What Causes Abdominal Twitching And Weakness In My Legs And Arms?

Posted on Tue, 14 Jan 2014

Medically reviewed by Ask A Doctor - 24x7 Medical Review Team

Tue, 14 Jan 2014 Answered on

Tue, 4 Feb 2014 Last reviewed on

Question : I need to ask some questions reguarding als. I have been having abdominal twitches off and on now for more than 2 years. Since November I have been having twitches all over. I have seen a Als specialist who did a EMG on one side plus a physical exam and said no you dont have ALS and to go back in 1 month. He also said I have general anxiety and to see a psychiatrist. As of my my exam I am epperienciengng weekness in my legs and arms plus trembeling. What do you suggest I do do next? could this be UMN problem andd not detected? or Bulbar?

Answered by Dr. Sudhir Kumar (3 hours later)

Brief Answer: My reply is below. Detailed Answer: Hi, Thank you for posting your query. Based on the description of your symptoms and negative EMG, I also think that you do not have ALS. The most likely cause of your symptoms could be benign fasciculations syndrome (BFS), where there can be generalized muscle twitchings, without any significant muscle weakness or wasting. As part of UMN involvement, there would be stiffness and spasticity of limbs, along with weakness. As part of LMN involvement, there would be muscle wasting (thinning of muscles) and fasciculations. EMG is quite specific, and if negative, it rules out ALS. If in doubt, the EMG study may be repeated after 3-6 months. I hope my answer helps. Please get back if you have any follow up queries or if you require any additional information. Wishing you good health, Dr Sudhir Kumar MD (Internal Medicine), DM (Neurology) XXXXXXX Consultant Neurologist Apollo Hospitals, Hyderabad, India Click on this link to ask me a DIRECT QUERY: http://bit.ly/Dr-Sudhir-kumar My BLOG: http://bestneurodoctor.blogspot.in

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Sudhir Kumar (3 hours later)

What about bulbar issues can that be ruled out? Is the emg on one side good enough? Could this be Parkinson disease? I cant get this out of my mind any suggestions on how I can put this out of my mind and go on with life. Can symptoms develope after a clean emg?

Answered by Dr. Sudhir Kumar (5 hours later)

Brief Answer: My reply is below. Detailed Answer: Thank you for getting back. You have no bulbar symptoms such as difficulty in swallowing or speaking. You also do not have symptoms of Parkinson's disease. Doing EMG on one side is enough to exclude ALS. Generally, ALS can be excluded after a clean EMG, however, if the neurologist is in doubt, the EMG may be repeated after 3-6 months. Please do not worry at present regarding ALS or PD. Best wishes, Dr Sudhir Kumar MD DM (Neurology)

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar