HomeAnswersNeurologymuscle twitchingWhat causes muscle twitches and heart palpitations?

I have had muscle twitches all around the body and heart palpitations for about six months. Please help.

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Answered by

Dr. Hitesh Kumar

Medically reviewed by

iCliniq medical review team

Published At March 7, 2021
Reviewed AtMarch 27, 2021

Patient's Query

Hello doctor,

I am an 18-year-old male. My weight is 70 kg. I have had muscle twitches all around my body and heart palpitations for around six months. Recently I have had a general weakness in both of the triceps that sometimes migrates into my forearms. I have also experienced anxiety and depression, and I have been reading symptoms online (which I know is a bad idea), and it has pointed to MS.

Answered by Dr. Hitesh Kumar

Hello,

Welcome to icliniq.com.

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

1. Since when you started to have these twitchings? Are these since six months only?

2. In which body parts you get these twitches?

3. Are these twitching increasing with time, or is it the same or decreasing with time?

4. Are these twitches visible by eyes or only felt inside by you?

5. Have you noticed any other factor aggravating it?

6. Do you have any limb weakness or thinning of the limb?

7. Have you undergone any investigative workup for these twitches? If yes, please send it here as an attachment.

8. Is heart palpitation occur at the time of twitchings? How long heart palpitation lasts in one time?

9. How is your sleep commonly?

- How long time does it take to get sleepy after lying in bed?

- Once sleepy, do you have a sound sleep or have frequent awakenings?

10. How is your mood commonly? Happy or sad or worried?

11. Since when you have anxiety and depression?

11. Are you already on any medicines? If yes, please tell their names and doses.

Investigations to be done

ECG. T3 (triiodothyronine).T4 (thyroxine). TSH (thyroid stimulating hormone). Serum Vitamin B12. Serum Vitamin D3.

Differential diagnosis

Benign fasciculation syndrome.
Cramp Fasciculation Syndrome.
Anxiety Disorder.
Neuromyotonia.
Motor neuron disease.

Probable diagnosis

Anxiety disorder.

Regarding follow up

Revert with above mentioned information for better understanding and further decision making.

Patient's Query

Hello doctor,

1. I have it for six months only.

2. All over the body, they usually happen in specific areas at once. Currently, it is around the jaw and neck.

3. The twitches had decreased in frequency from when I first had them.

4. Twitches are visible by eyes.

5. Thinking about twitches - but that could be because I know they will happen

6. My triceps feel very weak but still have the same strength.

7. No, I have not undergone any investigative workup for these twitches.

8. Heart palpitations occur while at rest but have subsided recently.

9. Sleep is usually seven hours. I get to sleep quite quickly after lying in bed.

10. Worried, but neither happy nor sad.

11. I have not yet been diagnosed with depression, but I believe symptoms have lasted for a year. Anxiety for around four months.

12. I take 25 mg of Zinc daily at night as well as 4000 IU vitamin D.

Answered by Dr. Hitesh Kumar

Hi,

Welcome back to icliniq.com.

Possibly the twitchings may be "fasciculations."

Being associated with palpitations and being anxious may point these fasciculations to be anxiety-induced.

But such fasciculations can also happen in few neurological and endocrinological disorders too. For that, it will require further evaluation.

Investigations to be done

ECG. Holter monitoring. T3, T4,TSH. Serum Vitamin B12. Serum Vitamin D3. NCV (nerve conduction velocity) and EMG (electromyography) for all four limbs. MRI Brain and screening whole spine. ANA (antinuclear antibody). ENA (extractable nuclear antigen antibodies) profile.

Differential diagnosis

Anxiety Disorder.
Hyperthyroidism.
Benign fasciculation syndrome.
Motor Neuron disease.

Treatment plan

I suggest you to consult neurologist physically for detailed neurological examination. Also consult psychiatrist for detailed psychological assessment. If psychiatrist find some mood disturbance or anxiety issues, can give a try of anti-anxiety medications.

Regarding follow up

Review with prescribed test reports, neurological and psychological clinical assessment record.

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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