white matter changes and muscle twitches

[KarenLL]

I know you can't diagnose, but wondering if you can give me (a 39 y.o. female) any idea of a direction to go at this point.
This past December, right upper eyelid began twitching, probably 50-100 times each day--after I'd blink, that eyelid would have a second delay in opening.  Lasted two months.  Diagnosed with hypertension (200/130)  in January and MRI/MRA done at that time showed "T2 hyperintensity in the subcortical white-matter, supratentorially bilaterally in a punctate distribution" which the radiologist felt was "suspicious for but not diagnostic of multiple sclerosis".  Neuro ruled MS out due to lack of symptoms and negative LP.  Said eye twitch was probably caused by my bangs.  Shortly afterwards, right eye stopped, but left lower lid did the same type of thing for almost two months.  About the same time, started getting twitches throughout body (back, legs, shoulders) with a period of two weeks when I could sit in bed at night and watch the sole of each foot twitch.  Eyes and feet now okay, but widespread twitches still a problem.  Also some subjective weakness, most pronounced in left leg.  I have a history of common migraines (maybe 3-4/year) over the past 13 years...recently had a spell of what the opthalmologist diagnosed as ocular migraines (3 times in one week), consisting of a blind spot in center of one eye and confusion but no headache.  Other history, I am anemic--taking iron since June and will be rechecked in September.  Wondering if recent symptoms warrant a recheck with neuro--or someone else (not stressed or depressed or anything).  Thanks.

[CCF-Neuro-M.D.-JT]

Twitching and MRI changes likely not related, especially in the setting of known hypertension (high blood pressure). The tiny lesions may represent small vessels (size of a hair) not getting enough blood which produces those changes on MRI. As for the twitching, it could be part of benign fasciculation syndrome. A neuromuscular exam and EMG may be helpful in sorting that out,

The confusion is somewhat concerning however. Not sure exactly how the blind spot ties in, but seizure is a possibility as is a TIA. Talk to your neuro about these symptoms who will direct you to the appropriate next step. (EEG for seizure workup vs carotid ultrasound to look at the arteries in your neck). Ocular migraine is certainly a strong possibility also, but it's important to make sure you don;t have anything else which needs more urgent treatment. Good luck.

[acesover]

I had the eye-twitching problem for a total of four years straight, constantly everyday, everytime I blinked like you described.  But it spontaneously went away about a year ago.  I don't think it is too much to worry about, but then again I am not a doctor, just someone speaking from experience.  The other symptoms you are describing seem to warrant a neuro exam.
good luck.

[marybuzz]

Am new to this forum, so I hope I'm not stepping out of line here.  Am newly dx with probable MS, only symptoms so far have been partial transverse myelitis, but MRI showed 15-20 periventricular lesions <1 cm each, intrameduallry lesion at T6, CSF + for OG bands, high IgG synthesis & index, so sounds like MS.  All symptoms have almost resolved (after 2 months), although I was never given any treatment, main problem is nocturnal myoclonus of both feet, no other twitching.  Is the myoclonus related to the MS or is it a separate entity, anyone else having this type of problem?  Only thing that slightly helps is SOMA, which I had been given earlier for my severe lower back pain - before I was dx with MS

[JSK]

What is "nocturnal myoclonus"?  I have a continuous twitch in the arches of both feet that actually move the big toes (for 2 1/2 years now, pushing 3 years).   Doctors are clueless as to what's causing it.  I also have other twitches, but they don't bother me since I know they will go away.

I'm more concerned with ALS than MS as it looks like atrophy in my feet, but they seem strong, maybe they always looked boney.
  
I would actually not have any problems with a MS diagnosis since I know a couple people with it & you wouldn't know unless they told you.  Just minor & strange feelings/issues, etc.

Good luck & keep posting.

[JSK]

PS:  My MRI's show unidentified white matter.  The Neuro says the brain is still new & unexplored & does not feel concerned about it.

[marybuzz]

Hope I can answer your question sensibly about nocturnal myoclonus. My feet and lower legs twitch at night,jerking really strongly, almost in a rhythmic pattern until I am in a deep sleep, doesn't usually bother me too much, but drives my wife crazy ( I wear a size 13 shoe and she says the whole bed shakes) Anyway, one MD said it was benign nocturnal myoclonus and said that sometimes Elavil works.  Haven't tried that yet, SOMA seems to work pretty well most nights.  Still don't know if this is related to my MS, it started about the same time I went in with symptoms of transverse myelitis.  The other symptoms are almost gone, but this one thing has stayed around.  Good luck, hope you get your symptoms under control.

