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Dr. Rick, MD
Dr. Rick, MD, Board Certified MD
Category: Medical
Satisfied Customers: 11419
Experience:  20+ years as a doctor. Internal Medicine Internship in NYC
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Another twitching/atrophy question...

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another twitching/atrophy question...
Hi. My name is***** and I am online and available to help you today. Thank you for your patience.
What is your question?
Customer: replied 4 years ago.

no problem - are you a neurologist, though? You seem to be an eye doctor...

That is correct. I am a retina specialist. Your question was not picked up in the neurology section, for some reason, so it was opened up to other experts so that you could be helped.
If you want to speak to a neurologist it might be easier for you to repost your question with more information.
Or, if you would like, I can assist you. :)
Customer: replied 4 years ago.

well, how much do you know about neuromuscular issues?

Not as much as a neurologist, of course, but a fair amount. What is your question?
If it is something beyond my training I will send this thread back to Neurology should you so desire.
Customer: replied 4 years ago.

It's concerning nm diseases - ALS, in particular. I have been petrified of having the disease since I began experiencing muscle twitching (all over) almost two years ago. During the time, the only other objective symptom I've had has been left shoulder weakness, which has been diagnosed as a rotator cuff issue.

I have had a total of seven EMG tests done, with the last one being under a month ago, with a neuromuscular disease specialist. He tested eight spots in my left arm and leg.

Problem is, about a week after the test, a muscle just above my RIGHT knee started twitching, multiple times a day, about 20s at a time, and for just under two weeks. From what I understand about Benign Fasciculation Syndrome, these "hot spots" are normal, and everyone gets them, and they eventually go away.

That particular twitch has indeed gone away, but of course, my worried mind keeps being worried. If it were the disease in progress, wouldn't that twitch have remained until the muscle was dead? As well, wouldn't I notice weakness prior to the twitching setting in?

You are correct. If you had some sort of horrible muscle or nerve disease that area would not be expected to get better on its own, as yours did.
I have a very good friend who suffers from ALS and is unable to move anything below his nose and has been this way for over 7 years, so I fully understand your concern.
It sounds to me like you are in excellent hands with your current neurologist. Since all your extensive testing has been normal so far it is my professional opinion that you need not worry at this point.
So. What is the take home message? Everything will be OK and you should continue to followup with your excellent neurologist.
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 don’t feel that I have earned a “10” rating in all areas, please let me know what I can do to meet your expectations.
Thanks in advance,
Dr. Rick MD FACS
Customer: replied 4 years ago.

it's been said to me a million times that twitching, in the absence of weakness and muscle atrophy, is just benign twitching, and many people fall victim to it. Some more than others.

I think it was just because that one twitch was so localized, that's what had me scared. That being said, it didn't affect my ability to do anything, thus I don't think there was any weakness.

I'm guessing that if a knee/quad muscle of any sort is damaged or dead, things like running and jumping would be very difficult, and my gait would be altered. Does that sound about right?

That is absolutely correct. I do not believe you have anything to fear at this point.
It's safe for you to press the positive feedback button now if you so desire. And, never fear, even after you press that button I don't go up in a puff of smoke -- I'll still be right here to continue helping you, but, as I do work for tips, I want to make sure you are happy before rating me.
Have a good day :)
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