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Neurology (Expert Forum)
Twitching frequently/skin irritated
Answered by
Lama Chahine, MD - Neurology
Cleveland Clinic
Cleveland - OH
This forum is for questions and support regarding neurology issues such as: Alzheimer's Disease, ALS, Autism, Brain Cancer, Cerebral Palsy, Chronic Pain, Epilepsy, Fibromyalgia, Headaches, MS, Neuralgia, Neuropathy, Parkinson's Disease, RSD, Sleep Disorders, Stroke, Traumatic Brain Injury.
Twitching frequently/skin irritated
by Falod, Sep 10, 2009 09:51AM
Hi,
The first symptom I saw was that my neck would be twitching a lot at random times it seemed, this went on for a few days. Soon after, I noticed twitches starting to flare up all over, neck (less often), thigh, calf, hand, arms, legs, bicep, fingers etc… This widespread twitching occurred at a fairly high frequency for a few days; recently the widespread twitching is still there, still seemingly random, but also seems to occur more after I exert that muscle. As an aside, all twitching usually ceases upon the moving of that muscle, but then it may restart once the muscle begins to rest.
Furthermore, around the time that the muscles started twitching after exerting them (they don’t ALWAYS twitch after I exert them, but SOMETIMES) I noticed that my left hip started to feel hypersensitive in the sense that clothing or a bed-sheet would irritate it by rubbing up against it. Over the past few days this feeling is now also on the top and left side of my left hip. Additionally, on the left side of my chest I felt this feeling too, but that went away in about 2 days and it is now still on my left hip-left thigh area. This has been there for about 4 days and seems to be worse at night. It only bothers me when something rubs up against it generally, or touches it. Also, the top of my left thigh sometimes gets this pulsing dull, but significant, pain in one area that will come and go with more use, mostly at night, this has been going on about 2 days.
Finally, the last symptoms involve my left arm. In short, my left wrist feels a little weaker than normal, feeling intensifies upon more use, and pins and needles in left bicep after something like typing a lot. While my wrist feels weaker, I do not notice any reduction in performance or grip strength, except that after making a fist it sometimes may cause it to feel weaker, and one or two fingers may start twitching for a bit.
Please let me know if you have any ideas, THANKS!
The first symptom I saw was that my neck would be twitching a lot at random times it seemed, this went on for a few days. Soon after, I noticed twitches starting to flare up all over, neck (less often), thigh, calf, hand, arms, legs, bicep, fingers etc… This widespread twitching occurred at a fairly high frequency for a few days; recently the widespread twitching is still there, still seemingly random, but also seems to occur more after I exert that muscle. As an aside, all twitching usually ceases upon the moving of that muscle, but then it may restart once the muscle begins to rest.
Furthermore, around the time that the muscles started twitching after exerting them (they don’t ALWAYS twitch after I exert them, but SOMETIMES) I noticed that my left hip started to feel hypersensitive in the sense that clothing or a bed-sheet would irritate it by rubbing up against it. Over the past few days this feeling is now also on the top and left side of my left hip. Additionally, on the left side of my chest I felt this feeling too, but that went away in about 2 days and it is now still on my left hip-left thigh area. This has been there for about 4 days and seems to be worse at night. It only bothers me when something rubs up against it generally, or touches it. Also, the top of my left thigh sometimes gets this pulsing dull, but significant, pain in one area that will come and go with more use, mostly at night, this has been going on about 2 days.
Finally, the last symptoms involve my left arm. In short, my left wrist feels a little weaker than normal, feeling intensifies upon more use, and pins and needles in left bicep after something like typing a lot. While my wrist feels weaker, I do not notice any reduction in performance or grip strength, except that after making a fist it sometimes may cause it to feel weaker, and one or two fingers may start twitching for a bit.
Please let me know if you have any ideas, THANKS!
Doctor's Answer
by Lama Chahine, MD, Sep 13, 2009 02:11PM
, Sep 13, 2009 02:11PM
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.
Your symptoms may be consistent with benign fasciculation syndrome, which I will abbreviate as BFS. This 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 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.
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. It is important in such cases to reduce stress/anxiety levels and to reduce caffeine intake.
Your left hand symptoms may be entirely unrelated, and depending on the exact fingers involved etc, could be a carpal tunnel syndrome or a similar syndrome called ulnar neuropathy, or could be a pinched nerve in the spine.
I suggest follow up with your primary doctor to discuss your symptoms and be examined, and you may benefit from evaluation by a neurologist as your primary doctor feels fit.
Thank you for this opportunity to answer your questions, I hope you find the information I have provided useful, good luck.
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.
Your symptoms may be consistent with benign fasciculation syndrome, which I will abbreviate as BFS. This 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 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.
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. It is important in such cases to reduce stress/anxiety levels and to reduce caffeine intake.
Your left hand symptoms may be entirely unrelated, and depending on the exact fingers involved etc, could be a carpal tunnel syndrome or a similar syndrome called ulnar neuropathy, or could be a pinched nerve in the spine.
I suggest follow up with your primary doctor to discuss your symptoms and be examined, and you may benefit from evaluation by a neurologist as your primary doctor feels fit.
Thank you for this opportunity to answer your questions, I hope you find the information I have provided useful, good luck.
