Twitch you can see...can it be normal?

[Twinsmom06]

I know there is a lot of twitch talk going around these days but I don't think I fit with any of the examples of recent issues I am having. It started yesterday, mild, where I would feel (and could see if I looked quickly) this twitch that spans from my upper arm (back side) up into my shoulder on my right side.

Today...NOT MILD! It reminds me of when I was pregnant with the twins early on when I could first see their kicks and flutters. It looks just like that and can last from 2 seconds to about 30 seconds. It’s fairly constant with only a short break of a few seconds to maybe a minute between flutter starting again.

I have had these feeling before...I think everyone does but it would be one twitch or a very short series...not lasting days and not being very noticeable. It's not a jerk but rather a flutter that comes and goes. No pain, no pressure...it’s just doing its thing...whatever it is!

So I guess my question would be is if this can be normal or is it something I should talk to neuro about. Being that I am in "limboland" I really try not to make every little thing a possible MS issue. I’m not trying to look for issues! So...not sure what to think with this one. Any thoughts?

Thank you again for any feedback...you guys and gals are awesome!!
Kim

[Sidesteps]

Jens - here's more infomation for you.

My doctor treated me with propanolol in June for my tremors, twitches and she said if I was having migraines it would help with that (ha ha!)

It's a beta-blocker. The tremor is better. The twitching is worse again. We know it's not a migraine...  I was also getting some deep aching (spasticity) and right now my spasticity is kinda bad so maybe the reaction to the tightness is some twitching too? I don't know.

Either way, this is what wikipedia says:
http://en.wikipedia.org/wiki/Benign_fasciculation_syndrome

"Some degree of control of the fasciculations may be achieved with the same medication used to treat essential tremor (beta-blockers and anti-seizure drugs). However, often the most effective approach to treatment is to treat any accompanying anxiety. No drugs, supplements, or other treatments have been found that completely control the symptoms."

[jensequitur]

Whups!  I'm wrong - twitching has no treatment.  Overactive nerves can be treated with Keppra or neurontin, but if you're twitching, you're on your own.

[jensequitur]

Twitching and spasticity are caused by the same problem - poor nerve transmission.  In spasticity, a poor or incomplete connection causes the muscle to tense (if it can't talk to the brain, it contracts.)  And twitching is another manifestation of the same problem... kinda.  Wikipedia says "They arise as a result of spontaneous depolarization of a lower motor neuron leading to the synchronous contraction of all of the skeletal muscle fibers within a single motor unit. "  So essentially it's a bad signal causing the muscle to fire.

Spasticity is treated with a spinal muscle relaxer, like Baclofen or Xanaflex, while twitching is treated with medications that calm the nerves, like Keppra or neurontin.

[Sidesteps]

Check out myokmia. It's a ripple feeling.

http://en.wikipedia.org/wiki/Myokymia


I have had so many variations of twitches that I've lost count. Some of mine are parasthesia as well but if you can see it though it's not parasthesia. lol ~

I know I don't have ALS - no obvious muscle wasting and had an EMG.

My Dr. is treating mine like it's a spasticity issue and I have to admit the medicine does seem to help a bit. I read somewhere but I don't recall where that twitches can be related to spasticity.

[Lulu54]

it's so hard to figure if something is normal or not when it comes to MS.  You will want to note this to your doctor on the next visit if it continues.  

My best fasciculation was shortly after dx and I had a spot about the size of a golf ball below my left knee.  You could watch it twitch and it jumped about like there were worms crawling just under the surface.  That lasted for several weeks - no pain involved but definitely not something normal.

[doublevision1]

Some info from the NIH on this usually benign condition:


Muscle twitching/Fasciculation

Muscle twitches are fine movements of a small area of muscle.

Considerations

Muscle twitching is caused by minor muscle contractions in the area, or uncontrollable twitching of a muscle group that is served by a single motor nerve fiber.

Muscle twitches are minor and often go unnoticed. Some are common and normal. Others are signs of a nervous system disorder.

Causes
•Diet deficiency
•Drug overdose (caffeine)
•Drug side effect (such as from diuretics, corticosteroids, or estrogens)
•Exercise
•Twitches not caused by disease or disorders (benign twitches) ◦Often affecting the eyelids, calf, or thumb
◦Normal and quite common, often triggered by stress or anxiety
◦Come and go, and do not last for more than a few days


Nervous system conditions that can cause muscle twitching:
•Amyotrophic lateral sclerosis (ALS - Lou Gehrig's disease)
•Damage to the nerve that leads to a muscle
•Muscular dystrophy
•Spinal muscular atrophy
•Weak muscles (myopathy)

Symptoms that suggest a nervous system disorder include:
•Loss of, or change in, sensation
•Loss of muscle size (wasting)
•Weakness

Home Care

There is usually no treatment necessary for benign muscle twitching.


When to Contact a Medical Professional

Call your health care provider if you have long-term or persistent muscle twitches.



What to Expect at Your Office Visit

Your health care provider will take a medical history and perform a physical examination.

Medical history questions may include:
•When did you first notice the twitching?
•How long does it last?
•How often do you experience twitching?
•What muscles are affected?
•Is it always in the same location?
•Are you pregnant?
•What other symptoms do you have?

Diagnostic tests vary depending on the suspected cause. Tests may include:
•Blood tests to look for problems with electrolytes, thyroid gland function, and blood chemistry
•Electromyogram (EMG)
•Nerve conduction studies
•MRI of the spine or brain

Alternative Names

Muscle fasciculation; Fasciculations of muscle

References

Barohn RJ. Muscle diseases. In: Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier; 2007: chap 447