Occasional Muscle Twitch

A muscle twitch is an involuntary contraction of the fibers that make up a muscle. Nerves control muscle fibers. When something stimulates or damages a nerve, it causes the muscle fibers to. Orthostatic tremor is a rare disorder characterized by rapid muscle contractions in the legs that occur when standing. People typically experience feelings of unsteadiness or imbalance, causing them to immediately attempt to sit or walk.

• Benign fasciculation syndrome (BFS) is characterized by fasciculation (twitching) of voluntary muscles in the body. The twitching can occur in any voluntary muscle group but is most common in the eyelids, arms, hands, fingers, legs, and feet. The tongue can also.
• If I use the term “hypnic jerk”, I’m not calling you names;). En.wikipedia.org Hypnic jerk. A hypnic jerk, hypnagogic jerk, sleep start, sleep twitch, myoclonic jerk, or night start is a brief and sudden involuntary contraction of the muscles of the body which occurs when a person is beginning to fall asleep, often causing the person to jump and awaken suddenly for a moment.
• Common causes of muscle twitching include the following: Twitching can occur after physical activity because lactic acid accumulates in the muscles used during exercise. It most often affects the.

Benign fasciculation syndrome (BFS) is characterized by fasciculation (twitching) of voluntary muscles in the body.^[1] The twitching can occur in any voluntary muscle group but is most common in the eyelids, arms, hands, fingers, legs, and feet. The tongue can also be affected. The twitching may be occasional to continuous.^[2] BFS must be distinguished from other conditions that include muscle twitches.

Signs and symptoms[edit]

The main symptom of benign fasciculation syndrome is focal or widespread involuntary muscle activity (fasciculation).^[1] The benign twitches usually have a constant location.^[2]

Other common symptoms are generalized fatigue or weakness, paraesthesia or numbness, and muscle cramping or spasms.^[1]Anxiety and somatic symptom disorders and symptoms are commonly reported.^[1]Muscle stiffness may also be present; if muscle weakness is not also present, and cramps are more severe, the stiffness may be categorized instead as cramp fasciculation syndrome.^[3] Cramp fasciculation is a variant of BFS which presents with muscle pain and exercise intolerance.^[2][4]

BFS symptoms are typically not accompanied by severe muscle weakness, and are typically present when the muscle is at rest. Individuals with BFS may have perceived weakness which is the sensation of a fatigued limb, but is not true clinical weakness. Fasciculations can move from one part of the body to another.^{[medical citation needed]}

Causes[edit]

The precise cause of BFS is unknown.^[5] It is not known if it is a disease of the motor nerves, the muscles, or the neuromuscular junction.^{[medical citation needed]}

Health anxiety disorder may be a cause among individuals who become concerned they have a motor neuron disease; this persistent concern is a psychiatric condition mostly noted among healthcare professionals and doctors.^[1] An association with anxiety level is established;^[1][6] BFS is reportedly found among 'anxious medical students' and clinicians under the age of 40,^[3] and this phenomenon known as 'fasciculation anxiety syndrome' is reinforced by access to information on the internet.^[4]

Fasciculations can be caused^[4] or worsened by intense and long periods of daily exercise.^[2]

BFS can also be caused by long-term use of anticholinergics,^[4] and fasciculations may be caused by other drug use or exposure to steroids, nicotine, caffeine, alcohol, insecticides and pesticides.^[2] Thyroid disease may also cause similar symptoms.^[3]

Diagnosis[edit]

Benign fasciculation syndrome is a diagnosis of exclusion; that is, other potential causes for the twitching must be ruled out before BFS can be diagnosed. Diagnosis includes blood tests, a neurological exam, and electromyography (EMG).^[2]

Another step in diagnosing BFS is checking for clinical weakness or wasting, which are found in more serious conditions.^[4][2] Lack of clinical weakness along with normal EMG results (in those with only fasciculations) largely eliminates more serious disorders from potential diagnosis.^[2][3] In younger people with only lower motor neuron (LMN) fasciculations, no muscle weakness, and no thyroid abnormalities, Turner and Talbot (2013) state that 'individuals under 40 years can be reassured without resorting to electromyography (EMG) to avoid the small but highly damaging possibility of false-positives'.^[3]

According to Kincaid (1997), the diagnosis is made when there is no clinical finding of neurogenic disease; he first reassures patients that no 'ominous disease seems to be present', and says, 'I suggest that patients like this be followed for a year or longer with clinical and electromyographic exams at about 6-month intervals before one becomes secure in the diagnosis that the fasciculations are truly benign.'^[7] Other publications recommend followups for four or five years before ruling the condition benign, although the percentage of individuals who progress to a more serious condition is very low.^[2]

Classification[edit]

Benign fasciculation syndrome and the variant cramp fasciculation syndrome 'can be regarded as part of a larger spectrum of disease that also incorporates acquired auto-immune neuromyotonia.^[4]

