Questions posted in the Neurology and Neurosurgery Forum have been answered by doctors from The Cleveland Clinic Foundation.

Question Title: Tegretol causing weird twitch?

Forum: Neurology Forum
Topic: Neurology - General


Hi,
My neurological history is a single grand mal seizure in my early 20's
(last year). At that time I was put on Tegretol. I remember about
a week after the seizure I developed this weird twitch in my
forehead, whereby the same area near the center of my forehead
would twitch rhythmically every 10 seconds or so, which lasted
for a day or two. AT that time I assumed it was due to the Tegretol.
Since then, every month or two, this same twitch reoccurs out of the blue.
Also I will go through periods where other muscles in my body twitch
at random, either in my fingers, hands, arms, legs, etc. These twitches
do not occur rhythmically, eg my finger might twitch once, then 30 seconds
later maybe my leg, then another minute a different finger, etc.
My questions are:
1) Is the repeating forehead twitch related to the other random twitching?
2) Can both of these be caused by Tegretol? (neither ever occured
previous to the seizure/Tegretol)
3) Is this something to be concerned about? I have since then had
an abnormal EEG, but a normal MRI.
One other observation I've made is the twiching seems to occur more
frequently during periods when I take vitamin and antioxidant supplements.
I'm not sure if I'm imagining this one, is it possible that vitamins
can affect twitching at all?
Thank you


=
It is impossible to say on the basis of a brief posting whether the two twitching problems, neither of which I have witnessed are in fact related.
It is possible that they are connected but this would be difficult to prove either way. I doubt if there is any connection with vitamins of dietary supplements, no link has ever been established.
Tegretol is known to worsen myoclonic seizures, these are isolated jerks of the body which may involve a single limb or the entire trunk.
Your problems, while they are described as jerks are too minor and isolated, involving very small muscles to be called myoclonic jerks so I feel the term is not really appropriate, it is odd though that they began soon after you started Tegretol.
The only way to clarify this question for sure would probably be to have an EEG running the jerks and see if there are any simultaneous changes on the EEG.
Either way I do not think this all suggests any serious underlying pathology, twitches are only significant if the build up to full blown seizures, are accompanoied by progressive weakness or by other forms of degeneration of the nervous system.
In the vast majority of cases, isolated twitches like these have little significance.




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