fasciculations, etc

  I am a 27 year old mother of 2, one of whom is 5 months old. During my last pregnancy, I had high blood pressure for which I took Aldomet (discontinued after birth) and was also put on bedrest for several months. Toward the end of the pregnancy, I began noticing minor weakness mostly in my hands when I was holding up a book. I would never drop it nor lose control, but it felt like I was about to start shaking, but never did. Since then, and much more in the past month, I've had muscle twitches in my arms & hands, legs & feet, and occasionally around my lips. I also have the same kind of weak feelings, although strength tests performed by my family dr and neurologist are fine. I have also had occasional pins & needles sensations, usually across my back, shoulders, up my neck, and down my arms. I breasfeed my baby and he gets up several times a night, so I am quite exhausted and haven't gotten a long stretch of sleep in over 5 months. One blood test showed my thyroid to be fine, but a more recent test showed it to be elevated slightly. I had an EMG today. He said the nerve part with the electric shocks was fine, but that there was a little variation on the pin part. He said it was minor and wasn't very concerned. He didn't explain it very well, though. What could this variation be? Could it be the start of something more serious? At this point, he thinks all my problems are due to thyroid amd lack of sleep and that the pins & needles are probably anxiety. Does that sound accurate? Would you suggest any further testing? What could other possibilities be? Thank you so much. Amanda
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Dear Amanda:
Thyroid dysfunction would be an appropriate consideration in an individual like you complaining of muscle twitching post-partum. It is difficult for me to guess what minor abnormality your neurologist found on EMG examination, but potentially may have been scattered fasciculation.
On reading your history, I do not think a major neurological or neuromuscular problem is high on the list of possibilities. It is indeed possible that several of your symptoms are related to anxiety, stress, lack of sleep, physiological changes post-partum, fatigue, and so forth.
Carpal tunnel syndrome is a common problem related to late pregnancy and even postpartum, and I am sure your neurologist has looked into that possibility.
In case your symptoms progress or persist, or in case you develop any new neurological symptoms, do not hesitate to call your neurologist. The possibility of this happening, I feel, is not very high.
I hope this is reassuring. Good luck!