toes and fingers flicking uncontrllably when sleeping

Since 4-5 years, my fingers and toes (mostly on my left foot) at times starts starts gyrating/moving uncontrollable when I am sleep, or when I am sitting down.  It happens mostly when I am sleep.  This invariably wakes me up with a crushing thirst.  Sometimes I can fall back to sleep for another 2/3 hours after going to bathroom and drinking a couple of glasses of water.  Most nights, I end up drinking 1/2 to 3/4 of gallons of water.  Sometimes toward the morning hours (4 to 5am) the water does not help.  In this case, I take a couple of potassium pills (99mg each) with couple glasses of water. This helps most of the time. When neither water or potassium help, then sometimes doing deep breathing helps. The potassium, magnesium and calcium came out within proper range in multiple blood tests.  The salt or spices in the dinner seems to make it worse. Please help.

[Christopher R Newey, DO]

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.

A condition called restless legs syndrome (or RLS) can cause uncontrollable movement of an extremity particularly at times of drowsiness/sleepiness. It may have the sensation of a creeping/crawling feeling and may be relieved with movement. The treatment is to increase the dopamine levels (for example with a medication called requip) or it may be treated with neurontin, which is used to treat neuropathic pain.

Other conditions that can cause unctonrollable movement that may need more urgent evaluation are limb-shaking TIA’s (which are mini-strokes caused by decreased blood flow to the brain) or seizure.

You should follow up with your primary care doctor to discuss your symptoms. You may need a sleep study, EEG, and/or carotid ultrasound. I also recommend that you have a serum ferritin level checked. Low levels have been associated with RLS. Also, I suggest you be screened for diabetes based on your symptoms. Lastly, make sure to have your sodium levels checked.

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