Hello, You are suffering from twitching of the knee and thigh. It commonly occurs due to muscle fatigue and strain. However other causes are dehydration, vitamin deficiencies, side effects of medicines, autoimmune disorders like Neuromyotonia. Muscle twitching and cramps can be an early sign of ALS, Amyotrophic lateral sclerosis also known as motor neurone disease. ALS causes stiff muscles, muscle twitches, and gradual increasing weakness and muscle wasting. This is a degenerative disorder that affects the brain and spinal cord. You are suggested to avoid stress and practice stress reduction techniques. Stay properly hydrated. Exercising appropriately helps to relieve symptoms. Your twitching s can be related to stimulants or caffeine, you’ll need to monitor your intake. You’ll also need to ensure you’re getting proper nutrition. Take food rich in vitamin B6, B12, folic acid and minerals. Get clinically examined by a GP, you will be treated accordingly with conservative treatment and physical therapy. Stay away from addictions if any. Take care. Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Nupur K., General & Family Physician