Re: Muscle vibrations - what is it ?

Posted By Stephen Clark on January 06, 1998 at 20:58:58:

In Reply to: Re: Muscle vibrations - what is it ? posted by CCf Neuro MD *!* on December 18, 1997 at 16:12:48:








: : Hi
: : I have a strange effect in my muscles, they vibrate.  I'm conscious of this
: : all the time but especially when I'm not busy I notice it more.  It is
: : especially noticeable in a muscle under contraction (not necessarily heavy
: : contraction, just light, normal use).  The vibrations are very small
: : and just visible, especially at the end of the limb where the natural leverage
: : makes them look bigger.  I'd guess the frequency is 5 or 10 a second, maybe more.
: : They occur everywhere, torso, limbs and face.  Are they 'fasiculations'?  I
: : thought that fasics were a definite and obvious single twitch in an isolated
: : muscle (I've had these too, but not often).  These never stop, and are continuous
: : and rhythmic.  They are most obvious in thighs, arms, fingers, torso and jaw -
: : occasionally I get a slight modulation on my voice from the jaw vibration.
Another feature is that I can feel my heartbeat almost anywhere on my body
: : and I am very conscious of it especially when relaxing quietly when almost
: : every muscle seems to move slightly on each beat.  Sounds weird I know, but
: : I'm sure this is a 'new' feeling.
This all started about 6 months ago, I also get mild aches in the same muscles that
: : started about the same time.
Can you offer any advice as to a possible cause? (I'm male,28,otherwise healthy)
: : I looked up 'fasiculation' and Motor Neuron Disease seems to be the only documented
: : cause which didn't give me much reassurance.
Don



=
Dear Don,
I am not 100% clear from your description as to the exact nature of the vibration  in your extremities. Could this be described, from your point of view as a tremor ? The voice involvement suggests this as a possible explanation. If this is the case you might fit the description of benign essential tremor.
: You mention fasiculations , and their association with ALS, however this is not the only situationin which fasiculations are found, the also ocurr in healthy people , especially after exercise and in a syndrome known as benign fasiculation syndrome. Fasiculations are really only a significant indicator of ALS if they develop in the context of  severe weakness and muscle wasting, in your age group, in the absence of  these symptoms I feel this is very unlikely
: This information is provided for general medical education purposes only.
: Please consult your physician for diagnostic and treatment options of your specific medical condition..
Wow - that was a fast response!
I wouldn't really describe it as a tremor.  First it seems too fast,
second it isn't just in the extremities but occurs in the big muscles too.
The 'tremor' in extremities seems to be due to the little vibrations in
other muscles as well as the finger muscles.
By 'vibration' I mean rapid, small amplitude, contract-relax cycles in the
muscle.  The effect is very slight (but still present) in relaxed muscle
and increases in severity with the degree of force in the muscle.  Under high
stress (like a push up) they are very pronounced and cause a lot more shaking.
As an example, if I hold my arm straight out in front of me, my fingertips
shake visibly (about 1/4 inch of movement) - and if I feel my bicep/tricep with
the other hand I can feel the small vibrations in these muscles (which are
too small to see).  If I did the same thing with a heavy book in my hand
the whole arm will shake noticeably.
The voice involvement is sometimes due to the jaw, other times due to the torso
muscles which cause the breath not to be smooth.
Gee - it's kinda hard to describe!
Is this typical of essential tremor?  It seems different to the tremor I see
in others.  Is the general muscle achiness significant?
Thanks for your advice
Don



=
The more you describe this symptom the more it sound like a tremor,
rather than fasiculation. The difficulty in describing the phenomenon
underlines the difficulty in making a diagnosis via the internet !
An examination by a physician is required to sort out exactly
what is going on, possible background causes include stimulant drugs
or withdrawal from sedative drugs and hyperthyroidism, in addition to
benign essential tremor,  in particular you probably need a blood
test to screen for thyroid disease.
I have the very same symptoms and have had them for two years. I consider them more of a fasciculation than a tremor but I also have a shakiness at different times. It's interesting that you noticed an increased sensation from your pulse as I also noticed that  same finding. All my medical tests for B-12, thyroid, MRI, etc. were WNL. I later found that I had been exposed to chronic low-levels of nitrous oxide in my work. I suspect this to be the culprit