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What Causes Random Muscle Twitching In Body?

Posted on Sat, 29 Mar 2014

Question: I've had muscle twitching in different places for the past 14 months but mainly in my legs and arms. They are more pronounced at rest but ive also noticed that the muscles in my legs, arms, and neck quiver when i flex or contract them. If i squat, my leg muscles seem to shake but I dont feel noticeable weakness. If i lay flat on my back and sit up my whole body shakes almost like my muscles are shuttering. My legs have this burning sensation, especially on my thighs, inner thighs, and knees. I've had a clean MRI of my brain and spine a year ago. I've also had an emg of my arms and legs which was normal. I've also had tons of blood tests and the only thing that raised a red flag was a low vitamin d level and a positive ANA test. I was negative for lupus and other specific autoimmune diseases. What do you think is going on? What do you recommend. Does this sound like ALS or MS? Does the muscle shudder indicate weakness?

Answered by Dr. Sudhir Kumar (2 hours later)

Brief Answer: Most likely cause is benign fasciculations. Detailed Answer: Hi, Thank you for posting your query. I have noted your symptoms and results of various investigations. First of all, I would like to reassure you that you do not have evidence of MS (multiple sclerosis) and ALS (amyotrophic lateral sclerosis). The most likely cause of your symptoms could be benign fasciculations syndrome (BFS). In this condition, random muscle twitches can occur in any part of body, without weakness or thinning of muscles. EMG is normal in this condition. In addition, there may be a mild peripheral neuropathy, in view of burning sensation. You may get relief from pregabalin or gabapentin capsules. Muscle shudder does not indicate weakness. As of now, you can wait and watch, do regular exercises, and get your EMG repeated after six months. I hope my answer helps. Please get back if you have any follow up queries or if you require any additional information. Wishing you good health, Dr Sudhir Kumar MD (Internal Medicine), DM (Neurology) XXXXXXX Consultant Neurologist Apollo Hospitals, Hyderabad, India Click on this link to ask me a DIRECT QUERY: http://bit.ly/Dr-Sudhir-kumar My BLOG: http://bestneurodoctor.blogspot.in

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Sudhir Kumar (1 minute later)

Thank you for your response. What do you mean by wait and watch - do you think I am still at risk? Can the EMG be normal at first and then eventually be dirty? I got one in April of 2013 and one in January of 2014. Is it possible that the damage is only upper motor neuron and not lower yet?

Answered by Dr. Sudhir Kumar (7 minutes later)

Brief Answer: Thank you for getting back. Detailed Answer: I do not think you have a risk of getting ALS or any other serious neurological disease at this stage. However, on some rare occasions, if you notice any new symptoms (weakness) or if you notice wasting (thinning of muscles), only then EMG should be repeated. If you remain same, then, there is no need to repeat the EMG. It is unlikely that you have upper motor neurone disease, as it would get detected on neurological examination (spasticity and hyper-reflexia). I hope it clarifies. Best wishes, Dr Sudhir Kumar MD DM (Neurology)

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Sudhir Kumar (9 minutes later)

Thanks for all your help. Last question. My legs shoot up pretty quickly during the knee reflex test and were considered +2. Since they were equally brisk he considered them normal. Could that be hyper reflexia? My muscles in my legs also ache and feel a little stiff. Is that considered spasticity? Do you still have the same opinion from earlier?

Answered by Dr. Sudhir Kumar (8 minutes later)

Brief Answer: I still have the same opinion. Detailed Answer: Thank you for getting back. Knee reflexes are generally the most brisk reflex in body, and 2+ is considered as normal. 3+ would be exaggerated and 4+ would be clonus (both would be considered hyper-reflexia). Mild ache and stiffness is not spasticity. It is much more than that and can not be missed while examining you or while watching you walk. So, I would still have the same opinion as earlier. I hope it helps. Best wishes, Dr Sudhir Kumar MD DM (Neurology)

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar