Muscle Twitches: Causes and Concerns in Neurology

Muscle twitching

Hello Doctor: I have noticed that since last week, the muscle below my right thumb has been twitching intermittently (visible to the naked eye).
Sometimes it occurs every few minutes, and other times it can be hours apart.
The twitching frequency varies, with longer contractions (lasting one to two seconds) and rapid twitches (lasting just over a second) occurring alternately.
Over the past two days, I have also observed sporadic twitching in my arm and legs, but it seems to occur in random locations and does not remain fixed like the twitching in my thumb.
The twitching in other areas does not seem to repeat in the same spot.
Late last night, I began to notice twitching in the muscle below my left thumb as well (not easily noticeable), with less pronounced contractions compared to my right hand.
The contractions in my left hand are slower and resemble simple rapid twitches.
Coincidentally, my sleep schedule has been irregular and of poor quality over the past week or two, and I have been experiencing particularly severe insomnia in the last couple of days, which seems to have exacerbated my symptoms.
I would like to ask the doctor if this is simply due to fatigue, or if other medical conditions cannot be ruled out.
Thank you!

Mr. Chen, 20~29 year old female. Ask Date: 2021/06/27

Dr. Jiang Junyi reply Neurology

Hello Mr.
Chen,
Your symptoms may suggest benign muscle twitching.
Certain situations in daily life could contribute to this issue, such as exercise, acute viral infections, anxiety, and medication use.
Prolonged exercise is one of the primary causes of muscle twitching.
Additionally, some medications may exacerbate twitching, including diuretics, corticosteroids, and excessive caffeine.
Certain infections can also lead to neuropathy, such as scrub typhus, among others.
Many patients find themselves in a vicious cycle where mild muscle twitching causes anxiety, which in turn worsens the twitching, leading to further panic and anxiety.
If your symptoms are accompanied by sensory abnormalities, it may be worth considering the possibility of spinal nerve root compression.
These symptoms can worsen due to overexertion or a deficiency in B vitamins.
Maintaining a regular lifestyle, increasing your intake of B vitamins during the day, and reminding yourself to get up and stretch every half hour can help prevent nerve compression and muscle tension from worsening your symptoms.
Taking a warm bath, massaging, or relaxing before bed for 4-5 hours can also provide relief.
Pharmacological treatment typically includes muscle relaxants, anxiolytics, and mild analgesics.
I recommend that you visit a neurology clinic for further evaluation; however, due to the current COVID-19 pandemic, it would be advisable to wait until the situation stabilizes before going to the hospital for examination.
Please ensure to practice self-protection, cleanliness, and disinfection before and after your medical visits, adhering to the new preventive measures.
Thank you for your inquiry, and feel free to discuss any related questions further!
Wishing you good health and peace,
Dr.
Jiang Junyi
Department of Neurology, Taoyuan Medical Center

Reply Date: 2021/06/27

More Info

Muscle twitches, also known as fasciculations, can be a source of concern for many individuals, especially when they appear suddenly or in various parts of the body. Your description of experiencing muscle twitches in your right thumb and subsequently in other areas, including your arm and legs, raises several important considerations in the field of neurology.

Firstly, it is essential to understand that muscle twitches can occur for a variety of reasons. Common causes include fatigue, stress, anxiety, and sleep disturbances. Given that you have mentioned experiencing poor sleep quality and increased anxiety recently, these factors could significantly contribute to the muscle twitching you are observing. Stress and anxiety can lead to muscle tension and spasms, which may manifest as involuntary twitches. Additionally, lack of sleep can exacerbate these symptoms, as the body requires adequate rest to recover and maintain normal muscle function.

Another potential cause of muscle twitches is electrolyte imbalances, particularly deficiencies in magnesium, calcium, or potassium. These minerals play crucial roles in muscle contraction and relaxation. If your diet has been lacking in these nutrients, it could lead to increased muscle excitability and twitching. Staying hydrated and ensuring a balanced diet rich in these essential nutrients can help mitigate these symptoms.

Moreover, while benign causes are often the most likely culprits, it is important to consider other neurological conditions that could lead to muscle twitching. For instance, conditions such as benign fasciculation syndrome, peripheral neuropathy, or even more serious concerns like motor neuron diseases could present with similar symptoms. However, these conditions typically come with additional signs, such as muscle weakness, atrophy, or significant changes in reflexes. Since you have not reported any weakness or significant changes in your muscle function, the likelihood of a serious underlying condition may be lower.

It is also worth noting that muscle twitching can sometimes be a side effect of certain medications or substances, including caffeine and stimulants. If you have recently changed your medication regimen or increased your intake of stimulants, this could also be a contributing factor.

Given your symptoms and the recent onset of muscle twitching, it would be prudent to monitor the situation closely. If the twitching persists, worsens, or is accompanied by other concerning symptoms such as weakness, numbness, or significant changes in coordination, it would be advisable to consult a neurologist for a thorough evaluation. They may recommend tests such as electromyography (EMG) or nerve conduction studies to assess the health of your muscles and nerves.

In conclusion, while muscle twitches can be alarming, they are often benign and related to factors such as fatigue, stress, and sleep disturbances. However, it is essential to remain vigilant and seek medical advice if symptoms persist or worsen. Maintaining a healthy lifestyle, managing stress, and ensuring adequate sleep can significantly help in reducing the occurrence of muscle twitches. If you have any further concerns or questions, do not hesitate to reach out to a healthcare professional for personalized guidance.

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