Hello doctor,
I am 31-years-old, and I have started having symptoms of twitching all over my body. I did a quick internet search and met with some scary answers. I do not have any weaknesses. I am still very strong, but I have a balance issue only when I stand. I can run and walk just fine. I have twitches in my knees and on the lower side of my foot. I also have diabetes and I am currently taking Metformin. Earlier, I was on Zoloft. I also underwent a head CT scan, a neurological exam, and blood tests. This problem has been going on for months now.
Kindly advise.
Hello,
Welcome to icliniq.com.
I would like to know some further details about your symptoms:
1) Have these twitches started in the past ten months, or have they been present even before? And how frequent are these twitches?
2) These twitches occur in which body parts?
3) Are these twitches visible to the eyes or only felt inside the body?
4) It is good that you do not have weaknesses in any body part. Have you noticed any muscle thinning of the arm, leg, hand, etc.?
5) Do you have neck or back pain?
6) Do you have tingling or pin prick sensations in your legs or feet?
7) For how long have you had diabetes mellitus?
8) Since when are you taking Zoloft (Sertraline), and for which symptoms?
9) For what symptoms you underwent a CT (computed tomography) scan of the head?
I would also like to know some more information:
1) How is your sleep routine? Do you get sleepy soon after laying in bed, or does it take a long time? Once you get sleepy, do you have frequent awakenings during sleep? Do you feel fresh on waking up from sleep in the morning?
2) How is your usual mood in day-to-day activities? Do you feel happier, or are you on the sad side (thinking about past events)? Do you worry a lot (thinking about future things, irritable stuff, or something else)?
I am advising the following investigations to be done:
1) MRI (magnetic resonance imaging) of the whole spine.
2) Nerve conduction velocity (NCV) test and electromyography (EMG) of all the ribs.
3) T3, T4, and TSH (thyroid-stimulating hormone) test.
4) Vitamin B12.
5) Vitamin D3.
6) ECG (electrocardiogram).
Also, please send your CT and blood report along with your neurological examination sheet if you have them. Please revert with the information mentioned above for better understanding and further judgment.
Thank you.
Hello doctor,
I can give all this information; yes, twitching started all over my body. It began with the lower back, then it got worse the same weekend, and I felt it in my hands, legs, and eyes, especially in my calves and side of my foot. There is no visible wasting in the muscles, and I was able to play in a football tournament last week. CT scan came back good, and so did all my other tests. The doctor said I passed my neurological exam, so he did not think I needed an EMG, and they said I had BFS.
Hello,
Welcome back to icliniq.com.
As per your description, if there is no muscle thinning and neurological examination did not show any significant signs, then the possibility of these being benign fasciculation is very likely. Fasciculation can be due to many causes. But among those cause more concerning is ALS (amyotrophic lateral sclerosis), which is primarily a clinical diagnosis and cannot be proven or ruled out by any specific investigation. Also, it requires time to see its progression. As in ALS, initially, all clinical criteria may not be present in a patient.
Fasciculation can be due to:
1) Anxiety.
2) Benign fasciculation syndrome.
3) Hyperthyroidism.
4) Cramp fasciculation syndrome.
5) Amyotrophic lateral sclerosis (ALS).
Among these, anxiety and benign fasciculation syndrome are most common.
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