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Shingles and Muscle Twitching
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Shingles and Muscle Twitching

In August I noticed a burning sensation in the right side of my scalp, in the hairline above my temple. Throughout the day, it worsened and eventually turned into a large blister which oozed and burned immensely. I thought I had been bitten by a bug and had an allergic reaction. I was given an antibiotic and took Aleve, and eventually it cleared and went away.

In late September I had a terrible stomack virus that seriously dehydrated me and put me in the hospital. It took me two weeks to recover. Since then I have had muscle twitches in my thighs, calves, feet, shoulder blade, and fingers, primarily on my left side, but sometimes on my right too. They occur when I lay down at night or when I sit for long periods of time.

Early November I noticed that in the hairline above my forehead, I have very small blisters and dry, irritated skin. I thought maybe it was from the hat I wear when I run and that my skin was irritated. Last night I noticed on the left side, I have another blister. It does not hurt, but it is large. This morning I woke up and it is dry and crusty with pus.

I have been under an extreme amount of stress. I have been to multiple doctors because of the muscle twitching. I do not seem to have any signs of a degenerative nerve disease and I go for an MRI next week. I happened to mention the blisters to a friend of mine last night and they suggested my ailment could be shingles. Would shingles cause all of this muscle twitching?!
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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 obtain a history and examine you, I can not comment on the what these twitches are nor what is causing them. However, I will try to provide you with some information regarding possibilities.

Regarding shingles, shingles is due reactivation of Varicella Zoster, the chicken pox virus. It causes the formation of little vesicles and may be associated with severe burning pain. However, this is usually restricted to a specific distribution, often not more than  few inches, along what is called a dermatome, or a specific nerve distribution. While it is possible that shingles caused the blister and burning near your hairline, it is unlikely to be causing the twitching.

Since you mention that your twitching is occuring the setting of a lot of stress and anxiety, one possibility is that it is due to benign fasiculation syndrome. Fasiculations in the majority of cases 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. It is important in such cases to reduce stress/anxiety levels and to reduce caffeine intake.

Benign fasiculation syndrome, which I will abbreviate as BFS, 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. If the diagnosis is confirmed and other causes are excluded, it can be safely said that the likelihood of progression or occurrence of a serious neurologic condition is low.

When BFS is present but not particularly bothersome or disabling, treatment is not necessary. If severe and it requires treatment, there are a few medication options though this condition is not very common, and the research that has been done on its treatment is limited. Minimizing caffeine and stress, and treating anxiety if it is present, will improve your symptoms.

However in general (and please understand I am not trying to imply I feel this is the case in you), when fasciculations 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 stress-related such as in your case 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. A lot of these diseases can be diagnosed or excluded with a study called EMG and nerve conduction studies which assess how well nerves conduct electricity and how your muscles respond to them.

It sounds like you have seen multiple physicians and you are scheduled for an MRI next week.  I suggest close follow-up with your neurologist regarding your symptoms.

Thank you for using the forum I hope you find this information useful good luck
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