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Dr. Andrew Rynne

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What causes intermittent tingling sensation and muscle twitching while having anxiety?

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Dr. Sudhir Kumar

Neurologist

Practicing since :1994

Answered : 5630 Questions

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Posted on Thu, 19 Apr 2018 in General Health
Question: I have delt with health anxiety for years now. It got bad about 7 years ago when I had widespread tingling along with widespread muscle twitching. I feared ms or als. Met with neurologist, said I was fine . I pushed for emg and mri. Every thing normal, Dr said I have a benign condition. I started to have a lot of anxiety about 2 months ago and made the mistake of googling ms and als again. That day after I read about symptoms my tingling and body wide twitching came back .2 months later my main fear is als again due to twitching even though I have had this in the past . My question: als would not present with widespread twitching correct ? I keep checking for atrophy ( which I have none) , do daily strength tests to check for weakness. None. Does this sound like benign Fasciculations,?i get so worried
doctor
Answered by Dr. Sudhir Kumar 14 hours later
Brief Answer:
Yes, your symptoms sound like benign fasciculations.

Detailed Answer:
Hi,

Thank you for posting your query.

I have noted your symptoms, other findings and EMG report.

I agree that they are suggestive of benign fasciculation syndrome (BFS). The symptoms are not suggestive of ALS or MS.

In ALS, there would be wasting (thinning of muscles). In ALS, Muscle twitching occurs in one part initially, and after years of progression, it becomes generalised. However, by then severe muscle wasting and weakness would be obvious.

Anxiety is known to worsen the symptoms of benign fasciculations. So, it would be useful to get your anxiety also treated.

Best wishes,

Dr Sudhir Kumar MD DM (Neurology)
Above answer was peer-reviewed by : Dr. Nagamani Ng
doctor
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Follow up: Dr. Sudhir Kumar 6 hours later
So twitching would start in one area ALS, then make that area weak or smaller before it moved? Sometimes my forearms feel sore after typing all day ( as I work on computer all day). There is no lack of strength, just a feel of fatigue. ALS would not start in both arms at once correct? Also it sounds like there would be real strength loss

Also , it seems like I convince myself that I have weakness at times . I read about leg weakness online then I start thinking maybe my leg is weak. If someone had actual weakness in ALS, after two months could they run, hop up and down stairs on one leg? Finally , ALS would start in one limb then take a few months to spread to others? Thank you
doctor
Answered by Dr. Sudhir Kumar 2 hours later
Brief Answer:
Yes, ALS would slowly spread.

Detailed Answer:
Thank you for getting back.

You are right. ALS would start in one limb, and it usually takes several months for the other limb to get affected. For example if the weakness and wasting of muscles start in right upper limb, it would at least take 4-6 months to involve the left upper limb. ALS does not start in both arms at once.

The weakness in ALS is significant enough to affect the activities of daily living, so, it would be noticeable at all times, and not only after reading about weakness or thinking about it!

Best wishes,
Dr Sudhir Kumar MD DM (Neurology)
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Sudhir Kumar 6 minutes later
Thank you , that is reassuring. In closing , if one actually had als, after two months they thought they had symptoms, they would probably see some type of noticeable weakness where they couldn’t do high intensity sports well.
doctor
Answered by Dr. Sudhir Kumar 8 minutes later
Brief Answer:
Yes, you are right.

Detailed Answer:
As I mentioned, the weakness of ALS is noticeable, and it hinders with activities of daily living. Therefore, it would reduce the ability to perform well in any sport.

Best wishes,

Dr Sudhir Kumar MD DM (Neurology)
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Sudhir Kumar 57 minutes later
One final question. Generally once twitching occurs , most of the time would t there already be weakness . So most of the tine weakness first then twitching due to dying muscle? Thank you

Basically, by the time one had twitching in als, they would normally have some atrophy and noticeable weakness.

Thank you
I will close out upon your final response


And it would take a few months to go from upper body to lower body or vice versa correct
doctor
Answered by Dr. Sudhir Kumar 7 hours later
Brief Answer:
Yes, weakness and wasting are noted before muscle twitching

Detailed Answer:
Thank you for getting back.

Yes, patients with ALS first notice wasting and weakness of muscles. Muscle twitching are often missed, and noticed only after they are pointed by neurologist, or specifically asked about that (unless they already know about ALS from Dr. Google).

Also, it takes several months for ALS to progress from upper to lower body, typically more than six months).

Best wishes,

Dr Sudhir Kumar MD DM (Neurology)
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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