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Whats the difference between ALS and BFS?

On Health & Drugs & Medications » Neurological Conditions

16,541 words with 15 Comments; publish: Sat, 15 Dec 2007 03:24:00 GMT; (900265.63, « »)

Just wondering if anyone is versed in the difference between als and bfs. I have had problems with twitching on different parts of my body for the last 7 months or so. One twitch, here and there (arm/hand/foot/thigh/side of torso, tongue), that I notice when I am sitting still or going to sleep. It's not that"going to sleep" type of twitching either. No pain.No weakness noticed. Some days are more pronounced than others, I can't really associate it with anything in particular. I am probably a little more type A neurotic than some, but I don't know. Someone on a different post suggested that healthcare workers have it more than others and I have been one for the last 9 years. I've asked around at work and people have brought up low calcium, low magnesium, and dehydration. I have tried to fix them all, but nothing has really changed. I'm a pretty healthy person overall,so I was unclear about the nutrition thing.

If anyone can make it a little easier for me to distinguish,I'd really appreciate it!!

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  • 15 Comments
    • The difference between BFS and ALS is simple...and profound. One (BFS) is a harmless but annoying condition, while the other (ALS) is a deadly, incurable disease.

      How can you tell? With BFS, you twitch, sometimes all over (I have BFS), BUT! you have no accompanying weakness, loss of coordination, body weight, etc. In ALS, twitching occurs during the process of nerve cell death. In many ALS cases, twitching only becomes apparent after significant muscle loss and strength loss has occured.

      Are you twitching, but otherwise healthy, strong, in good shape, good weight? You have BFS

      Are you twitching, and have lost significant body weight, unable to perform tasks you used to be able to do due to loss of strength etc etc? You might have ALS

      BFS is MUCH more common. The symptoms of ALS come on rather quickly (in the space of months usually) and DO NOT get better except under extemely rare circumstances, and then only temporarily.

      Hope this helps!

      #1; Sun, 16 Dec 2007 18:59:00 GMT
    • Thanks,yes it does help...alot! I know that ALS is deadly which is why I was so concerned. I haven't noticed any weakness or unusually different hand eye coordination, no other coordination problems or weight loss. So thanks...I feel much better...being 37 and married with 3 kids to raise it's a relief to say the least! Is it still necessary to get an evaluation and EMG with my symptoms being as they are?
      #2; Sun, 16 Dec 2007 19:00:00 GMT
    • hi all, could someone tell me more about bfs as i think i may have it. Im on waiting list for neuro, its been 2 months now. Mine started with tingling in perenium and vagina after birth of my son, it has spread everywhere now, 9 months. I have burning and aches too, thanks, april
      #3; Sun, 16 Dec 2007 19:01:00 GMT
    • The difference between BFS and ALS is simple...and profound. One (BFS) is a harmless but annoying condition, while the other (ALS) is a deadly, incurable disease.

      How can you tell? With BFS, you twitch, sometimes all over (I have BFS), BUT! you have no accompanying weakness, loss of coordination, body weight, etc. In ALS, twitching occurs during the process of nerve cell death. In many ALS cases, twitching only becomes apparent after significant muscle loss and strength loss has occured.

      Are you twitching, but otherwise healthy, strong, in good shape, good weight? You have BFS

      Are you twitching, and have lost significant body weight, unable to perform tasks you used to be able to do due to loss of strength etc etc? You might have ALS

      BFS is MUCH more common. The symptoms of ALS come on rather quickly (in the space of months usually) and DO NOT get better except under extemely rare circumstances, and then only temporarily.

      Hope this helps!

      do i have als or bfs and what do they mean? i hav been having twiches in my body and a fast heartbeat and trouble brething on an off for a year now and i had alot of tests done and the docters said they were all fine but then why am i still having signs of diseses?? i looked up als and i think i mite have it because sometimes i get weak when i get these 'atacks' of troubel brething and stuff do u think maybe i have ashma 2? omg i was healthy before all this started and now im scared im gonna die im only 16 help!!

      #4; Sun, 16 Dec 2007 19:02:00 GMT
    • have you been to see neuro? ask doctor about it.anxiety can cause your symptoms too, this is more likely, dont worry it will be ok. love april x
      #5; Sun, 16 Dec 2007 19:03:00 GMT
    • I hope this answers some of your qestions :bouncing:

      What does BFS stand for?

      Benign Fasciculation Syndrome

      Is BFS related to ALS?

      No, although exhibiting some of the same symptoms, ALS and BFS are two distinctly separate illnesses.

      Is there a cure for BFS?

      Currently, there is no known cure for BFS

      What are the symptoms?

      This condition represents a hyperexcitability of the neuromuscular system.

      Common symptoms of BFS are frequent muscle twitches (fasciculations or fascics), generalized fatigue, "pins and needles" sensations, migrating numbness, muscle cramping and/or spasms in the affected areas (usually the feet and calves), muscle aches and stiffness exercise intolerance, headaches, and itchiness.

