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
Hello doctor,
I noticed consistent twitching in my right thigh a couple of months ago. Since then, my symptoms have been body-wide twitching and perceived weakness in my legs and arms. Nearly a year ago, I began having a popping sensation on the right side of my throat when I swallowed. I had an ultrasound, and it showed nothing. The most concerning thing to me is the shortness of breath, goosebumps, jumpiness (possibly hyperreflexia), and numbness in my arms when I wake up every morning, and it goes away once I move them. I am taking tablets Losartan, and Cymbalta, along with Cyclobenzaprine which was prescribed to me when my muscles were tight. My concern is, are these symptoms of ALS? Kindly suggest.
Hello,
Welcome to icliniq.com.
I understand your concern and can explain that your symptoms are not suggestive of ALS (amyotrophic lateral sclerosis). I suggest your symptoms are more related to benign fasciculation syndrome. For this reason, I suggest you take a low dose of Clonazepam instead of Cyclobenzaprine to help improve your symptoms. Consult your specialist doctor, discuss with them and take medications with their consent. I recommend performing nerve conduction studies to exclude possible neuropathy or myasthenia syndrome. Some blood lab tests such as thyroid hormone levels for thyroid gland dysfunction, blood electrolytes, vitamin D, and vitamin B12 plasma levels for possible deficiency are needed too. I hope this helps you.
Thank you.
Patient's Query
Hello doctor,
I have been experiencing hand cramping and noticed possible atrophy in my left hand. I am attaching the related pictures. Do you see the atrophy in the attached pictures? Kindly suggest.
Hello,
Welcome back to icliniq.com
I saw the pictures attached (attachment removed to protect the patient's identity) and it does not suggest thenar atrophy. On the other hand, thenar muscle atrophy coupled with hand cramps is indicative of carpal tunnel syndrome. For this reason, especially if you experience hand numbness and cramps more prominent during the night, I suggest you perform nerve conduction studies in order to rule out carpal tunnel syndrome. I hope this helps you.
Thank you.
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Neurology
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