Muscle twitches and tingling

I'm a 59 year old female that has muscle twitches mainly in my calves, but occasionally on various parts of my body.(for at least 3 to 4 years now all the time, often at night or when at rest)
I've gotten bad muscle cramps on the sides of my calfs after going up and down a small ladder on various times.  I've been tested for als, ms, etc approximately 4 years ago.  Except for carpal tunnel all was ok.  Today I thought I felt a twitch on my tough.  Often I will feel as if there are tingles around my eyes and nose.  Sometimes my muscles will burn or hurt.  I am, however, very strong and can row, play tennis etc.
I have spent most of my life under a great deal of stress.  These muscle twitches etc worry me a lot and I know that doesn't help the situation.
Any suggestions?
Thanks in advance!

[Sara Khan]

Thanks for using the forum. I am happy to address your questions, and my answer will be based on the information you provided here. Please make sure you recognize that this forum is for educational purposes only, and it does not substitute for a formal office visit with your doctor.

Without the ability to examine you and obtain a history, I can not tell you what the exact cause of your symptoms is. However I will try to provide you with some useful information.

I am glad to know that you were ruled out for ALS or other disorders which would have shown up on an EMG study. I am giving my impression based on the belief that you EMG study was completely normal ( except for the carpal tunnel).

There is an entity called benign fasciculation syndrome. In this disorder there is twitching  and cramping of various voluntary muscles in the body. The twitching can occur in any voluntary muscle group but is most common in the eyelids, arms, legs, and feet. Even the tongue may be affected. The twitching may be occasional or may go on nearly continuously. Any intentional movement of the involved muscle causes the fasciculations to cease immediately, but they may return once the muscle is at rest again. As the name implies, it is benign and does not signify any serious underlying disorder. The symptoms worsen with stress, sleep deprivation, caffeine and anxiety.

No cause has been identified. Treatment is aimed at controlling stress, reducing caffeine intake, exercising and adequate sleep.

In most cases symptoms resolve spontaneously.

Sometimes twitching can be because of underlying metabolic changes, Have you recently lost a lot of weight or changed your diet in any way??Simple things like electrolyte abnormalities, dehydration, thyroid problems, vitamin deficiency can cause such symptoms. You should have your TSH (thyroid function) and Vit B12 level checked. I would not worry about more elaborate nutritional disorders unless there has been a drastic change in your diet which triggered the symptoms.