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What Causes Constant Twitching In Toe When Suffering From Benign Fasciculation Syndrome?

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Posted on Mon, 29 Sep 2014
Question: Greetings, i've had peripheral neuropathy issue in my left toe for over 8 years. Recently in July I began experiencing random twitches, sometimes they stay in a area for many days. For the last 3 days my right bicep has been constantly twitching. I've had EMT and nerve conduction tests done two weeks ago, all normal. I was told by my neurolgist that i have BFS. Is my recent symptom in my bicep still related to BFS? Also No pain or weakness in bicep, just annoying as hell. Should i make another appt or is this common of BFS?
doctor
Answered by Dr. Dariush Saghafi (1 hour later)
Brief Answer:
Bfs

Detailed Answer:
Good evening. My name is Dr. Dariush Saghafi and I am a neurologist from XXXXXXX Ohio.

I would like to answer your question in brief regarding benign fasciculation syndrome. You state that you have seen a neurologist who has performed and electrical study on you with negative results. You also state that you had neuropathy in your great toe for about eight years and have more recently started with annoying fasciculations and tremulous movements in your biceps muscle.

you state that there is no weakness involved with these fasciculations but that they are simply annoying. You would like to know whether or not it would be worthwhile seeing another consultant or doing additional tests.

Benign fasciculation syndrome is a relatively common although poorly understood phenomenon and highly under reported by Drs. other than neurologists. However, when a neurologist has performed an electrical study and done all of the proper lab work and neurological examination on a patient it is a fairly accurate diagnosis the first time around.

Do you know what the cause of the neuropathy in the great toe is? You say you've had it for approximately eight years without other symptoms or complications. It very well may be completely unrelated to the BF S that you have been diagnosed with or it may have been a premonitory symptom which up until recently manifest more symptoms with beeping nine fasciculations in your arms.

Therefore, on the basis of what you have told me and especially on the basis of the fact that there is no weakness that has become apparent to you in all the years that you had the neuropathy nor since you started with fasciculations in the arm, I would say that there is little need to consult another specialist or do more invasive testing unless things were to change in the future.

Having said that I would emphasize the fact that all labs relevant to such a presentation should have been done and cleared as normal before making such a diagnosis. If you know what labs have been done by your neurologist and would like to post them for me to review I would be happy to do that.

Otherwise, if the information I provided is helpful to you or questions would you be so kind as to provide a written element of feedback as well as a star rating of this conversation. Also, I would greatly appreciate your closing the query if you have no further questions on this matter as that will signal in that work to ready itself for processing, archival, and crediting of this question for future use.

I wish you all the best and again, if you have further questions please do not hesitate to address them directly to my attention and I will get back to you as quickly as possible.


Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Dariush Saghafi (12 hours later)
Greetings., the nerve issue with the toe is likely due roan old injury or trapped due to the bunion per my foot specialist. My main concern is the constant twitching of my right bicep for the last 4 days, and continues. Due to being diagnosed with BFS is it common for a twitch to lock into I.e, the arm? I still get twitches elsewhere Since my EMT and nerve conduction test done 19 days ago indicated all normal in the arms. Should I go back? Would ALS or something else have shown up?
doctor
Answered by Dr. Dariush Saghafi (9 hours later)
Brief Answer:
BFS CAN DEFINITELY PRESENT IN ONLY ONE MUSCLE IF IT WANTS

Detailed Answer:
Greetings to you back and thank you very much for your return response. To answer your question it is definitely not uncommon for benign fasciculation syndrome to present in one and only one voluntary muscle group or it may present in a variety of groups in different places of the body.

I have had the problem myself and I can tell you that eye twitching along with a small portion of my triceps muscle for nearly 6 days continuously day and night is something that I can understand and appreciate in terms of people becoming worried and wondering if it could be something else. Other symptoms that may occur include twitching of the Limb as well as muscle cramps and generalized fatigue. But this is different from actual muscle weakness which should be eliminated when doing a neurological examination on someone in whom you believe benign fasciculation syndrome is the diagnosis. As I presented reasons in my previous note to you the diagnosis of ALS should not be confused with this type of a problem since ALS typically presents with muscle weakness. People do not even notice the fasciculations very much before they noticed the weakness setting in or significant amounts of unexplained weight loss. These are some of the worrisome signs of ALS.

The condition may continue for several days, several weeks, or even several months continuously without stopping except curiously in many people you will notice the following and you can try this yourself. Activate your muscle voluntarily in the same area where the twitching is going on. in many cases the twitching will actually come under control and stop so long as you are contracting the muscle and exerting force. However, soon after the muscle comes to rest the area may begin fasciculating again. In fact one of the ways, we can test neurologically an area of fasciculation in the syndrome is to have a patient activate their muscles repeatedly and then take a short break.

I hope I have answered a few more of your questions regarding your concern and feel very comfortable on the basis of what you have told me that your diagnosis is benign fasciculation syndrome until proven otherwise. Once again, I would invite you to connect with me by WebCam if you would like and if you have anything that you could show me on video at www.HealthTap.com/drsaghafi.

My hours on teleconferencing are Wednesdays through Saturdays 3 AM through 6 AM and on Sunday nights from 11 PM until 3 AM. I would greatly appreciate if I have answered all of your questions satisfactorily for a small written feedback report as well as a star rating.

I would also be greatly appreciative of your closing this query if there are no further questions or comments that you would like to make. I wish you all the best and don't forget to look me up either on this network in the future specifically by addressing your questions to me or on the WebCam conferencing platform as I have given to you.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Dariush Saghafi

Neurologist

Practicing since :1988

Answered : 2473 Questions

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What Causes Constant Twitching In Toe When Suffering From Benign Fasciculation Syndrome?

Brief Answer: Bfs Detailed Answer: Good evening. My name is Dr. Dariush Saghafi and I am a neurologist from XXXXXXX Ohio. I would like to answer your question in brief regarding benign fasciculation syndrome. You state that you have seen a neurologist who has performed and electrical study on you with negative results. You also state that you had neuropathy in your great toe for about eight years and have more recently started with annoying fasciculations and tremulous movements in your biceps muscle. you state that there is no weakness involved with these fasciculations but that they are simply annoying. You would like to know whether or not it would be worthwhile seeing another consultant or doing additional tests. Benign fasciculation syndrome is a relatively common although poorly understood phenomenon and highly under reported by Drs. other than neurologists. However, when a neurologist has performed an electrical study and done all of the proper lab work and neurological examination on a patient it is a fairly accurate diagnosis the first time around. Do you know what the cause of the neuropathy in the great toe is? You say you've had it for approximately eight years without other symptoms or complications. It very well may be completely unrelated to the BF S that you have been diagnosed with or it may have been a premonitory symptom which up until recently manifest more symptoms with beeping nine fasciculations in your arms. Therefore, on the basis of what you have told me and especially on the basis of the fact that there is no weakness that has become apparent to you in all the years that you had the neuropathy nor since you started with fasciculations in the arm, I would say that there is little need to consult another specialist or do more invasive testing unless things were to change in the future. Having said that I would emphasize the fact that all labs relevant to such a presentation should have been done and cleared as normal before making such a diagnosis. If you know what labs have been done by your neurologist and would like to post them for me to review I would be happy to do that. Otherwise, if the information I provided is helpful to you or questions would you be so kind as to provide a written element of feedback as well as a star rating of this conversation. Also, I would greatly appreciate your closing the query if you have no further questions on this matter as that will signal in that work to ready itself for processing, archival, and crediting of this question for future use. I wish you all the best and again, if you have further questions please do not hesitate to address them directly to my attention and I will get back to you as quickly as possible.