Twitching in Seattle...

October 13, 2006 10:51 PM

I've been having muscle twitches for the past two months.

Before anyone asks, I already have an appointment with a physician, but it's two weeks from now. Anyhow, I've had occasional, isolated muscle twitches before, but a couple of months ago, after a somewhat stressful period, I began having consistent muscle twitches in my legs (first one, then the other). At this point I got on the internet and found information on ALS, causing me to freak out even further.

Now, two months later, I've been able to determine that they get substantially worse when I'm stressed. The twitching is still mostly in my legs, but occasionally happens in the arms and torso. They are generally 2-8Hz bursts, lasting 1-10 seconds, although more recently I've been having single-fire twitches. The twitches disappear when the muscle is flexed (although if it's a longer burst, it may reappear if the muscle is relaxed immediately thereafter). I have not detected any muscle weakness so far.

I finally booked a doctor's appt recently, but I still have "what if it's ALS?" moments every few days. I'd like some peace of mind. How likely are these symptoms to be benign? Paging our resident neurologist...

posted by anonymous to health & fitness (15 comments total)

Not a neurologist, but I've been getting twitches when I'm really stressed or not getting enough sleep for the past, oh 20 years or so. I'm still here and healthy. Hopefully that'll help ease your worries until somebody who knows what they're talking about can look at you.
posted by Opposite George at 11:13 PM on October 13, 2006

Yeah, I get this too on occasion. Mostly it's my upper arm muscles, but occasionally eyelids, and they usually coincide with stressful periods of my life, in combination with lack of sleep and overcaffeination. I had the same sort of freakout but I'm fine.
posted by number9dream at 11:51 PM on October 13, 2006

Ooh yeah -- I'm not a shrink, either, but I've also found that when I'm stressed I become totally convinced that every ache, burp and squeak is a sign of certain horrible and incurable illness. Even though I know I do this I still do it. So I know where you're at.

If you aren't doing this already, try blowing off steam with regular exercise (even if it's just a 1/2 hour walk.) Or address the stressors directly if you can (I know it's easy to say but sometimes very hard to do.)

Even if the twitches don't go away completely, you might find you're worrying about them less until you get to the doc.
posted by Opposite George at 12:17 AM on October 14, 2006

Muscle spasms can be from low blood calcium. While you wait for an appointment, you could try a little calcium supplement of some sort. In the long term, you're supposed to take calcium with some other things, like Vit D, and magnesium and potassium, somebody must have whatever it all is in a pill. In the old days, pregnant women used to take calcium gluconate syrup, and it would cure a charlie horse in 5 minutes, just because it got into the bloodstream so fast. If you took calcium and it got better, you'd know a lot more about the thing than you do now. There's a lot of calcium in Tums, you could pop a couple and see if it helps. Don't exceed whatever it says on the label. IANAD, entertainment purposes only, etc.
posted by unrepentanthippie at 12:18 AM on October 14, 2006

I get these twitches in my legs at night periodically, usually when I'm stressed, most often when I'm not eating well. I had a friend tell me once that this was a nutrition problem, and that I should eat lots of bananas (for the potassium?).

Each time I get twitches I eat three or four bananas, and whether or not it's a placebo, it seems to work. Try it -- there's nothing to lose!
posted by suedehead at 12:21 AM on October 14, 2006

A long ago roommate recommended that I eat a banana after I complained of an annoying plague of muscle twitches. Something about potassium, blah blah blah ginger. I tried it, it worked and continues to work.

On preview: I guess suedehead knows my ex-roommate too.
posted by jamaro at 12:23 AM on October 14, 2006

The benign syndrome of fasciculation and cramps accounts for the vast majority of this presentation.

That said, since ALS is part of the differential diagnosis, you should see a neurologist.
posted by ikkyu2 at 3:07 AM on October 14, 2006

I get fasciculations too which I'm sure are just down to stress, coffee and dehydration in my case. I did a bit of reading about it on the web and most places mention that it's common for people with benign fasciculations to fixate on the possibility of ALS even after doctors have ruled it out, so you're not alone in this worry.