      Clinically some patients have mild increases in creatine kinase. Muscle biopsy may show mild neurogenic changes. Electrodiagnostic studies show peripheral nerve hyperexcitability.

      Often the symptoms will get worse at night, or during periods of sickness or viral infections, stress, or overexertion.

      Many people experiencing these symptoms fear they may have ALS or MS. A simple clinical rule is that fasciculations in relaxed muscle are never indicative or motor system disease unless there is an associated weakness, atrophy, or reflex change.

      What are fasciculations?

      Fasciculations, or fascics are localized twitches of the muscle fibers.

      From the On-Line Medical Dictionary:

      A small local contraction of muscles, visible through the skin, representing a spontaneous discharge of a number of fibres innervated by a single motor nerve filament.

      What should I do if I am experiencing twitching or other symptoms of BFS? You should immediately consult with your General Practitioner (Family Doctor) or with a Neurologist.

      While the symptoms are often benign in nature, they can also be indicators of a more serious illness such as ALS or MS. You should be tested as soon as possible.

      I have been diagnosed with BFS, what now?

      While there are currently no known cures for BFS, and management of BFS symptoms is a subject for some debate, you should keep in contact with your Neurologist to keep abreast of any progress in the treatment of BFS.

      Also, if you experience any change in the symptoms that you are experiencing, you should immediately make your Neurologist aware of these changes as they may be indicative of other underlying symptoms.

      Is it possible for BFS to progress into ALS?

      No. This is a common worry for those who have been diagnosed with BFS.

      The number of people developing ALS after having been diagnosed with BFS is statistically the same as for the General Population.

      As long as you have been diagnosed by a qualified Neurologist, you should have no concerns. If fact, many people suffering with BFS have reported that their symptoms increase with stress and worrying, so you are probably making your symptoms worse than they need to be by worrying about your diagnosis.

      Fasciculations themselves can be present for years and not associated with a malignant condition.

      However, if you start to develop new symptoms (such as weakness), and a change is your symptoms, see a Neurologist as soon as possible.

      What tests can I expect my doctor to perform if he suspects I have BFS?

      Typically, the doctor will test your reflexes, have you perform some simple strength tests, and administer an EMG. In some cases, blood tests may be ordered or a muscle tissue biopsy will be taken.

      How long does BFS last?

      The symptoms can range in length from months to many years. In some cases, the symptoms never completely cease.

      Typically the symptoms with come and go, with periods of increased twitching, separated by periods of remission where the symptoms are milder, but still present.

      In some cases the periods of remission will get longer over time, with the active periods experiencing less intense symptoms.

      Is BFS a real disorder? Isn't this just stress /anxiety related, or is it all in my head? BFS is a confirmed, diagnosable disorder. If fact, a large percentage of the people diagnosed with BFS are in the medical profession (in a study by the Mayo Clinic of 121 people diagnosed with BFS, 40 were healthcare workers).

      Times of increased stress or anxiety may cause similar symptoms (i.e. twitching of the eyelid), that will go away when the stress causing antagonist is removed, however this is a common effect of stress and is not typically BFS.

      Often, those who are suffering from BFS will find that their symptoms get worse during the time when they are experiencing increased levels of stress or anxiety. It has been suggested that stress partially weakens or disables the immune system, therefore allowing latent disorders or sicknesses to grow in severity. (See: What causes BFS)

      What causes BFS?

      Doctors and scientists continue to debate the root cause and even the mechanism of BFS.

      The most prominent theory is that BFS is an auto-immune response to a viral infection. Many suffers of BFS have noted that that onset of their symptoms occurred just after a viral illness or infection, such as the flu. Also, many experience an increase in their symptoms during times of illness.

      The anatomic site of origin for muscle fasciculations and cramps has been debated for many years. Many authors have argued for a central origin of the abnormal discharges in the anterior horn cells. However some evidence favors a very distal origin in the intramuscular motor nerve terminals. Some researchers have found degeneration and regeneration of motor nerve terminals.

      #6; Sun, 16 Dec 2007 19:04:00 GMT
    • I am 39 year old female with three kids. 1 year and ten months ago I started getting twitches all over my body even my tongue. They seemed to coincide with a bad virus. Anyway, I was terrified it was ALS so my doctor put me on Paxil thinking they were anxiety related (the twitches were causing the anxiety!!!) and of course they did not go away so i went to see a neurologist who ran an emg and mri and told me I had BFS. They come and go and on certain days or weeks they are really bad like this week where I am getting them frequently in my right bicep. I don't have any other symptoms really to make me think I may have ALS but they do concern me because not only are they extremely annoying but I am afraid they will get really bad on my face for instance where it will be noticable and embarrasing. My neurologist says he has not heard of this happening to anyone, that usually they just come and go and will at times be flared up for unknown reasons. I just don't get it that's all!!! I am wondering if there's anything I can take to calm them down when they are bad. I take magnesium and a multivitamin so I am not deficient. Anyone have any suggestions? Also, at this point is it safe to say I would know if it WAS ALS? Wouldn't I have some weakness or atrophy by now? I understand it progresses somewhat quickly. Thanks!!!
      #7; Sun, 16 Dec 2007 19:05:00 GMT
    • Pauline:

      I know exactly how you feel.