[kaymom]

I was just wondering if the "blind spot" and the "confusion" could be related to diabetes? I am not sure about the twitching or headaches.  It's just a thought, considering there are so many people with diabetes who have never been checked.

[KarenLL]

Thank you for your comment about diabetes, certainly something to check with my doctor about, but I think she may have done bloodwork for that as part of my physical.  (I worked as a dietary aide in a nursing home as a teenager and remember seeing a patient going into insulin shock or something--really scary!)  The confusion I experience isn't like that, though...I drove myself to the opthalmologist's office and had to fill out a form while waiting to be seen, but had to laugh at myself because I couldn't understand the questions asked on the form (yet I knew that they weren't difficult, and that the problem was with me!)  I had a similar episode just over a year ago, when I was on the computer first thing in the morning, and suddenly the letters were "gibberish"--I could probably have named the letters individually, but they just didn't make sense all together.  Lasted for about 10-15 minutes.  Looking back at it, I have to wonder if it had something to do with my blood pressure being elevated, but I would have thought the MRI/MRA they did would have shown something they would relate to that, rather than even raising the question of MS!

[KarenLL]

Just a couple of questions.  Do you have any idea what caused your eye twitch?  (I've read about caffeine and being tired or too much time reading/on the computer, etc.)  Did you try anything to get it to stop?  Did anything work--or not work?  Four years, huh?  That is an incredible amount of time to put up with something so distracting; I know I hated it for the four months I was bothered.  Just curious, too:  do you (or did you) have muscle twitches anywhere else?  My eye twitches were obvious to others, but others aren't.  I notice them most when I am lying in bed at night or when they are somewhere on my body that is covered by clothing--I think because I feel the skin move against the other surface.  (I'm getting ready to "evict" my kids' hamsters, as I'm getting really tired of having to check and see if they've escaped their cages--they are never there, it's always just me!)

[FloFlo]

Anything new on determining the cause of you muscle twitching? I have had constant twitching all over my body for the past 21/2 months. Seemed to have started with the same type of upper eyelid twitch as you described (I too felt the delayed opening of my upper lid after a blink). Then after the eyelid stopped, I got a tricep spasm/twitch that lasted over a week and went 24/7. All over muscle twitches, "zinging" sensations, and big jolts started in as well. After about 2 weeks, the tricep spasm went away but the all over twitches continue. Anytime I hear of another person going through twitching, I want to know if they have found the source. My nuero did a MRI & EMG when this all started, EMG normal, MRI showed a 7mm cist that he says is benign. Have loads of other stuff going on and I wonder how much of it I bring on myself from the enormous stress I'm under worrying about this! Choaking feeling, trouble breathing, stiffness in face, weakness, hot feelings in random areas, random numbness, and the list goes on. I hope you have gotten some answers for your problems since I'm just starting the research process. It seems there are so many things that can cause spasms including benign fasiculations, but it sure feels like my body is trying to tell me something. Too many other things going on. I will check back to see how you're doing. I am 39 years old (as well) with two little ones. All this stuff makes the stupid little problems in life not look so bad, huh?!
Bye for now, FloFlo

[atepoint]

I know exactly what you people are going through with the twitches. My right eye started twitching about 2 months ago and i was just going to wait it out . One night a muscle in my left leg started twitching and i decided to see a dr. the first time he told me nothing, just took a bunch of blood samples and said have a nice day.The dr told me it would take 3 days to get the results back .During the first two days i thought id be smart and check on the internet , and let me tell you it scared me to death.All the diseases that cause twitches whoa !i went back to the dr.(a different dr.) and he said oh dont worry about it man their benign they'll go away . he put me on xanex told me i was having anxiety attacks when i told him what was going on .now i have twitches all over my body and frequently have anxiety(panic) attacks, and ive been to the dr once more and the emergency room once for those of you who have never had a anxiety (panic) attack it feels like your having a heart attack. they all keep referring me to neurologist but its gonna take till at least november to get an appointment as a new patient.
                  im going nuts over here !!!! lol

[anxious1]

Att: Flo Flo

I'm a 30 y/o guy, just got married. And I seem to have EXACTLY what you describe. It started with random burning sensations over mu body, now I get twitching, weird muscle feelings, etc..It all happened after a VERY stressful event that I still feel guilty about. That was 6 months ago. My Neuro said that it was typical..not sure what she meant.

Anyways, if you find anything, please let us know. I will do the same. I just did an MRI and the technician said "It looks normal"..but still haven't seen the MD to get the results.


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