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Dr. Rick
Dr. Rick, Board Certified MD
Category: Eye
Satisfied Customers: 10772
Experience:  Ophthalmology since 1994 with Retina sub-specialty interest
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I am a 41 year old woman. I had surgery on my kidney a

Customer Question

Hi, I am a 41 year old woman. I had surgery on my kidney a pyeloplasty 10/6/15. On 11/30/15 I had my first fasciculation in my chest muscle and from there i have them in both legs in my foot, biceps and eye. They skip around. I had an EMG on 1/6/16 and it was normal. My doctor said it was all "0s" which was very good and not to worry. My question is did I have the EMG too early? That would have been 5 weeks after the first fasciculation. Was it to early to properly diagnose something like ALS? I have no weakness. I am very worried. I also had blood work drawn and my electrolytes are normal.
Submitted: 10 months ago.
Category: Eye
Expert:  Dr. Rick replied 10 months ago.

Hi. My name is***** and I am online and available to help you today. Thank you for your patience.

Question and answer is just one of the services I offer. I can also provide you with additional services, such as live telephone or skype consultation, at a small additional cost. Let me know if you are interested.

From what you have posted, you did not have the EMG too early. I am glad the results were normal.

It is very, very, very unlikely from what you have posted that you have ALS

You can relax and stop worrying. It seems like your anxiety may be getting the better of you....

You most likely have myokymia. A common and benign condition. Please allow me to explain:

The most likely cause of your symptoms is called myokymia. Myokymia is an involuntary, local twitching of a few muscle fibers in the body of a muscle. This twitching, if it occurs in a limb, is not strong enough to actually move a joint but can be felt and sometimes seen as an area of quivering.

Myokymia commonly involves the eyelids and muscles around the orbit. It often appears and resolves for no apparent reason and has not been linked to any underlying significant pathology. What causes myokymia? Studies have shown that it is associated with anxiety, stress, lack of good sleep, high caffeine intake and the use of some drugs.

The best way to treat myokymia is to get more sleep, decrease caffeine intake and decrease stress. The good news is that myokymia is not a sign of serious underlying pathology and often resolves on its own.

Here is an excellent article on this topic:

http://emedicine.medscape.com/article/1213160-overview

Does this make sense to you?

I hope this information was helpful for you. But I do work for tips so I want to make sure you are happy with me before rating me. If you have another question on this or a related issue feel free to fire away. You may also receive an email survey after our chat, if you can please give me the top rating in all areas. It has been a pleasure to assist you today.

Thanks in advance,

Dr. Rick MD FACS

Customer: replied 10 months ago.
But you are an eye dr? I thought it would route me to a neuro?
Expert:  Dr. Rick replied 10 months ago.

That is true.....but, in my defense, I deal with a lot of myokymia and muscle problems and a good friend from college had ALS for 15 years before finally dying of complications and I was by his side the entire time.

So. I know a lot about ALS. And, believe me, from what you have posted here today you do not have it.

I hope this information was helpful for you. But I do work for tips so I want to make sure you are happy with me before rating me. If you have another question on this or a related issue feel free to fire away. You may also receive an email survey after our chat, if you can please give me the top rating in all areas. It has been a pleasure to assist you today.

Thanks in advance,

Dr. Rick MD FACS

Customer: replied 10 months ago.
Can you have an EMG to early or how soon does ALS show up on EMG after fasciculation S?
Expert:  Dr. Rick replied 10 months ago.

somehow I am showing that I opted out. Silly computer system :(

I am still here to help you.

Here is an excellent article on ALS that you might find helpful:

http://www.mayoclinic.org/diseases-conditions/amyotrophic-lateral-sclerosis/care-at-mayo-clinic/tests-diagnosis/con-20024397

please give me a positive rating :)

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