Dr. Hitesh Kumar
Neurology
The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.
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Patient's Query
Hello doctor,
I am a 34-year-old male. I have muscle twitches when relaxed, but they disappear when I move. I have pain in my right ring finger and cracking of elbow joints in both arms. I suffer from ulcerative colitis, and I am on Humira injection. My latest DMARD blood test returned normal.
Hello,
Welcome to icliniq.com.
I would like to know some details about your symptoms:
Since when you have ulcerative colitis? And since when you are on injection Humira? When you started to have muscle twitches? In which body parts, you have these twitches? Are these twitches visible to eyes or only felt inside? Have you noticed, in which situations, these twitches are more or get triggered? Do you have any thinning of muscles or weakness of hand grip in hand or leg?
Do you have impairment of sensation, in any body part? Do you have any neck or lower back pain, pain in elbow or other joints (either small joints or large joints of arms or legs)? If yes, in which which joints? What other medications (apart from Injection Humira) are you taking? Please mention the names and dosage? Do you had any significant weight loss in recent time?
How is your sleep in routine? Do you get sleep soon after lying in bed or it takes long time? Once you get sleep, do you have frequent awakenings during sleep? Do you feel fresh while awake from sleep in the morning? How is your usual mood in day today activities? Happy toward sad side (thinking about past events) or toward worried side (thinking about future things, irritable or something else)? How is your appetite?
Investigations to be done
Treatment plan
Regarding follow up
Patient's Query
Thnak you doctor,
I have ulcerative colitis for about five to six years and on Humira for one year. I have intermittent twitching in the calves, thighs, and stomach. It is not there always. Twitches occur more when I think about horrible things. I had my blood work done recently. My vitamin B12 levels, CRP, and full blood count are normal. No weight loss and no pain in elbows, just cracking sounds. No weakness or muscle loss in the hands. I was checked by a GP yesterday. I do have anxiety about my health, though. The minute I feel something wrong, I use the internet to diagnose my symptoms. Appetite is good, with no difficulty swallowing or chewing.
Hello,
Welcome back to icliniq.com.
As per your description, possibly you having associated anxiety disorder. Some muscle twitches can happen in anxiety too. If there is no impairment in power or hand or leg and no thinning of arms, or leg, chances are that these twitches may be benign fasciculations.
Investigations to be done
Differential diagnosis
Treatment plan
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Neurology
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