I would like to add the possibility that the twitching may be due to benign fasciculation syndrome (BFS)
This page regarding BFS may help you.
ALS is also known as Lou Gehrig's disease. It's a disease of degeneration of both upper and lower motor neurons manifest by lower motor neuron signs (weakness, wasting, fasciculation) and upper motor neuron signs (hyperactive tendon reflexes, Hoffmann's sign, Babinski sign, clonus). Its prevalence if about 5 in 100,000 in population. It has increased frequency after age 40; 10% begin before age 40; 5% before age 30.
Clinical features of ALS:
Onset symptoms: weak legs (footdrop), hands (painless difficulty with buttons), proximal arms, slurred speech, dysarthria, dysphagia; spastic gait disorder. Ultimately all skeletal muscle affected except sphincters (bladder and bowel control), eye movement.
Course of disease: progressive, no remissions, relapses.
-EMG, neurological examination (requires to see both upper and lower motor neuron signs).
From the description of your symptoms listed above, gross body/limb twitching is not a typical signs of ALS. However, fasciculations is part of the lower motor neuron signs; they are small muscle twitching underneath the skin, frequently described as "moving snake underneath the skin". You can see fasciculations in any muscle groups, including the tongue.
You may want to have your neurologist to recheck EMG to see if there is any changes in the exam, as you have progression or persistent of symptoms.
Another possible diagnosis of your "twitching":
- seizure (diagnostic testing: EEG)
- muscle fatigue
For your weakness and muscle pain, myopathy is also a possibility. Myopathy is a disease of muscle. EMG/NCV typically can diagnose myopathy. It sometimes requires muscle biopsy, blood tests (CK, aldolase) if indicated.
Your pain in multiple locations of your body can also be due to fibromyalgia. It is a pain syndrome. A rheumatologist may be helpful in this situation.
Good luck. Thanks for using MedHelp Forum.
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