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What Causes Muscle Twitches And Tingling In Hands And Feet?

Posted on Mon, 2 Mar 2015

Question: after months of on and off pain, muscle twitches, tingling in hands and feet, i had a lyme disease test done.. my neuros nurse called me back today and said they are still waiting on some reports but i had a positive ssb level. she said my neuro isnt concerned with it, and not to worry about it, but after i looked it up, now im freaking out...

Answered by Dr. Ajay Panwar (3 hours later)

Brief Answer:
Slightly high SSB levels can be normal.

Detailed Answer:
Hi XXXXXX,
Thanks for being on healthcaremagic.com.
I am Dr.Ajay Panwar,a neurologist, here to answer your query.

If you would have presented to me as an outpatient,I would have given you the following clinical explanation about your syndrome-
Though lyme disease can be one of the causes of the symptoms you are having but it must be associated with the temporal profile like 'Do you have any history of fever with rash in the past. I mean anything which led your physician to suspect it as Lyme disease.'You have not written the value of SSB level you had. Please write it along with the reference range. Slightly high ssb levels can be seen in normal individuals and does not mean Sjogren's syndrome.

Other common causes which can result in symptoms you are having can be-
1)Radiculopathy
2)neuropathy
3)Vitamin deficiencies
4)Diabetes

Please get the following investigations done- serum vitamin B12,blood sugar(fasting and post prandial). Please discuss with the neurologist who examined you that whether he needs you to get done 'Nerve conduction studies/Electromyography(EMG)' or 'MRI spine'-to see for neuropathy/anterior horn cell disease and radiculopathy.

Hope I have answered your query for now.If you have follow-up queries,I shall be glad to answer else,please close the thread-rate it and write a review.

Dr.Ajay Panwar,
MD,DM(Neurology)

Above answer was peer-reviewed by : Dr. Shanthi.E

Follow up: Dr. Ajay Panwar (1 hour later)

im not sure of ssb levels, but the message my nirse left she said my neuro isnt concerned and not to worry about it. i get an mri done on my brain and spine tomorrow to rule out MS. from your expert opinion, what would you think it could be? left hand, leg, foot pain.. also, it seems when i lay on my left side at night the pain gets worse and i can really feel my pulse.. im having really bad anxiety abou all of this. t

Answered by Dr. Ajay Panwar (9 hours later)

Brief Answer:
The causes as listed above should be ruled out.

Detailed Answer:
Hi XXXXXX,
Thanks for being in follow-up.

If your neurologist is not concerned about the SSB levels, then they must be just borderline high.
Though MS can cause such symptoms but months of on and off symptoms are against the diagnosis of MS. MS here comes lower down the list as a possibility.

Instead, commoner causes as discussed above - radiculopathy, neuropathy and diabetes should be ruled out first.

Specially, the way the pain increases in severity on turning towards left - hints that it is radiculopathy. MRI spine should be done. Please discuss with your neurologist.

Hope I have answered your query for now. If you have follow-up queries, I shall be glad to answer else, please close the thread-rate it and write a review.

Dr.Ajay Panwar,
MD,DM(Neurology)

Above answer was peer-reviewed by : Dr. Ashwin Bhandari

Follow up: Dr. Ajay Panwar (6 hours later)

thank you. i talked to my nurse, ssb is positive but my ANA is negative. she said many patients have been getting false positives thats why they arent concerned, she said my ANA would have to be positive in order for Lupus to be present. She said all other blood work was fine, and lyme test was negative. ruling out lyme and lupus is a good thing.

Answered by Dr. Ajay Panwar (16 hours later)

Brief Answer:
Its good that Lyme and Lupus are negative.I hope MRI rules out MS.

Detailed Answer:
Hi XXXXXX,
Thanks for being in follow-up.

Its really good that Lyme and Lupus have turned negative.I hope your MRI Brain and spine rules out MS.
Please consult with your neurologist about ruling out other possibilities discussed above.

Hope I have answered your query for now. If you have follow-up queries, I shall be glad to answer else, please close the thread-rate it and write a review.

Dr.Ajay Panwar,
MD,DM(Neurology)

Above answer was peer-reviewed by : Dr. Ashwin Bhandari