question-icon

Suggest treatment for benign fasciculation syndrome

default
Posted on Fri, 22 May 2015
Question: My Mom passed 2 and a half years ago from ALS. About a year ago I was told I have Benign Fasciculation syndrome. The muscle twitching is getting more frequent and spreading. Also the left hand has a slight tremor now. Do you think I have the start of ALS or am I seriously looking at having BFS?
doctor
Answered by Dr. Olsi Taka (28 minutes later)
Brief Answer:
ALS unlikely

Detailed Answer:
I read your question carefully and I understand your concern.

It might have been more easy if you had told something more about the localization and the spreading of these fasciculations which were considered benign. Usually ALS signs start insidiously in one limb only only later gradually involving other segments. Any other symptoms?

ALS generally is sporadic, meaning there is no heredity involved in 90% of cases, so you shouldn't be influenced by your mother's diagnosis.

I don't believe ALS to be likely first and foremost due to your age which is younger than the typical ALS patients. I am not saying that it can be completely excluded by age alone as there have been cases in young patients, but typically it's after the age of 45, have only ever had 1 patient under 40.

The fact that the neurologists haven't found any weakness or atrophy is against it as well. Fasciculations in ALS are imposed on the setting of an atrophied weak muscle, so atrophy should be present. Tremor is not a typical signs either.

So while I don't have the luxury of personally examining you, the combination of age and description makes me think ALS not to be likely. Since tremor is a new symptoms, if persistent and not related to other possible causes such as anxiety, you might want the neurologist to exam you again and evaluate the necessity of an EMG exam, but in the meantime try not to overworry at least about ALS.

I remain at your disposal for further questions
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
default
Follow up: Dr. Olsi Taka (6 hours later)
It started mainly in the forearms and quadriceps and I can now say that I feel and see them almost everywhere. Before the twitching and the tremors though. A few years ago I started getting these random stabbing pains in my feet. Very sharp and infrequent but I get them maybe once or twice a week. They go away usually in about 10-15 seconds. Thank you for your help and quick response. It's nice to be able to talk about it. I also was diagnosed in 2007 with classic migraines. They were really strong for about two years and I was taking nuerontin, which worked great but when the constant headache started to go away my doc agreed later it was a good thing I took myself off. I do still get migraines but the constant headache is still no longer present. Again, thank you.
doctor
Answered by Dr. Olsi Taka (1 hour later)
Brief Answer:
Read below.

Detailed Answer:
You're welcome and thank you for bringing some more info. That description is pretty compatible with benign fasciculation syndrome. The twitching, painful muscle spasms/cramps, jerking and tremor, paresthesias they are all part of the benign fasciculation syndrome. Now I would say I am pretty sure you don't have ALS, not just saying it's unlikely.
Usually no cause can be found for BFS, but electrolyte abnormalities and thyroid dysfunction can at times be the cause, so their levels must be tested - I suspect your doctors must already have done that though.

As for migraines, whether to get preventive treatment like neurontin depends on their frequency and severity, if they are contained than only treatment for the migraine attack is used, usually preventive treatment is used if more than two attacks a month.

I hope to have been of help.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
Answered by
Dr.
Dr. Olsi Taka

Neurologist

Practicing since :2004

Answered : 3668 Questions

premium_optimized

The User accepted the expert's answer

Share on
Suggest treatment for benign fasciculation syndrome

Brief Answer: ALS unlikely Detailed Answer: I read your question carefully and I understand your concern. It might have been more easy if you had told something more about the localization and the spreading of these fasciculations which were considered benign. Usually ALS signs start insidiously in one limb only only later gradually involving other segments. Any other symptoms? ALS generally is sporadic, meaning there is no heredity involved in 90% of cases, so you shouldn't be influenced by your mother's diagnosis. I don't believe ALS to be likely first and foremost due to your age which is younger than the typical ALS patients. I am not saying that it can be completely excluded by age alone as there have been cases in young patients, but typically it's after the age of 45, have only ever had 1 patient under 40. The fact that the neurologists haven't found any weakness or atrophy is against it as well. Fasciculations in ALS are imposed on the setting of an atrophied weak muscle, so atrophy should be present. Tremor is not a typical signs either. So while I don't have the luxury of personally examining you, the combination of age and description makes me think ALS not to be likely. Since tremor is a new symptoms, if persistent and not related to other possible causes such as anxiety, you might want the neurologist to exam you again and evaluate the necessity of an EMG exam, but in the meantime try not to overworry at least about ALS. I remain at your disposal for further questions