Differential[edit]

Other serious diseases that must be distinguished include motor neuron diseases (MND) such as amyotrophic lateral sclerosis (ALS),^[3]neuropathy,^[4] and spinal cord diseases.^[4]

According to Turner and Talbot (2013), 'the fasciculations of MND are often abrupt and widespread at onset in an individual previously unaffected by fasciculations in youth. The site of the fasciculations, for example, those in the calves versus abdomen, has not been shown to be discriminatory for a benign disorder. There is conflicting evidence as to whether the character of fasciculations differs neurophysiologically in MND.'^[3] It is 'exceptionally rare for patients later diagnosed with ALS to present with fasciculations alone', and ALS is ruled out with a normal EMG and no evidence of muscle wasting.^[2]

Treatment[edit]

There is support for treating any accompanying anxiety using cognitive behavioral therapy or antidepressants.^[1]Quinine is effective, but not recommended because of the potential for serious side effects.^[2]Calcium channel blockers may be effective, although the evidence for their use is weak.^[2] There is little evidence supporting other therapies.^[2]

Prognosis[edit]

The prognosis for those with BFS is good to excellent.^[5]

The syndrome causes no known long-term physical damage. Some individuals remain anxious even after being diagnosed with the benign condition and are often directed towards professionals who can assist with understanding stress and anxiety, or those who can prescribe medication to help manage anxiety.^{[medical citation needed]}

Spontaneous remission has been known to occur, and in cases where anxiety is thought to be a major contributor, symptoms are typically lessened after the underlying anxiety is treated.^{[medical citation needed]}

Research[edit]

There may be an association between widespread fasciculations or paresthesias with small fiber neuropathy.^[8][9]

References[edit]

1. ^ ^abcdefgBlackman G, Cherfi Y, Morrin H, et al. (2019). 'The association between benign fasciculations and health anxiety: a report of two cases and a systematic review of the literature'(PDF). Psychosomatics. 60 (5): 499–507. doi:10.1016/j.psym.2019.04.001. PMID31174866.
2. ^ ^{abcdefghijklm}Walter TR (March 2015). 'Benign fasciculation syndrome'. J Pain Palliat Care Pharmacother. 29 (1): 54–5. doi:10.3109/15360288.2014.997856. PMID25700216.
3. ^ ^abcdefgTurner MR, Talbot K (June 2013). 'Mimics and chameleons in motor neurone disease'. Pract Neurol (Review). 13 (3): 153–64. doi:10.1136/practneurol-2013-000557. PMC3664389. PMID23616620.
4. ^ ^abcdefghde Carvalho M, Kiernan MC, Swash M (September 2017). 'Fasciculation in amyotrophic lateral sclerosis: origin and pathophysiological relevance'. J. Neurol. Neurosurg. Psychiatry (Review). 88 (9): 773–779. doi:10.1136/jnnp-2017-315574. PMID28490504.
5. ^ ^abBrigo F, Storti M, Lochner P, Nardone R (June 2013). 'Transitory stapedial myoclonus in a patient with benign fasciculation syndrome'. J Laryngol Otol (Review). 127 (6): 605–6. doi:10.1017/S0022215113000297. PMID23480624.
6. ^Mitsikostas DD, Karandreas N, Coutsopetras P, et al. (April 1998). 'Fasciculation potentials in healthy people'. Muscle Nerve (Comparative study). 21 (4): 533–5. doi:10.1002/(sici)1097-4598(199804)21:4<533::aid-mus14>3.0.co;2-y. PMID9533790.
7. ^Kincaid JC (August 1997). 'Muscle pain, fatigue, and fasiculations'. Neurol Clin (Review). 15 (3): 697–709. doi:10.1016/s0733-8619(05)70340-6. PMID9227959.
8. ^Tzatha E, Langsdorf J, Carey B, Chin RL (March 18, 2013). 'Benign fasciculation syndrome as a manifestation of small fiber neuropathy (P01.139)'. Neurology.
9. ^Tzatha E, Chin RL (September 2014). 'Small fiber abnormalities in skin biopsies of patients with benign fasciculations'. J Clin Neuromuscul Dis. 16 (1): 12–14. doi:10.1097/CND.0000000000000047. PMID25137510.

You often hear people complaining about random muscles in their body starting to involuntarily twitch for no apparent reason. These spasms can be experienced by a small portion of any muscle of the body. What is the underlying cause and explanation of this familiar phenomenon? Continue reading to find out.

Muscle Twitching All Over Body, Why?

If you experience muscle twitches from time from time, you may wonder why it happens. Here are 8 causes for why muscle twitching all over the body occurs.

