Muscle Twitches: Neurological Insights and Concerns

Muscle twitching

In the past few weeks, I have been experiencing muscle twitching, so I underwent nerve conduction studies and electromyography (EMG).
1.
I would like to ask if it is sufficient to perform the EMG on just one side? 2.
I have noticed that my left big toe does not lift as high as my right, and some muscles on my left leg are not as developed as those on my right.
Could this indicate muscle atrophy? The doctor mentioned that this might be due to spinal compression.
Can spinal compression lead to muscle atrophy? 3.
A couple of days ago, I woke up with pain in both hands, and sometimes I feel a cool or burning sensation in certain parts of my body.
Thank you, doctor.

Chen, 10~19 year old female. Ask Date: 2022/09/08

Dr. Hong Weibin reply Neurology

1.
So I would like to ask, is it sufficient to perform an electromyography (EMG) test on just one side? Since EMG involves inserting needles into the muscles to measure physiological electrical activity, it can cause discomfort to the subject.
Therefore, it is usually performed only on the affected area.
2.
I noticed that my left big toe does not lift as high as my right one, and some muscles on my left foot are not as developed as those on my right foot.
Does this indicate muscle atrophy? The doctor mentioned that this might be due to spinal compression.
Can spinal compression lead to muscle atrophy? If there is asymmetry in muscle size between both sides, it may indicate muscle atrophy or hypertrophy.
Prolonged spinal nerve compression can potentially lead to slight atrophy of the muscles innervated by that nerve.
3.
A couple of days ago, I woke up with pain in both of my hands, and sometimes certain areas of my body feel cool or have a burning sensation when the weather changes.
My skin often exhibits allergic reactions.
If these symptoms are not persistent and tend to resolve on their own after a few days, there is usually no need for excessive concern.

Reply Date: 2022/09/08

More Info

Understanding muscle twitches and their underlying neurological implications can be quite concerning, especially when accompanied by symptoms such as pain, weakness, or unusual sensations. Based on your recent experiences and the results of your nerve conduction studies and electromyography (EMG), let's address your questions and provide some insights into the potential causes and implications of your symptoms.

1. Is it sufficient to perform an EMG on just one side?
Electromyography is a diagnostic tool that assesses the electrical activity of muscles and the health of the nerves that control them. While it is common to perform EMG on one side of the body, especially if symptoms are localized, it is often beneficial to compare both sides. This comparison can help identify asymmetries in muscle function or nerve conduction, which may indicate underlying issues such as nerve damage or muscle disease. If your symptoms are unilateral (affecting one side), the EMG may focus on that side, but if there are concerns about overall muscle function or if the symptoms are bilateral, testing both sides can provide a more comprehensive understanding.

2. Could the difference in muscle size and strength between my left and right foot indicate muscle atrophy?
The observation that your left big toe does not lift as high as the right and that some muscles appear smaller could suggest muscle weakness or atrophy. Muscle atrophy occurs when there is a decrease in muscle mass, often due to disuse, nerve damage, or other underlying conditions. In your case, if a spinal compression is suspected, it could indeed lead to muscle atrophy. When nerves are compressed, they may not effectively stimulate the muscles they innervate, leading to weakness and potential atrophy over time. It is essential to follow up with your healthcare provider to explore the cause of the spinal compression and its impact on your muscle function.

3. What could be causing the pain and unusual sensations in my hands and body?
Experiencing pain and unusual sensations such as tingling or burning can be indicative of several conditions. These sensations may arise from nerve irritation or damage, which can occur due to various factors, including spinal issues, peripheral neuropathy, or even conditions like carpal tunnel syndrome. The fact that you woke up with pain in your hands suggests that there may be a positional component to your symptoms, possibly related to how you are sleeping or the position of your arms during sleep. Additionally, if there is nerve compression in the cervical spine (neck), it could lead to pain and altered sensations in the upper extremities.

In summary, your symptoms of muscle twitching, pain, and differences in muscle strength warrant further investigation. It is crucial to discuss your concerns with your healthcare provider, who may recommend additional imaging studies, such as an MRI of the spine, to assess for any structural issues contributing to your symptoms. Physical therapy may also be beneficial to address muscle imbalances and improve strength. Remember that early intervention can often lead to better outcomes, so do not hesitate to seek further evaluation and treatment.

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