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Dr. Frank
Dr. Frank, Board Certified Physician
Category: Neurology
Satisfied Customers: 9000
Experience:  Board certified general Adult Neurologist, with experience in experimental neuroimaging and neurodiagnostics.
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I am a 34 year old female. I visited a neurologists today

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I am a 34 year old female. I visited a neurologists today due to muscle twitches. My muscle twitches began with my index finger pulling/twitching toward my thumb eight months ago. Since then my calves have begun to twitch, my twitches, my jaw twitches, my chin, and occasionally I have twitches in my arms and back. The only weakness noticed by my neurologist was weakness in my pinky fingers-all other physical tests were normal. I go back for an MRI and muscle and nerve testing later. My huge worry this entire 8 months has been ALS. Does the weakness in my pinky fingers point to ALS?
neuromd2012 :

Welcome to Just Answer. I am an Adult Neurologist and was contacted to answer your question.

neuromd2012 :

weakness in your pinky fingers that is symmetric does not suggest ALS

neuromd2012 :

if could be seen in problems efffecting the spinal cord, or the nerves at the C7 or C8/T1 level

Customer:

Would weakness in the left and not the right suggest ALS?

neuromd2012 :

if you have diffuse twitching, then BFS or benign fasciculation syndrome should be suggested

neuromd2012 :

yes

neuromd2012 :

if you only have weakness on the left

neuromd2012 :

it can be ALS

neuromd2012 :

but you need the evaluation

neuromd2012 :

w

neuromd2012 :

which includes the MRI and the EMG

neuromd2012 :

ALS is a disease of the upper and lower motor neuron

neuromd2012 :

so you should have some spasticity

neuromd2012 :

a problem hopping?

Customer:

no problem hopping

neuromd2012 :

so it really is more like BFS, but you should not have weakness with BFS

neuromd2012 :

it is also unlikely to have weakness in the pinky, and not the rest of your hand

neuromd2012 :

unless you have a specific problem in your wrist

neuromd2012 :

and none of that would explain the diffuse twitching

Customer:

I didn't realize I had weakness in my pinky until the physical exam by the doctor today. He said that was the only weakness he saw.

neuromd2012 :

I see

neuromd2012 :

do you have neck pain or shoulder pain?

Customer:

not really

neuromd2012 :

well I am not sure of the reason for the pinky weakness

neuromd2012 :

the EMG test is really what you need in this regard to answer that question

Customer:

That's scheduled for Sept. I just wanted to calm my worries about ALS.

neuromd2012 :

I see

neuromd2012 :

not to worry if you do not have spasticity as we discussed

neuromd2012 :

ALS is 1:200.000 in your age group

Customer:

I didn't ask the specific ALS question to my doctor, but he mentioned that after 8 months of twitching if it was indeed something very serious that I would present with more symptoms. Do you agree?

neuromd2012 :

that is correct

neuromd2012 :

after 8 months of twitching, you know if you have ALS from other issues

Customer:

Thank you for your help!

neuromd2012 :

you are welcome

neuromd2012 :

bye

neuromd2012 :

Dr Frank t

Customer:

Bye!

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