Slight twitches/pulsing sensation

[Janine2010]

I am in my late 30's, female, generally healthy. I am not on any medications. I have the following symptoms which are worrying, but not sure if they are linked.

*heart palpitations: this started several months ago. Random palpitation and occassional pain in chest area (left side above breast bone. Feels like a pulsing dull pain). This comes and goes but could be weeks before I feel it again-and might just last a few seconds. I had an echo done and they said there is a mild heart murmur, but nothing of concern (have never been told that before).

*about 2 wks ago noticed a lip twitch. Very mild and every few minutes. I normally woudn't even pay attention, but just started paying closer attention to my body.

*lip twitch went away after a few days and I started to feel slight numbness on the left side of my face. Almost like a heaviness or weakness. I wondered if it was Bells Palsy but was opposite side from previous twitch,and in fact the sensation went away in a few days.

*since then I have felt pulsing sensations at various points in my body. Almost like a heart beat sensation and can be in my foot, arm, back, side, finger. It lasts seconds so not long enough for me to analyze whether it's even noticeable to the eye.

*also notice slight..every so slight tremor on one finger (ring finger) when I hold my hand out and try not to move. At firts I was very alarmed but then noticed it was on other hand too--so maybe this is just normal reaction of finger when holding still. Everynow and then I feel very slight tingling (hands).

All these symptoms put together make me wonder what is going on? I notice them most when I'm focused and still (nights for example) so I wonder if it's in my head, but the pulsing feeling all around is certainly not.

Please help??

[Janine2010]

Thank you. Can elaborate on the following comment:

"Neuropathy leads to more constant sensory symptoms such as tingling, numbness, burning, and sometimes twitching."

In past few days, pulsations and twitching have subsided/lessened, but I continue to feel some numbness in extremities-almost like slight buzzing. It is in one leg, feet, one hand,etc. Is this neurological in your opinion?

[Neuro Forum]

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 a doctor.

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

Heart palpitations are of various causes and are rarely of neurologic origin. They can be due to cardiac conduction problems, valvular heart disease, or other heart problems and should be evaluated by a cardiologist with testings such as the echo as you had done, and other testing as indicated. Systemic disorders such as thyroid disease or anemia can lead to palpitations. Sometimes, they can be due to panic disorder or anxiety.

It sounds like your face twitching and face numbness were transient and it is difficult to know what to make of them. Several neurologic disorders can lead to transient sensory symptoms including multiple sclerosis and seizures. But more often, transient sensory symptoms usually have no explanation, are of little consequence, and typically do not progress. Disorders of the brain and spine, particularly demyelinating disorders, can lead to such transient symptoms. Neuropathy leads to more constant sensory symptoms such as tingling, numbness, burning, and sometimes twitching.

Pulsations in various parts of the body that are transient are not uncommon and are probably due to transient blood vessel dilation. They are rarely of clinical significance, if at all. They are not neurologic in cause.

The tremor, if it's very subtle, could be enhanced physiologic tremor: everyone has tremor and in times of stress/anxiety, or with excessive caffeine exposure, this tremor emerges. There are various other causes of tremor. Systemic causes such as thyroid disease can lead to tremor. Neurologic causes include most commonly essential tremor, parkinson's disease, etc.

Your symptoms are hard to tie together into one potential cause; it is unlikely for all of them to be related, and as you mention, you may have heightened awareness of normal variations in body function. Stress and anxiety may be contributing. However, a thorough review of your symptoms and a thorough examination is warranted to exclude physical examination findings that may warrant further investigations such as imaging of the brain or other testing. Continued followup with your physicians is recommended.

Thank you for this opportunity to answer your questions, I hope you find the information I have provided useful, good luck.