I don't want to derail, but in retrospect I wish I had viewed the onset of fasciculations as a sign that I needed to make some serious life changes instead of just trying to push through it. If this pressure is ongoing, think about whether you would be happier changing projects or even getting a different job. If you're subjecting yourself to long-term stress for the sake of someone else (this has been my problem), ask yourself if what they are getting out of it is really worth your not having a good life. Life is not meant to be free of problems but it's not meant to be a battle every single day either.
posted by teleskiving at 4:23 AM on October 14, 2006

Low B12.
posted by arimathea at 6:05 AM on October 14, 2006

I get occasional muscle twitches where is feels like a single fiber is in spasm. Almost always this coincides with travel or stress. I was told it was a potassium lack. I eat a banana and drink a bottle of gatorade as treatment. That and a little rest seems to work for me.
posted by Argyle at 8:50 AM on October 14, 2006

If you're not taking a multivitamin, start now so you can say for sure by your doctor appointment whether it's made any difference. Odds are good it will. If you already take one and you're still having the twitch, make sure you bring that up at the appointment.
posted by Lyn Never at 8:56 AM on October 14, 2006

Wow! I've had these on and off for years whenever I was really stressed out and overtired (including a few month period of an almost constant one in my neck; it really freaked people out!). I'd done research, but never found that wiki article. Really good to know I'm not alone. And I'll have to try that banana thing. Thanks, AskMe!
posted by mosessis at 11:02 AM on October 14, 2006

anon - I can't stress enough the importance of seeing your physician soon. A couple of things to keep in mind (ikkyu2, if you are reading this, please weigh in):

True fasciculations are often imperceptible to the patient, and so ALS will often not give the impression of full-on twitching. The term formiculation refers to the sensation of larger muscle group twitching, and has a different set of causes.

As one poster mentioned earlier, B12 deficiencies can cause this. If you discuss this with your doc, you need to insist that he/she check both a B12 level and a test called n MMA, and then discuss the results carefully, since there is not an absolute cut-off for either that definitely rules out B12 deficiency (unless, I suppose, both are very well within normal). B12 deficiencies are more common than thought in younger populations, irrespective of one's animal protein intake.

Please email me if you wish to address some of this further. I have some personal experience with this same phenomena and can understand some of your fears.
posted by docpops at 11:21 AM on October 14, 2006

If I eat a banana or two every day for a couple of weeks, and then suddenly stop banana consumption, I get mad twitches all over. I resume the bananas, or wait a couple weeks, or take a vitamin, and the twitches go away.
posted by jennyjenny at 11:25 AM on October 14, 2006

... a couple of months ago, after a somewhat stressful period, I began having consistent muscle twitches in my legs (first one, then the other). ... The twitching is still mostly in my legs, but occasionally happens in the arms and torso.

I had BFS (benign fasciculation syndrome, as linked to by ikkyu2 above), and you probably have it, too. One big sign of BFS is florid twitches in various places. People developing ALS may not even be aware of their more subtle fasciculations, and their twitches generally appear in a specific location AFTER muscle weakness has developed in that specific location. What you're describing sounds like classic, mild BFS.

I went through an ALS scare, too, because of similar symptoms. I saw a calm and non-patronizing neurologist who told me how unlikely a diagnosis it was, but he also said that when he was in medical school, he had diagnosed himself with ALS -- which, of course, he never developed. But he gave me a thorough physical exam, which I passed, and even though I was vastly reassured by the exam, I kept my appointment for the next month where I got some mildly ouchie testing with tiny needles and weak electrical current (EMG) that revealed NO signs of ALS.

BFS may be related to B12 deprivation, may be related to stress, may be related to suggestibility, may be related to over-exercising, and/or may be related to hormonal changes, such as pregnancy. It's one of those disorders that isn't fully understood yet, as you may gather.

From my experience, I believe there is a strong psychosomatic component. My symptoms dropped a lot after my first neuro consult, and disappeared completely after getting a clean EMG. I'm not saying that the twitches are all in your head, as there may be a physical factor. But reassuring yourself that this is not ALS would probably be pretty helpful.

Take it easy on yourself until your appointment, eat a balanced diet with suffcient potassium and B12, because it's just plain good for you, and take heart in the fact that you really don't present as an ALS patient. But do keep the appointment, because you need to hear this from a doctor, too.
posted by maudlin at 1:26 PM on October 14, 2006