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HomeAnswersNeurologymuscle twitchingI have twitching and cramps in the muscles. Can this be amyotrophic lateral sclerosis?

Why do I have twitching and cramps in my muscles all over my body?

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

iCliniq medical review team

Published At March 17, 2022
Reviewed AtMarch 17, 2022

Patient's Query

Hello doctor,

I am a 26-year-old female. About four years ago, I woke up one day and noticed that I had twitching in my thumb. It has progressed rapidly to every muscle in my body even places I did not know could twitch were twitching. It has not gotten any better. In fact, right now my right thumb is twitching, it never stops. I have a hard time sleeping because of it. It is annoying and scary and I cannot stop thinking I have amyotrophic lateral sclerosis. I have been doing strength tests multiple times a day lately and now my left arm feels heavy, tired and weak. I have also noticed that I have excessive saliva in my mouth constantly and a hard time swallowing food with it getting stuck in my throat. I am very anxious about it and have been telling myself that it will be fine. Please help me out.

Answered by Dr. Hitesh Kumar


Welcome to icliniq.com.

I would like to know some details about your symptoms:

1. Apart from twitching, do you have weakness or thinning of any muscles? Are these twitchings visible by eyes or only felt inside?

2. Do you have any sensory symptom like tingling, burning, pins and needles sensation? If yes, in which body parts?

3. Do you have any significant neck or lower back pain?

4. Do you have any difficulty in controlling urinary urge?

5. Have you ever consulted for these twitching and has any investigation been done? If yes, which all investigations? Has any diagnosis been made?

6. How is your common mood - happy, sad, or worried?

7. How is your sleep usually?

8. Do you have any associated medical condition or on any medications? If yes, please describe.

I advise you to get the following investigations done.

1. MRI (magnetic resonance imaging) of brain.

2. MRI of whole spine.

3. NCS (nerve conduction study) and EMG (electromyography) of all four limbs.

4. T3 (triiodothyronine), T4 (thyroxine), and TSH (thyroid-stimulating hormone).

5. Vitamin B12.

6. Vitamin D3.

7. Calcium.

8. Magnesium.

Revert with above-mentioned information for better understanding and further judgement.


Differential diagnosis

1. Anxiety induced twitching.

2. Benign fasciculation syndrome.

3. Cramp-fasciculation syndrome.

4. Motor neuron disease.

Patient's Query

Hello doctor,

I do not have any muscle weakness. I do strength tests multiple times a day and have had twitching all over my body for the last years. I have health anxiety. Sometimes, I get some muscle cramps. I am considering to see a doctor soon.

Answered by Dr. Hitesh Kumar


Welcome back to icliniq.com.

If there is no muscle weakness and no thinning of muscles in any part for the last four years, it seems less likely to be amyotrophic lateral sclerosis. The chances are more that it can be benign fasciculations or it can be anxiety induced. Still, I would suggest consulting a neurologist for detailed physical examination and investigations to rule out a few things. Also, I advise you to get a psychiatrist consultation to address the anxiety issue.

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

Dr. Hitesh Kumar
Dr. Hitesh Kumar


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