      My twitches -- 95% are in my calves/thighs -- only began in August and were triggered, evidentally, by what I have come to find out was Mycoplasma Pneumonia. The pneumonia is gone, but the anxiety of thinking I had ALS or MS before I was treated for the pneumonia caused anxiety, which in turn kicked in the twitches. I also have seen a qualified neurologist and have had an EMG, a brain MRI (with contrast) and a spine MRI. Not to mention a series of blood work. Nothing but the pneumonia antibodies came back positive.

      I know how annoying these twithces are. Believe me. I have them 24/7 and am a 38-year-old father of 1. I was prescribed 1 mg of the anti-seizure/anxiety med Clonezepam (sic?) to help, but they have only helped with sleep, not the twitches.

      As you stated, the only anxiety I have is this twiching, but since the negative MRIs and EMG results came back, I have tried not to think about them, yet they are still there. Every day.

      You are not alone. I also have another friend, your age and a mother of 2, who have had them for a year as well and she is at her wits end.

      Hang in there.

      John

      #8; Sun, 16 Dec 2007 19:06:00 GMT
    • One poster stated it very well earlier. The main system with ALS is weakness.
      #9; Sun, 16 Dec 2007 19:07:00 GMT
    • Thank you John and others! The persistent twitches in my right bicep did finally let up after about a week or so after doing so much physical work with my right hand and arm. I also try to not think about them since my neurologist assures me there is nothing dire going on but it's tough when they are so severe. Somebody recommended aboutbfs.com and to go to the message boards and read up on "hot spots" like my right bicep which are supposed to be common.. Thank you! I will do that because it's such a strange thing that it really helps to read about others with the same problem. It's really hard to believe that there is not something seriously wrong and then the whole thing with being embarrassed that they might get progressively worse and others might notice them -- I am vain after all. In any case, there are much worse fates. Thanks again!
      #10; Sun, 16 Dec 2007 19:08:00 GMT
    • I have similar issues...

      I've been diagnosed with General Anxiety diorder (take celexa for it) , and lately (last month and a half or so) i have been getting twitches. All over, even in my stomach.They have gotten much better since i started taking a magnesium supplement, like my doctor suggested i do , when i had them over two years ago (again for around a month)

      But i am terrified of ALS.. Everytime i have a twitch i go online and look up ALS symptoms, drives me nuts...Doctor checked calcium levels and they were fine, didnt order any more tests, since the twitches come on and off..

      Its been an extremely stressful time, work deadlines, wife about to deliver twins and reading about als, and no time to work out the stress...

      I don't feel any weakness though, and can still bench press the 130lbs i normally do..

      hoping its not als...and is anxiety related..

      #11; Sun, 16 Dec 2007 19:09:00 GMT
    • Twitching doesn't mean ALS. With ALS you get weakness, then generally twitching.
      #12; Sun, 16 Dec 2007 19:10:00 GMT
    • hi all

      in your quest for answers reguarding muscel twitches go to an expert lyme disease dr and be properly tested at a lyme savvy lab. if you do not your chances of getting properly identified and treated for a long enough time are very slim. be sure to check the lyme threads here and judge for yourself.

      jon

      #13; Sun, 16 Dec 2007 19:12:00 GMT
    • wow thank you so much for the explanation of BFS. i have been experiencing some twitching and that pins and needles thing in my chest. As i read more and more i feared that it would be ALS. But one thing i didnt see under BFS is tripping. I have sometimes found myself tripping at random times on a sidewalk. I'm not sure if thats just me or the sidewalk or something more serious
      #14; Sun, 16 Dec 2007 19:12:00 GMT
    • This is a great thread, lots of interesting information about BFS...

      I have been around the neurological loop myself - suspected MS, suspected fibromyalgia etc. On top of that, I'm dealing with a diagnosis of bipolar disorder and problems from my IBS (Gah!!) I feel like I should be asking for a warranty replacement for this body. LOL.

      Jokes aside, I'm fairly sure I have BFS ... I mean I'm twenty-four, female, so an unlikely candidate for ALS ... BUT I have had significant muscle weakness and some atrophy over the last 12 months, I have lost a LOT of strength in my legs, torso and arms. This really sucks. My balance is pathetic, I trip all the time. Sigh. I've had an electromyogram come back negetive, so it definitely can't be ALS. Yet my psychiatrist and a rheumatologist that I saw both think I have a neuromuscular condition of some sort.

      I guess some of us BFSers do get weakness and stuff. Annoying.

      I'm supposed to go for more tests with my neuro but just can't be bothered right now!!

      Stay well all BFSers

      #15; Sun, 16 Dec 2007 19:13:00 GMT