I appreciate the detailed reply. I have not had any related symptoms that make me worry but as i get older (48 now) i'm starting to check into things that might make life at older ages more difficult. In this case, would i need to worry that my legs might tire sooner than normal given all the activity in the muscle group that seems to occur? In terms of my diet, i do not drink anything with caffeine in it and although sometimes the twitching gets worse with streneous exercise it continues even if i do none for days. I was wondering if something dietary could be at play (aside from Caffiene). I read that potassium can help with cramping, is there anything else that might affect this?
I forgot to mention that i can force toe cramps without much effort by squeezing my toes outward or down strongly (weird thing to do, i know). Anyway, thanks in advance for any additional input. I may see my doctor to explore casually as part of my annual exam.
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.
Since your muscle twitching has occurred for many years, it is unlikely to be something serious. One of the most likely possibilities benign fasciculation syndrome, which I will abbreviate as BFS, it is a condition in which there are involuntary twitches of various muscle groups, most commonly the legs but also the face, arms, eyes, and tongue. It must be emphasized that in the MAJORITY of cases they are BENIGN meaning that they are of no consequence and are not resulting from a serious cause. In such cases, the twitches may be related to anxiety/stress, caffeine, and often occur after recent strenuous activity or muscle over-use, which it sounds like may be the case in you if you exercise a lot. It is important in such cases to reduce stress/anxiety levels and to reduce caffeine intake if these are exacerbating factors.
If you have frequent cramping, another possibility is cramp-fasiculation syndrome.
However in general (and please understand I am not trying to imply I feel this is the case in you), when muscle twitches occur in the setting of associated symptoms such as progressive loss of sensation, tingling or numbness, weakness, trouble swallowing and other symptoms, the cause may be due to a peripheral nervous system problem. In general the symptoms would not be episodic and triggered by certain things but would be more constant/frequent without consistent triggers. The location of the problem could be the anterior horn cells, the area where the nerves that supply motor innervation to our body comes from. These are the cells that give off the nerves that allow us to voluntarily contract our muscles. The diseases that might affect the anterior horn cells include ALS (also called Lou Gherig's disease), a condition called spinal muscular atrophy, polio-like viruses, west nile virus, and other infections. Another nervous system problem, neuropathy, may also lead to fasciculations. There will again be associated weakness or sensory changes.
While it is likely your symptoms are benign, discussing them with your primary doctor (family physician) is recommended just to make sure nothing else is going on, with referral to a neurologist as deemed necessary by your primary doctor.
Thank you for this opportunity to answer your questions, I hope you find the information I have provided useful, good luck.