There are cases in which someone with ALS was misdiagnosed with BFS.

Imagine the devastation when the patient finally receives the correct diagnosis.

From a clinical standpoint, early ALS can resemble benign fasciculation syndrome – at least from the subjective reporting of the patient.

How often is ALS mistaken for BFS by a doctor?

“Although ALS can be misdiagnosed as BFS, this is not common,” says Bonnie Gerecke, MD, director of the Neurology Center at Mercy in Baltimore.

There is no data on how often ALS is misdiagnosed as BFS.

Now it happens that initially, the patient may be told that their symptoms seem to be related to a number of conditions, one of which is benign fasciculation syndrome.

But this is not a diagnosis; it’s an initial assessment.

Dr. Gerecke explains, “The hallmark of BFS is muscle twitching in the absence of other pathological signs and symptoms.

“If a patient presents with muscle twitching and no other symptoms and has a normal examination other than for twitching, it is usually not difficult to recognize this syndrome.

EMG test. Paul Anthony Steward, CreativeCommons

“ALS is associated with weakness and muscle wasting and not just isolated muscle twitching.”

A neurologist will have the patient perform some tests in the office to measure for weakness, and of course, the EMG will be very telling about whether or not nerve conduction is normal.

BFS is not progressive, but ALS is – and sometimes rapidly – and the associated weakness as it progresses is significant.

The bottom line is that it is rare for a person with ALS to be diagnosed with benign fasciculation syndrome.

But to learn just how this can happen, read this interview with Michael Cartwright, MD, a board certified neurologist at Wake Forest Baptist Medical Center in Winston Salem, NC. You will be very surprised by how he says ALS is diagnosed.

Dr. Gerecke has a special interest in ALS, myasthenia gravis, myopathy/muscular dystrophy, peripheral neuropathy and radiculopathy. She is board certified in general neurology and neuromuscular medicine.
Lorra Garrick has been covering medical, fitness and cybersecurity topics for many years, having written thousands of articles for print magazines and websites, including as a ghostwriter. She’s also a former ACE-certified personal trainer.