Dr. Anshul Varshney
Internal Medicine
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Patient's Query
Hi doctor,
I am a 28-year-old male, approximately 205 pounds. Over the past year, I have been getting muscle fasciculations in my calves (mainly) and also in my quads. I have seen several doctors and they have checked my reflexes and feeling in my legs and said it is all fine. The fasciculations occur, or get worse when I do weights that strain the back of my neck, where it meets the base of my skull. For example shoulder press, or bench press. I have proven that this is the problem many times now. Caffeine, alcohol, etc., are all stimulants that make it worse. It may be due to the weights. The fasciculations are bad, I have had countless sleepless nights because the twitching is so bad. It is important that I find the problem as I do not want to stop weights permanently. I requested my doctor to prescribe me with some drugs and he has given me Gabapentin 300 mg. These actually help and reduce the fasciculations. I also went to a chiropractor who was excellent in helping my mobility through my neck and back but could not stop the twitching. He said that I need to see a neurologist. Does anyone know what is wrong with me? Or what I should do from here?
Hi,
Welcome to icliniq.com. Involuntary muscle twitching or fasciculations could result from various causes. Most common being anxiety, hyperthyroidism, nerve compression at lower back, restless leg syndrome, vitamin B12 deficiency, vitamin D deficiency. If we think of uncommon causes, they could be amyotrophic lateral sclerosis or multiple sclerosis. In my opinion, you need a comprehensive workup first. That includes thyroid profile, vitamin D and B12 levels, blood counts, MRI LS (magnetic resonance imaging lumbar spine) spine, and EEG (electroencephalogram). So, you do not need to rush to a neurologist. First of all, go to your general practitioner. Request him for these tests. Let the report come and then you can go for a neurology opinion. My recommendations in such cases for treatment would be taking Methylcobalamin injections, vitamin D and calcium supplements. You can also ask your doctor to prescribe you Pregabalin in sustained release form for at least three months.
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Internal Medicine
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