question: Hi doctor, I am a 38 year old male, and I have been feeling twitches in my arm. I started feeling this constant twitch about six weeks ago. I did not experience any weakness in that arm or anywhere else in the body. The twitches lasted for about a week and then went away. The twitches have now appeared four weeks later in the same area (upper arm). Again, there is no apparent weakness, which I have tested by lifting weights at the gym and both my upper and lower body strength seems to be fine. What is worrying me to death is, could these twitches be an early sign of ALS? Is it possible that weakness will follow even though I do not have it now? Do ALS twitches go away for four weeks at a time and reappear? If I started to experience constant twitches six weeks ago, if this was ALS should not I have experienced some weakness by now? Is the fact that the twitches are localized to the same place a bad thing?