Muscle Twitches: Concerns and Neurological Insights

Q: Muscle Twitches: Concerns and Neurological Insights

Hello： There are many potential causes for muscle twitching. <br>In addition to muscle fasciculation, there are muscle myokymia, muscle spasm, muscle myoclonus, and others that are difficult to translate. <br>The causes are quite diverse, but the most common ones include stress,

Regarding muscle issues?

Hello Doctor, I have recently been experiencing muscle twitching.
The twitching occurs in specific areas after significant movements; for example, after sneezing, the muscles around my ribs twitch a few times.
The twitching is more noticeable when I lie down in bed, especially in the mornings and evenings.
Sometimes, when I turn over while lying on my side, the side that was previously in contact with the bed also twitches.
I am very worried that I might have amyotrophic lateral sclerosis (ALS), and I am currently 21 years old.

A year ago, I was concerned about pain in my limbs and underwent electromyography (EMG) and nerve conduction studies on the right side of my body.
Six months ago, I was worried about multiple sclerosis (MS) and had evoked potentials (visual and auditory) and awake electroencephalography (EEG) done.
About two weeks ago, I felt something strange in my throat and noticed slight difficulty swallowing, so I consulted a doctor.
She asked me to show her my hands to see if they trembled, and she said I was just experiencing autonomic dysregulation.
After that, I went home and started paying attention to my hand tremors, and a few days ago, my muscles began to twitch, which made me worry about Parkinson's disease.
I returned to the doctor a week ago, and she assured me that it was definitely not Parkinson's and ordered blood tests for ion levels, with results expected on April 30.

I am currently very anxious about ALS.
I read that twitching can be caused by miscommunication in nerve signaling, which made me think that this might explain my twitching (this is just my guess, but some doctors have said it doesn't necessarily indicate a specific type of twitching).
I hate that I am caught up in this issue; on one hand, I want to know the truth and spend all day looking at incomprehensible reports and observing my muscles, while on the other hand, I just want to live a peaceful life.
Yesterday, I considered making an appointment for a full-body EMG at the hospital.

Regarding medication, previous doctors have prescribed me pink pills for autonomic nervous system regulation, but I haven't taken them.
I only took the current medication after meals (a pink pill plus half a white muscle relaxant).
Today, I experienced a frightening situation where I passed some watery stool while passing gas, which scared me to death.
I feel like my anal sphincter muscles might be malfunctioning.
When I went to the bathroom to clean up, it seemed like I dripped a bit (today's bowel movement was partly loose).
I have never experienced this before.

As for urination, I have had frequent urination since childhood and have undergone numerous tests (blood sugar tests every six months and kidney evaluations every year, all of which were normal at least until six months ago).
Recently, I have also felt weaker at the end of urination and often have to wait for the last bit of urine to come out.
Many diagnoses indicate that at my age, prostate enlargement is unlikely, and I suspect there might be an issue with my bladder muscles.
I do not smoke, drink alcohol, or consume coffee, but I often drink beverages and tea.
I am really worried about my muscle twitching.
Thank you for your response.

Dàxuéshēng, 20~29 year old female. Ask Date: 2021/04/20

Dr. Hong Weibin reply Neurology

Hello: There are many potential causes for muscle twitching.
In addition to muscle fasciculation, there are muscle myokymia, muscle spasm, muscle myoclonus, and others that are difficult to translate.
The causes are quite diverse, but the most common ones include stress, electrolyte imbalances, lack of sleep, dehydration, excessive caffeine or stimulant intake, certain medications, fatigue, kidney disease, and diabetic neuropathy, among others.
The vast majority of simple muscle twitching is related to the conditions mentioned above.
If your muscle twitching is not continuous but occurs intermittently after turning over or making large movements, it is usually unlikely to be due to motor neuron disease (commonly known as ALS).
It would be advisable to continue monitoring with a neurologist for a period of time and discuss your symptoms with the physician.
Hong Wei-bin

Reply Date: 2021/04/20

More Info

Hello! Thank you for reaching out with your concerns regarding muscle twitches and the associated symptoms you are experiencing. It’s understandable to feel anxious about these issues, especially given the complexity of neurological conditions. Let’s break down your concerns and provide some insights based on medical knowledge.

Understanding Muscle Twitches
Muscle twitches, also known as fasciculations, can occur for a variety of reasons and are often benign. They can be triggered by factors such as stress, fatigue, dehydration, caffeine intake, or even overexertion of muscles. In your case, you mentioned that the twitches become more noticeable after physical activity or when you are lying down, which is not uncommon.

Concerns About Neurological Conditions
You expressed significant worry about conditions like Amyotrophic Lateral Sclerosis (ALS) and Parkinson's disease. It’s important to note that while muscle twitching can be associated with neurological disorders, it is not a definitive indicator of such conditions. ALS, for instance, typically presents with muscle weakness, atrophy, and other specific symptoms, rather than just twitching alone.
Your previous tests, including electromyography (EMG) and nerve conduction studies, have likely provided your healthcare provider with valuable information. These tests can help differentiate between benign muscle twitching and more serious conditions by assessing the electrical activity of muscles and the health of the nerves that control them.

Anxiety and Its Impact
You mentioned experiencing anxiety and self-doubt regarding your symptoms. Anxiety can exacerbate physical symptoms, including muscle twitching. The mind-body connection is powerful; stress and anxiety can lead to increased muscle tension and spasms. It’s crucial to address these feelings, as they can create a cycle of worry that intensifies your physical symptoms.

Gastrointestinal Symptoms
Regarding your gastrointestinal symptoms, such as the unexpected bowel movement and changes in urination, these could be related to a variety of factors, including dietary changes, stress, or even a temporary gastrointestinal upset. If these symptoms persist, it would be wise to consult a healthcare provider for further evaluation. They may suggest tests to rule out any underlying conditions affecting your gastrointestinal or urinary systems.

Recommendations
1. Follow-Up with Your Doctor: Given your ongoing symptoms and concerns, it’s advisable to maintain open communication with your healthcare provider. They can help interpret your test results and provide reassurance or further testing if necessary.

2. Manage Anxiety: Consider techniques to manage anxiety, such as mindfulness, meditation, or cognitive-behavioral therapy (CBT). These approaches can help reduce the impact of anxiety on your physical symptoms.

3. Lifestyle Adjustments: Ensure you are staying hydrated, maintaining a balanced diet, and getting adequate rest. Regular, moderate exercise can also help alleviate anxiety and improve overall muscle function.

4. Monitor Symptoms: Keep a journal of your symptoms, noting when they occur and any potential triggers. This information can be helpful for your healthcare provider in understanding your condition better.

5. Avoid Self-Diagnosis: While it’s natural to research symptoms, self-diagnosing can lead to unnecessary worry. Rely on your healthcare provider for accurate information and guidance.

In conclusion, while muscle twitches can be concerning, they are often benign and related to stress or fatigue. Your previous evaluations have likely ruled out serious conditions, but ongoing communication with your healthcare provider is key to addressing your concerns and managing your symptoms effectively. Remember to take care of your mental health as well, as it plays a significant role in your overall well-being.

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