muscle twitching

[jsuzanne]

I've been having muscle twitching in my right inner arm (underside of elbow) and my upper right inner thigh.  I feel a bit alarmed by this so I'm wondering what it might be? thanks

[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 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.

One potential cause of muscle twitching is benign fasciculation syndrome, which I will abbreviate as BFS. It 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.

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 sounds like your twitching occurs on only one side of the body, which is a little unusual for BFS, but you do not mention any associated symptoms such as weakness or numbness/sensory loss. Twitching occurring occasionally and in isolation (without associated symptoms) is likely to BFS. However, as in some cases an underlying neurologic problem could be present, I do recommend evaluation by your primary doctor (PCP/internist) and after he/she evaluates you with history and examination, further testing may be ordered or referral to a specialist may occur depending on his/her assessment.

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

[jsuzanne]

oops---sorry I meant the twitching is in my left arm.