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.
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Patient's Query
Hi doctor,
About two weeks ago, I started having twitching in the front of my right calf. The next four days, it began to spread to my left calf and thighs. Sporadically I will get them on peck, shoulder, triceps, back near the armpit, and shoulder blade. My lower body nearly always twitches, while my upper body is sporadic.
I suffered from Guillain Barré syndrome in the past, which developed a lot of health anxiety, and I also lost my reflexes, which I think restricts a regular neuro examination. I do not have clinical weakness except some fatigue in my previously Guillain Barré syndrome affected areas. EMG is clear, but without liability, it would be normal. Do you think this is concerning regarding amyotrophic lateral sclerosis?
Hi,
Welcome to icliniq.com.
I understand your concern and explain that a normal EMG (electromyography) excludes ALS (amyotrophic lateral sclerosis). The lack of weakness too. For this reason, I think that your symptoms are related to anxiety. Nevertheless, I would recommend checking thyroid hormone levels for possible thyroid gland dysfunction, blood electrolytes, vitamin B12, and vitamin D plasma levels for possible deficiency.
I hope you will find this information useful.
I remain at your disposal for any further questions whenever you need.
Kind regards.
Patient's Query
Hi doctor,
I have heard that fasciculations can sometimes occur before weakness?
Also, what level of weakness would or should I experience with Amyotrophic lateral sclerosis (ALS)? Would an EMG detect abnormality so early without weakness?
Hello again.
Welcome back to icliniq.com.
If fasciculations are present, EMG (electromyography) would be able to detect motor neuron disease or ALS. Besides, weakness can be detected during a physical examination performed by the doctor. The weakness usually begins in the hands, by difficulty with fine gestures or in legs with cramping. To conclude, I would definitely exclude ALS (amyotrophic lateral sclerosis) in your case. Please perform the above-mentioned tests in order to investigate other possible causes that may lead to this clinical situation.
Hope you will find this answer helpful.
If you have any other questions, please do not hesitate to ask me again.
Kind regards.
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Neurology
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