Muscle Twitches: Insights from Neurology and Patient Concerns

Q: Muscle Twitches: Insights from Neurology and Patient Concerns

Hello, sir： You mentioned, "This time I didn't have an electromyogram, and I can only listen to different doctors' opinions at various neurology clinics, but the body's twitching still cannot be eliminated. <br>Besides seeing a doctor, what should I do?" The condition you are con

Muscle twitching

Hello, doctor.
I am the person who previously consulted you about muscle twitching during my university years (about three years ago).
Recently, I couldn't bear the fear and went to see a neurologist again, discussing the twitching in my left thenar eminence (which I also asked you about recently).
The doctor reassured me that it’s nothing serious and advised me not to worry too much.
He suggested that engaging in vigorous exercise (like weight training, etc.) could also help with the twitching in the soles of my feet (which has been an issue since last year, and the doctor is aware of it).
During our conversation, the doctor emphasized that having symptoms or test results that match does not necessarily mean there is a problem, and not having symptoms or mismatched test results does not mean there isn't one.
However, he mentioned, “Perhaps you are really on the edge,” which made me very anxious.
I immediately asked him what that meant.
Does it mean I am going to develop ALS? The doctor’s response is a bit unclear in my memory, but generally, he said, “Things are not as you think.” At the end of the appointment, he told me not to worry and that I would be fine in the future, but I am really scared.
Although I trust this doctor and believe he understands my situation, I still feel anxious whenever my muscles twitch.
Even after leaving the appointment, I worried whether the doctor thought I might be developing a serious illness, which is why he said that to maintain my quality of life.
Yet, my mind keeps telling me: “Other people have normal muscle twitches; why do yours last so long and occur so frequently? You must be sick.” I don’t know what else to do; I still feel worried and scared.
This time, I didn’t have an electromyography test done.
I can only register for different neurology clinics to hear various doctors' opinions, but the twitching in my body remains unresolved.
Besides seeing doctors, what should I do? I don’t know.

Xin Xian Ren, 20~29 year old female. Ask Date: 2024/04/16

Dr. Jiang Junyi reply Neurology

Hello, sir: You mentioned, "This time I didn't have an electromyogram, and I can only listen to different doctors' opinions at various neurology clinics, but the body's twitching still cannot be eliminated.
Besides seeing a doctor, what should I do?" The condition you are concerned about, amyotrophic lateral sclerosis (ALS), refers to a disease affecting motor neurons.
Motor neurons are nerve cells that control our muscle movements.
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.
Issues with motor neurons can typically be evaluated using electrophysiological tests for diagnosis.

Nerve conduction studies assess the conduction velocity and waveform of large fiber nerves.
An electromyogram (EMG) evaluates the muscle response in the areas innervated by the nerves to check for muscle damage, even when the innervating nerves are normal.
I recommend that you visit a neurology clinic for further examination and follow-up.
You may want to consult a physician specializing in peripheral nerves, as they have more experience with electromyography.
Thank you for your inquiry, and feel free to discuss any related questions! Wishing you good health, peace, and happiness.

Dr.
Jiang Junyi, Neurology Department, Taoyuan Medical Center / Hualien Medical Center, cares about you.

Reply Date: 2024/04/16

More Info

Muscle twitches, also known as fasciculations, can be a source of significant anxiety for many individuals, especially when they are persistent or occur in noticeable areas like the hands or feet. Your concerns are valid, and it's important to understand both the neurological aspects of muscle twitches and the psychological impact they can have on your well-being.

From a neurological perspective, muscle twitches can arise from various causes. Commonly, they are benign and can be attributed to factors such as stress, fatigue, caffeine intake, or dehydration. In many cases, they do not indicate a serious underlying condition. Your neurologist's reassurance that your symptoms are not indicative of a severe illness is a positive sign. However, it’s understandable that the phrase “you might be on the edge” can evoke fear, especially when related to conditions like amyotrophic lateral sclerosis (ALS) or other neurodegenerative diseases.
The key takeaway from your neurologist's advice is that symptoms do not always correlate directly with serious conditions. Many individuals experience muscle twitches without any underlying pathology. The human body is complex, and muscle activity can be influenced by numerous factors, including emotional stress and physical exertion. Engaging in regular exercise, as your doctor suggested, can help alleviate some of the anxiety associated with these symptoms. Exercise releases endorphins, which can improve mood and reduce stress, potentially leading to a decrease in the frequency of muscle twitches.

In terms of managing your anxiety, it may be beneficial to explore relaxation techniques such as mindfulness, yoga, or meditation. These practices can help you develop a more positive relationship with your body and its sensations. Cognitive-behavioral therapy (CBT) is another effective approach for addressing health anxiety. It can help you reframe negative thoughts and reduce the fear associated with your symptoms.

If your muscle twitches persist or worsen, or if you develop new symptoms, it may be worth discussing further diagnostic options with your healthcare provider. While you mentioned not having undergone electromyography (EMG) recently, this test can provide valuable information about the electrical activity of your muscles and help rule out any neuromuscular disorders. However, it’s essential to weigh the benefits of additional testing against the potential for increased anxiety.

In summary, while muscle twitches can be concerning, they are often benign and related to lifestyle factors or stress. Maintaining open communication with your healthcare provider, engaging in regular physical activity, and utilizing stress-reduction techniques can significantly improve your quality of life. Remember, it’s okay to seek second opinions or additional support if you feel it would help you feel more secure in your health journey. Your well-being is paramount, and addressing both the physical and psychological aspects of your symptoms is crucial for achieving a balanced state of health.

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