Benign fasciculation syndrome vs Amyotrophic Lateral Sclerosis

Posted by johnsmith1980 @johnsmith1980, Jul 3, 2021

My grandfather had ALS (46 y.o. onset), my mom had some undefined dementia (45 y.o. onset, and I am inclined to think now it was FTD). I am 41 now. My concern is twitching soles (the side fine muscle where the arch is). Right sole is way more intense than left. It twitches every 3 seconds, non-stop, 24/7. Firing is not intense. And I have no idea for how long it has been there, month or years. I noticed 7 months ago when my soles started hurting after a long walk or run. I went to see neurologist, underwent EMG and NCV which was clean. No other symptoms such as weakness or muscle waste. So Dr. agreed it's BFS. I've read tons of studies, articles, talked to people firsthand. Everyone with BFS reports twitching of multiple muscles - that is widespread, and I have twitching of only one specific muscle - even if it's on both sides. Yes, sometimes I had that all-over-body twitching too, since I am an anxious person with a range of psychosomatic symptoms. But I am really concerned about my sole. Can BFS persist forever only in one muscle symmetrically? Can fasciculations precede weakness years before ALS onset? Can it be a coincidence that someone with ALS in the family surprisingly have BFS? Having read tons and tons of material, I have never come across some similar situation. It's such a grey area in science. At times I am so scared feeling like I am walking on the edge of 2 outcomes. And I am not ready to get tested for genes since not sure if I can deal with the results in case it's unfavorable.

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Profile picture for monkeytime777 @monkeytime777

Hi. I saw a similar question from a couple weeks ago but didn’t want to ask a question in their thread. I am a 53 year old otherwise healthy male and two weeks ago I started getting twitching in both quads and hip flexors. A few days later I experienced them also in my shoulders and arms along with my legs. I don’t have any apparent muscle weakness although my hamstrings have a sensation of being weak some of the time.

I’m really nervous this is ALS even though it might not fit the more usual presentation of muscle weakness first. The twitching keeps me up at night but sometimes after I’ve gotten a little rest the twitching subsides or is cut down significantly. I also get what I think are myoclonic jerks as I’m falling asleep. Sometimes three or four of them. At times when I’m distracted or exercising most or all of the twitching seems to go away but then later it comes back with a vengence. In addition I do have what seems like nerve hypersensitivity where my muscles fire faster than normal at times.

I do have anxiety although I’ve never formally been diagnosed and I definitely have health anxiety. I have an appt with my GP this week but I just wanted to ask if anyone has had a similar presentation of symptoms that turned out to be BFS and not ALS. I’m pretty scared right now and am hoping that the fact that the twitches are all over rather than just in one location can still be BFS. Has anyone else had BFS present this way? Thank you!

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I had BFS present this way in 2009 and I too went through terrible health anxiety. It was chronic, now I just get it from time to time. It is uncomfortable and feels scary, so I pray. I hope you feel better soon.

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Profile picture for j77 @j77

I have heavy legs and heavy upper arms and numbness in my groin area.I also have loss of feeling in the trunk of my body.I can't believe I can walk at all because of how weak I am.I had the Pfizer vaccine,but just the first two doses and no additional vaccines or boosters.I think all of these symptoms are brought on by covid,but I am sure the vaccines are not the Best either.Who knows what the side effects of those will be.When I went to the Specialist he found a Borderline antibody for Myasthenia Gravis.There are different types of Myasthenia Gravis and there are different types of Myasthenia diseases.You might want to get checked for it.They can be brought on by covid,infection or extreme stress.I was doing research and long covid clinics are using mestinon to treat long covid patients.Mestinon is the same drug used to treat Myasthenia Gravis. It helps the muscles and nerve signals to work properly.They also have been using it to treat Chrnoc Fatigue.I think Chronic Fatigue,Autoimmune diseases and Epstein Barr are all being set off in the body from Covid.

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I am doing better. I got off of gabapentin. I hope that was it.

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Profile picture for normadela67 @normadela67

I am doing better. I got off of gabapentin. I hope that was it.

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That is Good News!