1. Common Causes

The common, less serious causes of muscle twitching include:

• Exercise
• Smoking
• Anxiety and stress
• Nutritional deficiencies
• Caffeine, and other stimulants
• Irritation of the eyelids or surface of your eye
• Reaction to drugs, such as corticosteroids and estrogen

Twitching of the eyelids, calves and thumbs is common and harmless which are probably caused by trivial life-style related reasons. There's nothing worrisome about them as the symptoms are likely to fade within a few days.

2. Benign Fasciculate Syndrome (BFS)

Benign fasciculate syndrome or muscle twitching syndrome is a non-threatening neurological disorder. Its primary symptom is muscle twitching all over body, which could impact the fingers, arms, legs, back, eyelids or even the tongue. You may also experience anxiety, pain, fatigue, numbness, muscle fatigue, etc.

The exact reason for BFS is yet to be found. But these twitches may be triggered by keeping muscles at rest for long, relieved by voluntary moving them, and aggravated by infection, exhaustion and stress. This condition can be relieved by reducing stress, quitting coffee, smoking and other stimulants, trying relaxing techniques like meditation, taking dietary supplements and drugs like anti-anxiety or anti-epileptic medication.

Occasional Muscle Twitch In Leg

3. Peripheral Nerve Hyperexcitability

This condition is primarily characterized by muscle twitching, cramps, abundant sweating, rigid calf, leg and torso muscles. It includes a myriad of conditions: Cramp fasciculation syndrome – you may experience muscle twitches, along with ache, rigidity and cramps and exercise intolerance; Neuromyotonia or 'Isaac's syndrome' – a disorder with consistent motor activity.

Precise cause is unknown; however, autoimmune action, presence of cancer and genetic predisposition are considered to be triggering factors. Doctors may choose a symptomatic approach to treat this condition. For example, anticonvulsants like phenytoin and carbamazepine are used to treat muscle contractions, ache and rigidity. Occasionally immunosuppressants are prescribed for relief.

4. Amyotrophic Lateral Sclerosis

Amyotrophic lateral sclerosis is a progressive neurodegenerative disease where the obstruction of communication between the brain and the skeletal are obstructed because of the degeneration of motor neurons in the spinal cord and the brain.

Primary symptoms include muscle twitching all over body, muscle spasm and stiffness, labored breathing, difficulty in speaking, mastication and swallowing and poor coordination. Muscle weakness and even complete body paralyses may ensue later on. A drug called Riluzole is a favored treatment; however, it only delays the advancement of the disease.

5. Muscular Dystrophy

It is a batch of inherited muscle diseases, including Duchenne muscular dystrophy, Emery-Dreifuss muscular dystrophy, limb-girdle muscular dystrophy and congenital muscular dystrophy are some. Duchenne muscular dystrophy is the most common one that affects only males of young age. Major symptoms include muscle weakness which commences from the legs and the pelvic region, resulting in constant falling and struggling to rise from a sitting or lying position and progressive decline in muscle skills.

Treatment revolves around restoring muscles and delaying the advancement of the condition. Prednisone is often prescribed; however, it may have long term harmful effects. Aids like wheelchair, walkers and braces may be used. Besides, performing flexibility exercises is recommended.

6. Weak Muscles

This belongs to neuromuscular disorder in which the main symptom is frailty and instability of muscles. Muscle twitching all over body and muscle rigidity are also common symptoms. These disorders can be inherited or acquired.

Treatment depends on the cause of the condition. A unified approach of medicines and physical therapy is needed to help the patient function. Supportive aids like braces are also used. In some cases surgery may be advised.

7. Spinal Muscular Atrophy

This is a genetic condition resulting in atrophy of the voluntary muscles of arms and legs. The types are classified according to the age group that is affected: type I – 6 months; type II - 2 years; type III – 3 years; type IV – 20-30 years (adult form) and Kennedy's disease – 20-40 years (rare).

Major symptoms are muscle weakness, tremors and spasms followed by difficulty in breathing, eating and limb weakness. It is caused by mutation or absence of survival motor neuron gene (SMN-1) which makes a protein that fortifies motor neurons. Abnormal gene leads to degeneration of the motor neurons of the spinal cord. You can try drug and physical therapy along with supportive braces (or surgery) and respiratory assisting devices to get relief.

8. Isaacs' Syndrome

Muscle Twitch Definition

The last reason for muscle twitching all over body is Isaac's syndrome. This is a neuromuscular disorder caused by hyperexcitablity and overshooting of peripheral axons which activate muscle fibers. Main symptoms include muscular spasms, convulsions, sweating, delayed relaxations, and ache and weakened muscular. These are visible even during sleep or under general anesthesia.

Occasional Muscle Twitch Streamer

The causes include autoimmune reactions in which antibodies bind to potassium channels of the peripheral nerves. Another acquired cause is radiation therapy. The occurrence of disease is between the ages of 15-60. Treatment includes anticonvulsants like phenytoin and carbamazepine to manage muscle ache, rigidity and spasms. The prognosis of this disease is poor and unclear. There is no known cure yet.