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I have been having twitches in my left thumb, calves, arms,

Hi - i have been...
Hi - i have been having twitches in my left thumb, calves, arms, thighs etc. also, have been waking up with pins and needles and numbness in my left hand and forearm. Could this be ALS..?
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Answered in 7 minutes by:
1/23/2018
Dr Subbanna MD
Dr Subbanna MD, Neurologist (MD)
Category: Neurology
Satisfied Customers: 5,921
Experience: American Board Certified Neurologist, Internal Medicine
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Hi Justin, I am an American Board Certified Neurologist with vast experience in diagnosing & treating all neurological as well as all other health/medical conditions, and I am very glad to help you with your health concerns.

I see you have been having symptoms as you have described above and you are concerned whether this could be secondary to ALS. As a Neurologist I frequently diagnose & treat this type of health situation and I can certainly help you in this regard.

I am currently preparing & typing my answer and I will post my answer here as soon as it is ready.

Best Regards!

Dr Subbanna MD

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Customer reply replied 29 days ago
Thanks. Just to add, I have some pain in each of my forearms but only pins and need,es etc in the left side.

You are very welcome! I appreciate for this additional information. I am typing now, I will follow up with you at the earliest.

Best Regards!

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Okay I am ready; I am posting my answer here;

ALS definitely does not appear the cause for your symptoms such as muscle twitching you have been having

Please see there are myriad causes for muscle twitching and the presence of twitching does not automatically imply there is some serious underlying problem such as ALS (or MND/Motor Neuron Disease), and in fact muscle twitching is most often secondary to some non-serious (benign) causes, or secondary to some treatable/curable medical conditions (that are mentioned below) - rather than due to something of serious in nature like ALS etc.

Muscle twitching is most commonly secondary to following non-serious (benign) causes OR secondary to following treatable/curable medical conditions such as the following;

1) Stress

2) Anxiety/Nervousness

3) Muscle fatigue/heavy & prolonged exercises

4) Excessive caffeine intake

5) Sleep deprivation

6) Non-fatal medical conditions such as the following;

a) Thyroid gland dysfunction

b) Electrolyte abnormalities (calcium or magnesium)

c) Nutritional/vitamin deficiency etc

7) Medication side effects

8) Benign fasciculation syndrome (BFS) is another common non-serious benign cause for muscle twitching etc

I am not telling all these are applicable in your case, but these are the common causes for muscle twitching that we come across in our clinical practice.

If not already done then you need a thorough further clinical evaluation including a thorough examination in the clinic to explore all the above mentioned possibilities. Also if you had no blood tests done after the twitching started then you need blood tests now to explore the possibility of the conditions I have mentioned above (thyroid or electrolyte issues etc) and then treated appropriately depending upon the test results.

And also please see many times no obvious cause for muscle twitching is identified even after thorough evaluation and investigations – which is a good sign because such twitchings are unlikely due to any serious underlying health conditions

Please see you are unlikely a case of als for the following various reasons;

1) First of all als is expected to present with progressive weakness of the muscles, as well as progressive atrophy of the muscles (losing muscle bulk) etc, but you have not mentioned any such symptoms that are pointing towards the possibility of als.

In the absence of any obvious progressive weakness of the muscles or any progressive atrophy of the muscles this is unlikely from als

2) The pattern of twitching you have been having too is not pointing towards als, what you have is generalized type of twitching and this is not typical for als, by the time an als patient has generalized twitching they have so much clinical weakness of the muscles they are wheel chair bound and need assistance for almost every daily activities, so this pattern of the twitching you are having is also indicating this is some benign issue rather than als.

3) You are also have sensory symptoms such as numbness, tingling sensation (pins & needles feeling), pain etc. ALS is a type of MND (Motor neuron disease). It is called motor neuron disease because it is caused by the degeneration of the motor neurons. ALS being a pure Motor neuron disease the presence of sensory symptoms such as pins and needles, numbness, pain etc tells us conditions like als are unlikely. Motor symptoms like progressive muscle weakness, progressive muscle atrophy etc are expected to be seen in a case of als but sensory symptoms like numbness or tingling sensation, or pain etc are not expected to be seen in a case of als, and if sensory symptoms are present we should start exploring other possibilities instead of als

So looking from any angle you are unlikely a case of als

ALS certainly does not appear the cause for your muscle twitching & the other symptoms you have been having.

Once again I can very confidently and very strongly reassure you, there is certainly no evidence for als in you, absolutely not, and there is not even an iota of doubt in this regard, so please not to be scared.

Wishing you the best health!

All the very best!

Please let me know if you have any additional questions or if you want to discuss this further. Please take a moment and kindly click a positive rating (preferably 5 Star/Excellent) to credit for the time & effort put by me in answering your health question, and this is the only way I will be credited for my service to you. Rating me now does not close your question and if you have follow-up or additional questions you can ask them after the rating too!

Assuring you the best services

Best Regards!

Dr Subbanna MD

Dr Subbanna MD
Dr Subbanna MD, Neurologist (MD)
Category: Neurology
Satisfied Customers: 5,921
Experience: American Board Certified Neurologist, Internal Medicine
Verified
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Customer reply replied 29 days ago
Thanks Dr Subbanna - your response has put my mind at rest. To be honest as long as this is not life breathing then I am not too concerned but will take your advice and visit the doctor. I will provide you a 5* rating now. Thanks again..

You are very welcome Justin! My pleasure! I am very glad you found the above information helpful!

Yes, this is certainly not life threatening of fatal kind of health situation, this is definitely something benign in nature and there is absolutely no suspicion for serious health conditions such as als etc in you for sure!

Wishing you all the very best!

Thanks & Best Regards!

Dr Subbanna MD

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Sorry, I meant "not life threatening or fatal kind of health issues" - sorry for the above typo.

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