Is random muscle twitches an early sign of als or is it more focal?

Focal is more common: The most common symptom of ALS is asymmetric muscle weakness in the upper extremities, mainly on the thumb and index finger side of the hand. Difficulty swallowing and speaking occur in about 20% of cases. Random muscle twitches in the fingers and eyelids are usually a sign of myokymia, a benign condition. See your primary care for further evaluation. Thanks for trusting Health Tap!

Possibly: Usually it starts on the limbs, but can start on the eye. it is just variable. Diagnosing it early and treating it early probalby does no affect the ultimate outcome. See your doctor and get an evaluation and be sure to share your fears

?fasciculations?: Not clear what the twitches represent, as many muscular irritability syndromes do exist, especially those associated with myokymia in the face, which is NOT ALS. If you did have motor neuron disease, it would most likely start in the hand unilaterally, and the flickering muscle fibers would be associated with reflex increase. Many pts with fascics do have benign problems, including hyperthyroid.