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Profile picture for j77 @j77

Hi Alecia!Were the Doctors able to give you treatment for your issue?I have alot of twitching and spasms along with muscle weakness.The neurologist told me it is not ALS,but I am still not sure.I wonder if part of my symptoms might be similar to what you have.I just had Genetic testing done.I am waiting to heat back from the doctor.

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Hi the only treatment I received is baclofen for the muscle spasms. I only take it if I absolutely have to because its not safe for me to take really. The last time I took it I woke up on the couch and had absolutely no clue what day it was, why I ended up there, or anything I had done after the baclofen kicked in. I had a friend there with me so I was able to take one because I needed it. Apparently they fed me and I was talking and everything but I have no recollection of it and I slept for 14 hrs. At least the amount of time that I'm sleeping is decreasing. The first time I was not able to function for 3 days. I did not sleep the whole time but I was not able to do anything constructive and slept the majority but I also got out of bed and put a gallon of milk in the cupboard but did not open it and get a drink. I hope you find some answers.

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Profile picture for monkeytime777 @monkeytime777

Hi. I saw a similar question from a couple weeks ago but didn’t want to ask a question in their thread. I am a 53 year old otherwise healthy male and two weeks ago I started getting twitching in both quads and hip flexors. A few days later I experienced them also in my shoulders and arms along with my legs. I don’t have any apparent muscle weakness although my hamstrings have a sensation of being weak some of the time.

I’m really nervous this is ALS even though it might not fit the more usual presentation of muscle weakness first. The twitching keeps me up at night but sometimes after I’ve gotten a little rest the twitching subsides or is cut down significantly. I also get what I think are myoclonic jerks as I’m falling asleep. Sometimes three or four of them. At times when I’m distracted or exercising most or all of the twitching seems to go away but then later it comes back with a vengence. In addition I do have what seems like nerve hypersensitivity where my muscles fire faster than normal at times.

I do have anxiety although I’ve never formally been diagnosed and I definitely have health anxiety. I have an appt with my GP this week but I just wanted to ask if anyone has had a similar presentation of symptoms that turned out to be BFS and not ALS. I’m pretty scared right now and am hoping that the fact that the twitches are all over rather than just in one location can still be BFS. Has anyone else had BFS present this way? Thank you!

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I noticed that you post is almost a year old so I hope you are doing well. I have suffered with body wide muscle twitching for close to 20 years. It was diagnosed as BFS by my Neurologist and I did develop Idiopathic Peripheral Neuropathy in my feet 3 years ago. My advice is to find a good Neurologist and they will perform a neuroglial exam and EMG/NCS. Twitching body wide is not a symptom of ***. It starts in one hand and always has WEAKNESS associated with it.

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I have been having serious fasciculations (mainly calves and thighs, although occasionally in biceps, hand, and upper body). My wife said it looks like an alien trying to get out of my leg.

My neurologist (already under care for chronic microvascular ischemia and lacunar strokes) has done testing to establish the cause and has been able to rule out everything but BFS and ALS. He said that the definitive test that is recommended is a 3 limb needle EMG. I have had needle EMG twice before (ulnar nerve) and prefer not to go through this painful procedure since a positive diagnosis for ALS will have no impact on the prognosis or treatment (there is none).

Also, my local neurological practice (in DE) does not seem very familiar with or dealt with many (probably very few) cases of these rare disorders. My PCP has recommended that I go to Jefferson (Phil) or Johns Hopkins (Balt).

Does anyone have experience with this type of situation? Has anyone used surface EMG vs needle. I have read that good results can be obtained with this without the pain of a needle EMG, and I think that Penn offers it.

My next neuro appt is 12/11. I am contemplating getting a second opinion from Penn.

TIA,
Keith

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Profile picture for keithl56 @keithl56

I have been having serious fasciculations (mainly calves and thighs, although occasionally in biceps, hand, and upper body). My wife said it looks like an alien trying to get out of my leg.

