitch is very visible. It goes and comes. It will stop if I move it in a certain way. Is this serious? My arm feels strong, and I can spread my fingers wide. I am so worried about this intermittent twitch. It has not moved to twitch anywhere else, but has been confined to the small area on my forearm. Can you please tell me if this is something deadly?

Dr. Ashok Kumar Choudhary

Andrology Geriatrics Psychiatry Psychologist/ Counsellor Psychotherapy Sexology
#

Hello,

Welcome to icliniq.com.

I read your query and understand your concerns.

  • Let me tell you that, it is possible to confirm the diagnosis of ALS (amyotrophic lateral sclerosis), only after physically examining the patient.
  • About your concerns, I would like to inform you that an isolated twitching of any muscle is normal at this age. The other common cause of muscle twitching is anxiety and exertion.
  • In my practice, I have seen at least 20 patients who had symptoms similar to yours and, reported no weakness or atrophy despite the passage of five years or more. I mean to say that, if there is no weakness and progression, with the background information of anxiety, I feel it should be considered normal.
  • The chances of it being a chronic disease are very thin if any.

I hope this answers you. Feel free to write back to me if you have more questions. Thanks and regards.

For more information consult a neurologist online --> https://www.icliniq.com/ask-a-doctor-online/neurologist

Thank you doctor,

In the case of ALS, would the area with the twitching always have a weakness? I feel none. Does the twitching come with muscle changes or without it? When I move, the twitching stops. Is that how ALS twitching acts? Is the twitching in ALS strong and occur three to four times a day or constant?

Dr. Ashok Kumar Choudhary

Andrology Geriatrics Psychiatry Psychologist/ Counsellor Psychotherapy Sexology
#

Hello,

Welcome back to icliniq.com.

From the posed questions, it seems to me, that you want the answers to be very specific.

  • In ALS, it has been observed that often the individual presents with weakness, rather than twitching. Twitching or fasciculations may or may not be present, but weakness and atrophy are always present.
  • They can come together, but twitching is generally later than weakness and atrophy. I must acknowledge here, that there is universal law in this regard.
  • You mentioned that there is twitching when you stop the movements. It is not what happens in ALS. They are spontaneous and not in the control of the individual. To be precise they are random. No typical pattern is known in ALS.

I hope this answers you further. Feel free to write back to me if you have more questions. Thanks and regards.

For more information consult a neurologist online --> https://www.icliniq.com/ask-a-doctor-online/neurologist

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