Helped Over 500,000 patients with 98%+ satisfaction.

Connect & Get Personalized 1-to-1 Answers from Expert Doctors

DoctorSpring > Question Home

Physician with fasciculations affecting body fearing ALS

Resolved Question:

hi I am a 40 year old GP (Primary care physician) in Australia. since last 4 weeks I have been having fairly regular fasciculations - started with left eyelid, moved to right eyelid then arms, legs, back, thighs and buttocks. I have had these fasciculations in last 6 months - but were completely intermittent and last 4 weeks they have been constant, sometimes associated with sudden finger movements and seems to affect the web space of hands and posterior tibial area of foot. However there are no fixed postions. just after these (3-4 weeks back) I had some ache in my right biceps especially on contraction and also a vague restless feeling in both arms (although not clumsiness). trial of magnesium improved significantly and rest seems to help. no weakness in either arms or legs. I do walking for 4 kms / day with no difficulty. obviously being a physician myself the first concern was ALS however I an convincing myself for BFS . Since last 2 days I have noted being little bit more tired. no previous medical history, only thing I take is vit D and the last levels were therapeutic. sometimes I take 2 tabs / day and was also wondering about vit D toxicity and not sure whether it can cause fasciculations. the reason for consult today was some fasciculations in left mid arm which were pretty consistent for few seconds and then I started having some aches in left arm. I weight 89 kgs and I am generaly fit and furthermore there is no history of ALS in family. no weakness, atrophy noted. The questions were what is your opinion in general with patients diagnosed as ALS in particular what symptoms do they have. I have done heaps of research and the result was more confusion. dont want to get EMG done as I am concerned regarding false postiives / negatives and it can be normal earlier on and obviously will require further recordings. In the abscence of any weakness / atrophy what are the chances of ALS as i know thay can precede other symptoms by months / years. please reply ASAP so that I can answers more questions raised by you. I am a trained phhysician from UK and also doing General practice and Emergency Medicine in Australia. Thanks for your prompt response

Category: Neurologist, Medical

Ask Your Own Question

 30 Doctors Online

Hello Dr,

Thank you for posting your query in detail at DoctorSpring.

I am a qualified Neurologist and have experience of about 15 years in treating neurological disorders, and would have seen about 500 cases of ALS so far in that period.

First of all, I would like to reassure you that based on your description, my diagnosis would be BFS, and not ALS.

Also, vitamin D toxicity does not usually lead to fasciculations.

Patients with ALS usually present with weakness and/or wasting of muscles and these symptoms tend to progress over time. Within six months, there is definite worsening. Symptoms begin in one limb and then progress to other limbs over 2-3 years. It does not start in whole body at a time.

I agree with you that EMG is not definitive, in the absence of typical clinical symptoms, and also it would need to be repeated. So, I also would follow up a patient clinically rather that do an EMG if some one came to me with symptoms such as yours. The only time I would do an EMG is if the patient requested me to do in order to be more sure that it is not ALS.

I hope it helps. I would be pleased to answer any follow up queries.

Best wishes,

Dr. Sudhir Kumar MD (Medicine), DM (Neurology)
Senior Consultant Neurologist, Institute of Neurosciences,
Apollo Hospitals


Dr.
Category:
Experience: 
Dr. and 4 other Medical Specialists are ready to help you

Users who read this, also read:

Make informed and better medical decisions.

Join the 500,000 people who found a smarter, quicker way to get Answers, Recommendations & Expert Opinions.

Expert Doctors at fingertips

Recommendation on next step. Second-opinion.Multi-specialty.

Save Time

Average time for answers: 6 hours.

Save Money

$35 for typical specialist consult vs. $120 for a local appointment.

Free Follow-ups

Clarify, ask further questions for free in private conversation.

100% Satisfaction

Money back guarantee for the 1st reply. MEDNET Quality Board.

Start My Consultation

CHAT NOW

About DoctorSpring.com

Doctor Spring is a novel online Doctor consultation platform where you can get your medical questions answered by leading Doctors. Just Submit your question and rest assured that you will consult a Doctor easily. Once you submit the question, the Doctor from the concerned specialty will reply within hours. You can always ask more questions or add details with follow-up question options and make it an online doctor chat. You may use this service to consult a specialty or for getting medical second opinion. All paid services come with a MEDNET quality assurance and 100% money back guarantee.

DoctorSpring in news