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I am a 38 year old healthy women and have been having

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Hi, I am a 38 year old healthy women and have been having fasiculations in both calf muscles since August. No muscle weakness seems apparent. I occasionally get fasiculations in other parts of the body albeit briefly. I often have small jerks as well mainly in the legs. I have seen a neurologist and have had an mri, emg and ncs and all were normal. I am still very concerned about motor neurone disease. My left shoulder recently started to feel sore and a little weak but the emg only took place 6 weeks ago and I had tests in this area. I am going to go back I think to see the neurologist but I’m very concerned that the emg missed something or that my symptoms have got worse and therefore would
Assistant: What seems to make the symptoms worse or better? Have you noticed any swelling?
Customer: now be different
Assistant: Anything else in your medical history you think the Doctor should know?
Customer: No and I would really like to have contact with a neurologist who has dealt a lot with motor neurone specifically

Hello -

 

Just to be sure, you had the EMG performed in the legs, where you were having the fasciculations?

 

And no significant weakness anywhere?

Customer: replied 9 days ago.
Yes emg in legs and in the arm and other areas. No significant weakness felt apart from the left arm and shoulder. Should I send a picture of results?

OK, thanks.

 

The EMG is the key here.

The fact that there was no issue with actual fasciculations seen on the EMG is important as that rules out motor neuron diseases.

 

And you don't have any significant weakness here.

 

The left arm/shoulder issue with soreness isn't going to be ALS either, as you would not get pain/discomfort from ALS.

 

 

I sincerely hope that I have helped you, and that I have earned my 5 star rating today! Please remember to rate my service by selecting the 5 stars at the top of the screen ( rating me now does not close your question). We can continue here until you are satisfied, simply use the reply box and let me know. Thank you!

Customer: replied 9 days ago.
The neuroscientist said results all fine. But could things have developed since then in the last 5 weeks?
Customer: replied 9 days ago.
Should I send an image of the report

Sure, you can upload the report here.

 

It's very unlikely that you would have had any progression over 5 weeks.

The EMG would pick up very subtle findings, perhaps even before you could notice them. And the fact that there was no actual fasciculations seen in the muscles that were "twitching" -- means ALS is ruled out.

Customer: replied 9 days ago.
Do you have much experience with mnd
Customer: replied 9 days ago.
And also these jerks I often get, is this normal?

That's only the first page, but nothing exciting there.

 

People can get fasciculations, particularly anxious people. Also smoking and caffeine can make it worse.

Customer: replied 9 days ago.
Second page here
Customer: replied 9 days ago.
I don’t smoke and I’m not a big caffeine drinker

Every muscle tested was normal.

 

So you are fine.

Customer: replied 9 days ago.
And it’s not likely it has since developed? Are there any border line figures? I’m sorry to ask but I didn’t really discuss the findings
Customer: replied 9 days ago.
Have you personally dealt with patients with mnd before

Yes, it certainly has not developed in the past few weeks.

The muscles themselves tested as "normal", so no evidence of issues seen.

 

Yes, we have seen patients and had diagnosis of ALS before, but they clearly have abnormalities in strength and with their EMG, where there is widespread abnormalities seen in multiple muscles.

Customer: replied 9 days ago.
Are there any border line figures?

All of it looks fine.

Customer: replied 9 days ago.
Ok thank you

You're welcome.

Try not to worry, you're fine.

Customer: replied 9 days ago.
It’s really hard not to worry when you look at the internet and everything points to mnd. Are the jerks normal?

Yes, they are very normal, and many people have them.

Customer: replied 9 days ago.
Thank you, is it worth getting a repeat emg or not at this stage. I have read that some people have normal readings and then get diagnosed some months later

A repeat EMG isn't going to help at this time.

If you notice progressive weakness in an arm or leg -- then EMG would be helpful.

Customer: replied 9 days ago.
How would I notice the weakness?

It would be obvious to you -- you would have trouble walking, or holding onto things.

Customer: replied 9 days ago.
Ok thanks very much

You're welcome.

Customer: replied 9 days ago.
Am I able to ask what your field of expertise is and what your position is? Thanks

I'm a neurosurgeon that deals with arm/leg weakness all the time, and we order EMG tests to evaluate this -- and it is extremely rare (less than 5 people in 15 years) that I have diagnosed ALS.

I sincerely hope that I have helped you, and that I have earned my 5 star rating today! Please remember to rate my service by selecting the 5 stars at the top of the screen ( rating me now does not close your question). We can continue here until you are satisfied, simply use the reply box and let me know. Thank you!

Customer: replied 9 days ago.
Great thanks. I do feel Re assured but is there anything I can do for the fasiculations?

There not much specific treatment. Because you don't have any signs of radicular issues (nerve issues from the spine) on your EMG, this will just get better with time.

Customer: replied 9 days ago.
And the fact there for 3 months is not a concern? And that the calf fasiculations are almost constant and then on occasions I get short stay fasics in other parts of body? I really am sorry to bombard you I just am extremely worried about this

Random fasciculations aren't worrisome.

 

Calf fasciculations are a bit more curious, but your EMG didn't show any concerns in the gastrocnemius muscle. But perhaps considering MRI of the lumbar spine to rule out a "pinched" nerve could be done.

Customer: replied 9 days ago.
So the emg has definitely ruled out als
Customer: replied 9 days ago.
Would a pinched nerve cause the fasics in both calves?

EMG rules out ALS.

A pinched nerve at the L5-S1 could cause it in both calves.

Customer: replied 9 days ago.
Many thanks

You're welcome.

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