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Widespread Chronic Muscle Twitching

Back in November of 2008, I literally woke up one morning with my muscles twitching everywhere and I mean everywhere. It has not stopped since. I have chronic widespread muscle twitching and cramping with acute attacks of intense itching on my arms. I have no rash when this occurs. I noticed when I do have the intense itching which my Dr. diagnosed as Pruritis, I get really nauseous and vomit. I have seen two Neurologists. The first Neuro did blood work, EMG, and muscle biopsy. I was diagnosed with Mitochondrial Myopathy. When I got a second opinion, I was told I DID NOT have a mitochondrial Myopathy and that it was benign fasiculations. I don't see how this can be benign, the symptoms are terrible. I twitch and cramp, and Itch, and I get little shock like sensations when I move suddenly at times. Particularly I feel them in my abdominal area.....During the time leading up to this I had a baby 3 months before this all started ( MY 5th Child). I had a Duramorph during labor which is like an Epidural. I ended up getting a Blood Patch because I was leaking spinal fluid. I had a Mirena IUD put in 6 weeks post partum. I also had a flu shot about a month before this started and also, I had a lot of Dental work done. I had about 8-10 fillings put in and at the time and I was taking quite a bit of Ibuprofen during a months time for pain..I'm wondering if any of this could have caused my problems I'm having. I do have Hypothyroidism. I'm on Synthorid and I take a small dose of Metoprolol for acute Atrial Fibrillation. I'm only 28 years old and I just feel like something has to be causing this and I would like to get to the bottoms of this. Any advice would be appreciated! Thanks.
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Avatar universal
MEDICAL PROFESSIONAL
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.

It must be emphasized that in the MAJORITY of cases muscle twitches 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. Tremors of the hands can be physiological that is exacerbated by stress/anxiety and caffeine.

Benign fasciculation syndrome, often abbreviated as BFS, 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.

Often these symptoms may reflect emotional/psychiatric problems related to stress (what is called somatization disorder). The latter is a true medical condition whereby instead of a patient experiencing depression or anxiety, they experience physical symptoms, and once the stress is addressed, the symptoms resolve.

Lastly, have you had your thyroid function checked recently? Thyroid abnormalities can have neurological presentations.

You should continue following up with your primary care physician. Have you had an EEG, EMG/NCS, or MRI? You may wish to discuss these various tests and determine if any would be appropriate.

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

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