HomeAnswersNeurologyfasciculationWhat is the cause of my persistent twitches all over the body?

I have persistent twitches all over my body. Can this be due to excessive intake of antacids?

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The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.

Answered by

Dr. Hitesh Kumar

Medically reviewed by

Dr. Vinodhini J.

Published At August 26, 2020
Reviewed AtAugust 26, 2020

Patient's Query

Hello doctor,

About one month ago, I started to get twitches all over my body. Everywhere from my toes and fingers to backs of my thighs, neck, and torso. They feel like small little zings and are present all day long. I have no idea why the twitching is happening. Things I have considered, I have bad indigestion, so I took a lot of tums. I have stopped recently, but the twitching has stayed. I drink alcohol, probably two glasses of wine at night. When I have wine, I do not notice the twitches as much. I also have very bad anxiety. I am currently on Effexor XR, Prilosec.

Answered by Dr. Hitesh Kumar

Hello,

Welcome to icliniq.com.

I would like to know some further details about your symptoms:

Are these twitches visible by eyes? Or these only felt by you without being seen by eyes? Have you noticed what triggers these twitches? Like when being more anxious, empty stomach, cold weather, smoking, etc? Do you have a focal weakness, thinning of any part of arm, leg, or hands? Do you have any paresthesias, tingling, burning sensation in leg, feet, arm, and hand? Since when you have an anxiety problem? And since when you taking tablet Effexor?

How is your sleep routine? Do you get sleep soon after laying in bed? Or does it takes a long time? Once got sleepy, do you have frequent awakenings during sleep? Do you feel fresh on awakening from sleep in the morning? How is your usual mood in day-today activities? Happy toward the sad side (thinking about past events) toward the worried side (thinking about future things, irritable, something else)? How is your appetite? Have you noticed any significant changes in your body weight?

Investigations to be done

T3, T4, and TSH (thyroid stimulating hormone). Serum vitamin B12. ECG (electrocardiography). NCV (nerve conduction velocity) and EMG (electromyography). All four limbs and tongue. MRI whole spine.

Differential diagnosis

Anxiety disorder. Hyperthyroidism. Benign fasciculation syndrome. Motor neuron disease.

Regarding follow up

Revert with above mentioned information for better understanding.

Patient's Query

Thank you doctor,

I can felt only the twitches but cannot be seen. I do not have any triggers. I do no have a focal weakness, thinning of any part of arm, leg, or hands. Sometimes I get tingling in toes during cold. I have an anxiety problem for 18 years and I am taking Effexor for 10 years. I wake up multiple times throughout the night but fall asleep easily. I am always worried and anxious. My appetite is good, and no significant change in body weight.

Answered by Dr. Hitesh Kumar

Hello,

Welcome back to icliniq.com.

As per your description, these twitches are possibly fasciculations and seem to be benign fasciculations. Such fasciculations are very commonly seen in anxiety disorder patients. Though there are some other causes for such fasciculation, for which few investigations are being suggested (to rule out other things).

Rarely, a few cases of motor neuron disease may begin with such fasciculation without any weakness or thinning of any limbs. But may progress with time and shows a typical clinical feature of motor neuron disease.

Investigations to be done

T3, T4, TSH. Serum vitamin B12. ECG NCV and EMG all four limbs and tongue. MRI whole spine.

Differential diagnosis

Anxiety disorder. Benign fasciculation syndrome. Hyperthyroidism. Motor neuron disease.

Treatment plan

Initially, I suggest to get suggested investigations to try to rule out few known causes. If investigations does not reveal any particular cause, anti-anxiety medications + psychotherapy may be of help.

Preventive measures

Daily jogging or treadmill for at least 20-30 minutes in the morning.

Regarding follow up

Revert with suggested investigation test reports.

Same symptoms don't mean you have the same problem. Consult a doctor now!

Dr. Hitesh Kumar
Dr. Hitesh Kumar

Neurology

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