My neurologist (already under care for chronic microvascular ischemia and lacunar strokes) has done testing to establish the cause and has been able to rule out everything but BFS and ALS. He said that the definitive test that is recommended is a 3 limb needle EMG. I have had needle EMG twice before (ulnar nerve) and prefer not to go through this painful procedure since a positive diagnosis for ALS will have no impact on the prognosis or treatment (there is none).

Also, my local neurological practice (in DE) does not seem very familiar with or dealt with many (probably very few) cases of these rare disorders. My PCP has recommended that I go to Jefferson (Phil) or Johns Hopkins (Balt).

Does anyone have experience with this type of situation? Has anyone used surface EMG vs needle. I have read that good results can be obtained with this without the pain of a needle EMG, and I think that Penn offers it.

My next neuro appt is 12/11. I am contemplating getting a second opinion from Penn.

TIA,
Keith

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Hi, @keithl56 @rmfmayo @johnsmith1980 and @johnbishop. I merged the 2 discussions about benign fasciculation syndrome and amyotrophic lateral sclerosis (ALS) into one to bring everyone together on the topic.

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Profile picture for keithl56 @keithl56

I have been having serious fasciculations (mainly calves and thighs, although occasionally in biceps, hand, and upper body). My wife said it looks like an alien trying to get out of my leg.

My neurologist (already under care for chronic microvascular ischemia and lacunar strokes) has done testing to establish the cause and has been able to rule out everything but BFS and ALS. He said that the definitive test that is recommended is a 3 limb needle EMG. I have had needle EMG twice before (ulnar nerve) and prefer not to go through this painful procedure since a positive diagnosis for ALS will have no impact on the prognosis or treatment (there is none).

Also, my local neurological practice (in DE) does not seem very familiar with or dealt with many (probably very few) cases of these rare disorders. My PCP has recommended that I go to Jefferson (Phil) or Johns Hopkins (Balt).

Does anyone have experience with this type of situation? Has anyone used surface EMG vs needle. I have read that good results can be obtained with this without the pain of a needle EMG, and I think that Penn offers it.

My next neuro appt is 12/11. I am contemplating getting a second opinion from Penn.

TIA,
Keith

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I’ve had several EMGs and they are totally painless. I don’t even feel the needle. It’s so small.. Now the Nerve conduction study is painful and Uncomfortable. I have twitching all over my body and I’ve had it for 20 years About three years ago. I was diagnosed with peripheral neuropathy in my feet, which is idiopathic. If you have no weakness, I doubt you have anything sinister going on.

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Profile picture for keithl56 @keithl56

I have been having serious fasciculations (mainly calves and thighs, although occasionally in biceps, hand, and upper body). My wife said it looks like an alien trying to get out of my leg.

My neurologist (already under care for chronic microvascular ischemia and lacunar strokes) has done testing to establish the cause and has been able to rule out everything but BFS and ALS. He said that the definitive test that is recommended is a 3 limb needle EMG. I have had needle EMG twice before (ulnar nerve) and prefer not to go through this painful procedure since a positive diagnosis for ALS will have no impact on the prognosis or treatment (there is none).

Also, my local neurological practice (in DE) does not seem very familiar with or dealt with many (probably very few) cases of these rare disorders. My PCP has recommended that I go to Jefferson (Phil) or Johns Hopkins (Balt).

Does anyone have experience with this type of situation? Has anyone used surface EMG vs needle. I have read that good results can be obtained with this without the pain of a needle EMG, and I think that Penn offers it.

My next neuro appt is 12/11. I am contemplating getting a second opinion from Penn.

TIA,
Keith

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EMG is not that bad. The nerve portion with the minor shocks is a little uncomfortable but not terrible. I found the needle portion to be even easier. Certainly less than getting blood drawn. I would say do it if it helps determine what is going on.

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Maybe they have improved it. My wife had to stop hers in her leg because it was so painful. When I had my 2 ulnar nerve EMG's it felt like they were sticking a hot poker into the fleshy part under the thumb and every time they moved it it was excruciating. I've been shot and it was less painful. The woman doing my last one said that she has had big, tattooed bikers that couldn't take it. I am figuring that at my appt on 12/11 that the neuro is going to recommend it. I'm still trying to figure out if the surface EMG is possible.

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