Understanding Twitching: Causes, Symptoms & When to See a Doctor

Question
"Does ALS always involve weakness with the twiching?  I am a 45 year old female.  FOr the past 15 months I have body wide twitching.  It started with a lip twitch for 1 day, then I began to notice every twitch.  My feet are the worst--the arches and outer feet twitch and calves twitch 24/7. It seems like I have a single thump or multiple thumps somewhere in my body most of the time.  I get occassional cramps in my feet and toes, too.  They are better when I am busy and not focusing on them. I saw a neuro at 1 month.  He checked my reflexes and did blood work--said that it was all benign.   I have no weakness.  I can walk on my toes and heels fine.  I speed walk 5 to 7 miles per day.  AFter 15months of constant twitching would I have weakness by now?  Please advise. May it be related to perimenopause?  Is foot twtching common?  I notice my husbands feet and calves twitch, too.


Answer
Hi Sue,

All individuals' muscles will twitch now and then. However, ALS can involve twitching due to a pathological setting. The involvement of the body varies amongst different individuals with ALS. We term these twitching events as fasciculations. In ALS, the nerve fibers of muscles degenerate or could may very well create new nerve fiber growths which irritates the muscle. Thus, the twitching occurs. Your neurologist would be best to evaluate this. S/he will refer you to a physiatrist (aka physical medicine or sports medicine physician) for rehabilitative management. As of date, I have not heard of any "cures" for this problem.



John Thai, MD