Muscle Twitching: Causes and Concerns in Young Adults - Neurology

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Involuntary muscle twitching at irregular locations?


Hello Doctor, about a month ago, I started experiencing twitching in my right eye bag and my left calf.
After an EEG, the doctor said it was normal, so my family suggested I get blood tests for thyroid function.
I might be overthinking things, but I vaguely feel like my whole body has slight tremors.
The twitching in my eye bag has stopped, but my left foot's dorsum, sole, and calf continue to twitch.
I also wake up at night feeling restless and have been experiencing this for several days.
Due to the national holiday, I felt anxious and sensed a lump in my throat, worrying about a potential thyroid storm.
The test results showed no abnormalities, but I still feel slight weakness in my legs and persistent muscle twitching, so I went to see an orthopedic doctor.
They diagnosed me with mild patellar malalignment, but I don't feel any pain, and the twitching has now shifted to my left foot's sole, thigh, and upper limb muscles.
At night, my hands feel tense, and I have difficulty making a fist, waking up from sleep, but the feeling of restlessness has diminished.
I am currently waiting for nerve conduction studies.
My current symptoms include twitching in my abdomen, left rib cage, hands, back of the hands, calves, thighs, and quadriceps, but it's less frequent than before.
I forgot to mention that I've been experiencing alternating diarrhea and normal bowel movements for a while, and just yesterday, I had diarrhea three times and consulted a doctor.
I described my experiences to him, and he suggested it might be autonomic nervous system dysregulation, prescribing me gastrointestinal medication and encouraging me not to be anxious.
I haven't taken it yet, and I feel better now.
It's really confusing; my symptoms change every week, but only my left foot's sole, thigh, knee area, and rib cage have slight, irregular twitching that has persisted for a month.
Doctor, do you think I have autonomic nervous system dysregulation? Can this symptom cause muscle twitching? Can patellar malalignment cause muscle twitching? I'm now going to bed early and taking B vitamins, but I still experience twitching, although it's smaller and intermittent.
Occasionally, I can see it with the naked eye.
Doctor, I'm 23 years old with no family history; is it possible for someone so young to develop motor neuron disease? Isn't the probability extremely low? Since the beginning, I've been searching online for information, and I've probably read thousands of articles.
I think about it every day, and it's very distressing.

Shanwei, 20~29 year old female. Ask Date: 2020/05/31

Dr. Hong Weibin reply Neurology


Hello: If you experience visible persistent muscle twitching and pain, you can seek assistance from a neurologist to determine if an electromyography (EMG) is necessary.
Muscle twitching can have many causes that require differential diagnosis, and not all causes are as alarming as motor neuron diseases, so there's no need to worry too much at this stage.

Reply Date: 2020/05/31

More Info


Muscle twitching, also known as fasciculation, is a common phenomenon that can occur in individuals of all ages, including young adults. In your case, the twitching you are experiencing in various parts of your body, particularly in your left leg and other areas, can be attributed to several factors, including anxiety, sleep deprivation, and possibly even lifestyle choices.

Firstly, it’s important to understand that muscle twitching can be benign and often does not indicate a serious underlying condition. In many cases, it can be linked to stress, fatigue, or overexertion. Given that you have mentioned experiencing anxiety and sleep disturbances, these factors could be contributing to your muscle twitching. Anxiety can lead to muscle tension and hyperactivity of the nervous system, which may manifest as involuntary muscle contractions. Additionally, sleep deprivation can prevent your muscles from fully relaxing, leading to twitching and discomfort.

You mentioned that you have been experiencing a range of symptoms, including feelings of weakness in your legs, abdominal issues, and even gastrointestinal disturbances like diarrhea. These symptoms can be interconnected. For instance, gastrointestinal issues can sometimes be exacerbated by stress and anxiety, leading to a cycle of discomfort that can further heighten your anxiety levels. It’s also worth noting that the autonomic nervous system, which regulates involuntary bodily functions, can become dysregulated under stress, potentially leading to symptoms like muscle twitching and gastrointestinal disturbances.

Regarding your concerns about conditions such as thyroid disorders or motor neuron diseases, it’s reassuring to know that your thyroid tests came back normal. The likelihood of developing a serious condition like amyotrophic lateral sclerosis (ALS) at your age, especially without a family history, is indeed very low. Most muscle twitching in young adults is not indicative of a severe neurological condition.
Patellar malalignment (patellar valgus) is another concern you mentioned. While this condition can lead to knee pain and discomfort, it is less likely to be a direct cause of widespread muscle twitching. However, compensatory movements or changes in posture due to discomfort in the knee could potentially lead to muscle fatigue and twitching in the surrounding muscles.

As for your current symptoms, including the twitching in your left foot and thigh, it may be beneficial to focus on lifestyle modifications. Regular physical activity, proper hydration, and a balanced diet rich in vitamins and minerals (including B vitamins) can support muscle health and reduce symptoms. Additionally, practicing relaxation techniques such as mindfulness, yoga, or deep-breathing exercises can help manage anxiety and improve your overall well-being.

If your symptoms persist or worsen, it would be prudent to follow up with your healthcare provider for further evaluation. They may consider additional tests, such as nerve conduction studies, to rule out any underlying neurological issues. However, based on your description, it seems that your symptoms are more likely related to anxiety and lifestyle factors rather than a serious medical condition.

In conclusion, while muscle twitching can be concerning, especially when accompanied by other symptoms, it is often benign and can be managed through lifestyle changes and stress reduction techniques. It’s essential to maintain open communication with your healthcare provider and seek support when needed. Remember, taking care of your mental health is just as important as your physical health, and addressing anxiety can significantly improve your overall quality of life.

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