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Having twitching in left hand. Given cortisone injection. Suggestions

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Practicing since : 2001
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I have some neurological questions and concerns. I am having twitching in my left hand between the thumb and index finger. It started November 2012, and lasted for about 3 days. It happened again about a month ago except the twitching was on the palm side of the same hand right below the thumb. The twitching on the palm side was causing my thumb to move. Again it lasted about 4 days. The twitching returned again last Monday, this time on the top of my hand between the thumb and index finger, just like it did back in November 2012; however, it was causing my index finger to move and the twitching was more constant for that first day. This continued that day off and on every few minutes for approximately hours. The next day the twitching was gone. Each day since then I have had slight twitching everyday but only 3 or 4 times a day. It is very odd because sometimes I can move my hand and make the twitching stop; other times it may twitch more when my hand is at rest. I can see and feel the twitching, but I don't seem to have any noticeable weakness in that hand. When I am using my hands for some type of work, I don't have the twitching or at least I don't notice it. I will also get some minor aches in the bicep area of my left arm and I also get left shoulder pain from time to time. My rheumatologist has given me a cortisone injection in my left shoulder for osteoarthritis pain. I do get twitching in other places, (elbow, knee, bicep, calf) but those are short lived and don't happen very often. My doctor has checked the following lab tests
calcium, glucose, BUN, Creatinine, thyroid, electrolytes and all were within normal limits. I have also had some mild pins and needles type feeling in the tips of my fingers, in the palm and sometimes between the thumb and index finger of the same hand. I also get some tingling, pins and needles feeling in other areas as well.
I have researched my symptoms online and the first thing that pops up is ALS. Needless to say I am very scared. I have a history of osteoarthritis and cervical disc herniation. Could either of those conditions cause my symptoms?
I saw my Rheumatologist and he doesn't think it is ALS; however, he did not know for sure. He said I should watch it and see if I develop any other symptoms such as weakness or atrophy. This is giving me great anxiety, and I know that stress and anxiety can make symptoms like this worse. Does this seem like ALS? Does ALS always start in the hand area? If I have been having these symptoms for approximately 6 months, wouldn't I have signs of weakness by now? Are there any other autoimmune conditions that can cause symptoms like this?
My hand seems to function just fine. I can pick things up, and I don't drop anything. I will occasionally notice a little pain and discomfort in the area of my thumb when I pick up a heavy object with my left hand.
Like I said I am very scared. Any information you could give me would be greatly appreciated. Thank You!
Posted Mon, 3 Jun 2013 in Headache and Migraines
 
 
Answered by Dr. Gopal Krishna Dash 3 hours later
Hello,
Thanks for the query,
I understand your concern
I have read your detailed medical data
I feel that you have benign fasciculation syndrome which will improve with time. I am a neurologist and you will be happy to note that I have been having these symptoms since last 3 years without much problem.
The only certain way to exclude the diagnosis is needle EMG tests done by a neurologist trained to do the test.
I feel that you even do not need the test. But if you are concerned, please do the test and get clarified about the issues related to ALS.

Please let me know if you need any help
Best wishes
Above answer was peer-reviewed by
 
Follow-up: Having twitching in left hand. Given cortisone injection. Suggestions 4 hours later
Thank you for responding. I have a few more questions.

I have heard of BFS, but I was concerned of ALS because of everything I have read online. Can a person have this type of twitching that I am having with ALS and not
have any weakness associated with it? Is it possible to have twitching before any signs of weakness or atrophy show up because that is what I have read?
If this is BFS, why is it happening predominantly in one area? Is the muscle aching that I sometimes feel in my bicep area also associated with BFS? What causes BFS and why did this twitching start so suddenly?

I apologize for all of the questions, but I am very concerned since this is predominantly in my left hand.
 
 
Answered by Dr. Gopal Krishna Dash 21 hours later
Please find the responses point-by-point

I have heard of BFS, but I was concerned of ALS because of everything I have read online. Can a person have this type of twitching that I am having with ALS and not have any weakness associated with it? ans_VERY UNLIKELY TO HAVE ALS WITHOUT WEAKNESS AND TWITCHING ALONE


Is it possible to have twitching before any signs of weakness or atrophy show up because that is what I have read? ans_YES IT IS POSSIBLE

If this is BFS, why is it happening predominantly in one area? Is the muscle aching that I sometimes feel in my bicep area also associated with BFS? What causes BFS and why did this twitching start so suddenly? ans_THE CAUSE IS UNKNOWN SO FAR AND CAN AFFETCT ANY BODY PARTS

I apologize for all of the questions, but I am very concerned since this is predominantly in my left hand. ans_No issues at all
Above answer was peer-reviewed by
 
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