Muscle Twitches: Causes and Concerns in Neurology

Q: Muscle Twitches: Causes and Concerns in Neurology

Hello, Sir： The condition you are concerned about, commonly known as amyotrophic lateral sclerosis (ALS), primarily involves issues with motor neurons. <br>Motor neurons control muscle movement; generally, the motor neurons in the brain are referred to as upper motor neurons, whi

Muscle twitching

Hello Doctor: Recently, I have been experiencing muscle twitching all over my body at irregular times for nearly a month.
It tends to occur when I lie down, change positions, or sneeze, with the most common areas being my left chest, back, and abdomen, followed by my lower back, thighs, and arms.
When lying down, the twitching happens once every one to two minutes.
Although there is a lot of information available on this issue, I still cannot determine the nature of my muscle twitching, so I have a few questions: My muscle twitching started after experiencing myofascial pain (in the left chest and neck), and my myofascial pain has not completely resolved after a month.
Is there a connection between the two? I found that it is difficult to self-assess whether it is amyotrophic lateral sclerosis (ALS) and that tests like electromyography (EMG) are necessary.
However, I would like to ask if there are any distinguishing features of muscle fasciculations in ALS, such as frequency, duration, or specific locations? I apologize for asking a question that many have already posed, but I am concerned about my weakness in my limbs and worry it might be a serious condition.
Thank you, Doctor!

Niming, 20~29 year old female. Ask Date: 2021/08/20

Dr. Jiang Junyi reply Neurology

Hello, Sir: The condition you are concerned about, commonly known as amyotrophic lateral sclerosis (ALS), primarily involves issues with motor neurons.
Motor neurons control muscle movement; generally, the motor neurons in the brain are referred to as upper motor neurons, while those in the brainstem and spinal cord are called lower motor neurons.
When motor neurons become damaged, our muscles do not receive adequate nutrients and chemicals, which can lead to muscle death.
Muscle twitching is one of the signs associated with lower motor neuron involvement (along with muscle atrophy, weakness, and fasciculations).
If upper motor neuron signs are observed in the same limb, such as enhanced tendon reflexes, the Hoffmann sign, or the Babinski reflex, it may be necessary to consider ALS.
This means that a diagnosis of motor neuron disease cannot be made solely based on muscle twitching.
I recommend that you visit a neurology clinic for further examination and follow-up.
Please ensure to practice self-protection, maintain cleanliness and disinfection, and adhere to new preventive health measures before and after your medical visit.
Thank you for your inquiry, and feel free to discuss any related questions! Wishing you good health and peace.
Dr.
Jiang Junyi, Department of Neurology, Taoyuan Hospital, cares about you.

Reply Date: 2021/08/20

More Info

Muscle twitches, also known as fasciculations, can be a source of concern for many individuals, especially when they occur frequently or in multiple areas of the body. Your experience of muscle twitches over the past month, particularly in the left chest, back, abdomen, waist, thighs, and arms, raises several important considerations in the field of neurology.

Firstly, it is essential to understand that muscle twitches can arise from various causes, ranging from benign to more serious conditions. Common benign causes include stress, fatigue, caffeine intake, and dehydration. These factors can lead to increased excitability of the motor neurons, resulting in involuntary muscle contractions. Given that you mentioned experiencing muscle twitches after a recent episode of myofascitis (muscle inflammation), it is plausible that the inflammation and irritation of the muscle tissue could contribute to the twitching sensations you are experiencing. Inflammation can lead to increased sensitivity of the nerves and muscles, which may manifest as twitching.

Regarding your concerns about amyotrophic lateral sclerosis (ALS), commonly known as Lou Gehrig's disease, it is understandable to be anxious about the possibility of a serious neurological condition. ALS is characterized by the degeneration of motor neurons, leading to muscle weakness, atrophy, and fasciculations. However, there are specific features that differentiate benign muscle twitches from those associated with ALS. In ALS, muscle twitches are often accompanied by muscle weakness and atrophy, which may not be present in your case. Additionally, the twitching in ALS tends to be more widespread and can occur in muscles that are not actively being used.
The frequency, duration, and location of the muscle twitches can also provide clues. In ALS, twitching may be persistent and occur in a pattern that correlates with muscle weakness. If you are experiencing isolated twitches without significant weakness or atrophy, it is less likely to be indicative of ALS.
It is also worth noting that muscle twitches can occur in the context of other neurological conditions, such as peripheral neuropathy or radiculopathy, where nerve roots are affected. These conditions can lead to abnormal nerve conduction and result in muscle twitching.
To further evaluate your symptoms, a thorough neurological examination is recommended. This may include tests such as electromyography (EMG) and nerve conduction studies to assess the function of your muscles and nerves. These tests can help determine if there is any underlying neuromuscular disorder contributing to your symptoms.

In the meantime, managing stress, ensuring adequate hydration, and maintaining a balanced diet can help alleviate some of the twitching. If your symptoms persist or worsen, or if you develop new symptoms such as significant weakness, it is crucial to seek medical attention promptly.

In summary, while muscle twitches can be concerning, they are often benign and may be related to factors such as muscle inflammation or stress. The key is to monitor your symptoms closely and consult with a healthcare professional for a comprehensive evaluation to rule out any serious underlying conditions. Your health and peace of mind are paramount, so do not hesitate to reach out for further assistance if needed.

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