Hello everyone,

I am 27 years old male and new to this forum. First of all, I appreciate the way PALS are helping people who are concerned or affected with ALS, despite their daily struggle. Secondly, I found this section of the forum to discuss with my symptoms, though I am aware that nobody can detect problems over internet, nevertheless...

About 6 months months back (May end) I have developed widespread twitching but more often on right arm, right thigh, right back shoulder and left arm. I visited general practitioner and he suggested me to a neurologist. I had two thorough neurological exams which was normal except grade 1 reflexes (at knees, hamstrings and Achilles as well as in upper extremities like biceps, triceps and Bronchioradialis).

Next, an EMG/NCV was performed (right deltoid, medial gastrocnemias, vastus medialis and rectus femoris) which came out to be normal (normal insertional activity, no spontaneous activity, normal motor unit action potentials with full recruitment pattern) as well. Also had MRI which was normal. This was done in August end after 3 months of symptoms. I have been given a follow up but in April 2015.

Here is what I am writing to you for :

My twitching is still there with same intensity and frequency. My question is : does normal emg (even at very early stage) rules out LMN ALS or classic case of ALS? I have no Babinski, hoffman or brisk reflexs at the the neuro exam. Nor do I feel any spasticity in limbs (but some stiffness in lower back). Does this suffices to rule out UMN predominant ALS (even at very early stage)?

Just to mention one more thing: I had talipes (club foot) surgery during childhood. Since then my legs are a bit weaker. So if I have to walked for sometime, it starts to pain and this has been there since childhood. But now even if I walk say for 15 mins (a bit quickly) at a stretch, I feel quite a pain in both the lower legs which immediately subsides if I sit down somewhere.
Does this qualifies as weakness observed in ALS? Also I have never been athletic in my life.

Welcome sb1986.

Hi sb1986 and welcome to NeuroTalk!

This forum (ALS) is a bit quiet and you might not get many responses right away.

We have a New Members Introductions forum..... http://neurotalk.psychcentral.com/forum88.html which might prove to be more active especially during this holiday week.

You can mention that you've already visited the ALS forum because members welcoming you will more than likely suggest that forum to you.

In a word, yes, a normal emg/ncs rules out ALS. In your lower extremities you may have some other process going on, perhaps related to the club foot issue. Have you had an MRI of your lumbar spine?

Twitches were linked to ALS in the media and with the prevalence of the internet, many people have googled symptoms and had ALS pop up (myself included.) Twitches in ALS are in a dying muscle that ceases to function. Very different from random twitches that show up in various parts of your body.

Check out benign fasiculation syndrome. www.aboutbfs.com. Some people have overactive nerve impulses that aren't pathologic.

Look at your hydration status, electrolytes, especially magnesium. My neuro told me to get my 64 oz. of water every day and drink a Gatorade.

Thanks Kitt, Kitty and Jenng...

@Kitty: Okay, I will introduce myself to the forum you suggested ... Thank you.

@Jenng: Yes I had an MRI of lumbar spine/brain which are normal.

See you in the other forum then... thanks.