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HomeAnswersNeurologymuscle twitchingDo I have twitching of different muscles due to ALS?

I have twitching of different muscles. Can I be sure it is not ALS?

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

Dr. Hitesh Kumar

Medically reviewed by

iCliniq medical review team

Published At May 25, 2018
Reviewed AtJanuary 11, 2024

Patient's Query

Hello doctor,

The last week and a half every few minutes, I got a muscle twitch in random parts of my body. My left eye twitches more constantly than that. I have general anxiety and major health anxiety which I am wondering can play a role. I have no muscular weakness at all, and no atrophy from what I can tell. My reflexes are normal except for brisk bilateral patella tendon reflex which I have had all my life. All strength tests are normal. Any idea what could be causing this?

Answered by Dr. Hitesh Kumar

Hello,

Welcome to icliniq.com. Frequent muscle twitches without any muscle weakness or atrophy and normal reflexes can be due to anxiety. The other possibility can be benign fasciculation syndrome. But before labeling this, it is advisable to rule out other possible grave diseases. Let me suggest a few tests: 1. Triiodothyronine (T3), Thyroxine (T4), and Thyroid stimulating hormone (TSH). 2. Nerve conduction velocity test on all four limbs. 3. Electromyography on all four limbs. 4. Magnetic resonance imaging (MRI) brain. 5. MRI cervical spine. Review with the reports.

Patient's Query

Thank you doctor,

I have been told in amyotrophic lateral sclerosis (ALS), weakness, and atrophy happen before fasciculations. Also, that twitching starts in extremities and works its way centrally. Also, I never have fasciculations with movement. They stop when movement occurs. I know you need to do your job and make sure all bases are covered. But, can I be pretty sure it is not ALS?

Answered by Dr. Hitesh Kumar

Hello,

Welcome back to icliniq.com. In ALS (amyotrophic lateral sclerosis), usually, atrophy and weakness are also associated. But it is not necessary that fasciculations start after weakness and atrophy. They can happen simultaneously too. It is right that they usually happen in limb muscles (arm or leg), not usually involve facial muscles. But can involve the tongue. Even by tests (NCV/ EMG/ MRI), it is not possible to rule out ALS 100 %. The diagnosis is a clinical diagnosis with the exclusion of other pathology. Maybe a follow up and observation of symptoms with time will bring more clarity.

Same symptoms don't mean you have the same problem. Consult a doctor now!

Dr. Hitesh Kumar
Dr. Hitesh Kumar

Neurology

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