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Have twitching all over, mostly in legs, feet and arms. Blood test normal, put on bet blocker. Suggest?

DOCTOR OF THE MONTH - Nov 2013
Nov 2013
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Neurologist
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I am quite worried about odd twitching i have been having all over my body. Mostly in my legs and feet, and in my arms every once in awhile. I have had blood tests done and everything came back normal. The doctor put me on a beta blocker, which i don't quite understand why. I am worried about ALS after going to good ol Dr. Google, is there any thing you could tell me to ease my mind.
Posted Thu, 26 Sep 2013 in Brain and Spine
 
 
Answered by Dr. Sudhir Kumar 1 hour later
Brief Answer:
These are most likely benign fasciculations

Detailed Answer:
Hi,

Thank you for posting your query.

Muscle twitchings commonly occur in benign fasciculations syndrome (BFS). In this condition, the predominant finding is random muscle twitchings. Other features such as muscle wasting (thinning of muscles), weakness of muscles, and exaggerated deep tendon reflexes do not occur (these features occur in amyotrophic lateral sclerosis- ALS). Muscle twitchings in BFS would resolve on own with rest and reduction of anxiety.

Also, your age is unusual for ALS. It typically occurs in people above 50.

Also, if in doubt, an EMG can be done, and a normal EMG would definitely stop your anxiety.

Regarding beta blockers, sometimes, it is used to reduce anxiety and tremors.

I hope it helps. Please get back if you have any more queries.

Best wishes,
Dr Sudhir Kumar MD DM (Neurology) XXXXXXX Consultant Neurologist
Above answer was peer-reviewed by
 
Follow-up: Have twitching all over, mostly in legs, feet and arms. Blood test normal, put on bet blocker. Suggest? 1 hour later
Thank you for your reply :) What is the difference between a tremor and a fasiculation? Also, I would like to explain a little more about how I feel, I'm pretty sure its not ALS as well but something is definitely not quite right. With this BFS, can it cause numbness and tingling too? I get the twitching in both legs and it feel like popcorn popping right under my skin, but it also feel kind of numb from the outside of knee, down my leg, into my feet and toes. Also to be quite honest it fells like my ankles and turning inward and i'm walking oddly. Now with this comment I would also like to add that during an anxiety attack (which I have has alot of since last Novemeber) I have a tendency to rock my ackles back and forth or walk on my tip toes. In doing this so much could I have done something to my legs that could cause all of this twitching and numbness feelings. Just trying to search for a few more answers other BFS.
 
 
Answered by Dr. Sudhir Kumar 1 hour later
Brief Answer:
Detailed answers are below

Detailed Answer:
Thank you for getting back and providing more details.

Tremors are movements across a joint, such as shaking of hands or fingers, etc;whereas fasciculations are contractions within a muscle and there is no movement at a joint.

In BFS, tingling and numbness do not occur. So, with these additional symptoms, one extra possibility could be peripheral neuropathy, a disease of the nerves of legs and feet. It can be confirmed by nerve conduction studies. Common causes could be vitamin B 12 deficiency and thyroid disease at your age. Rocking movements could contribute to your symptoms.

Best wishes,
Dr Sudhir Kumar MD DM (Neurology)
Above answer was peer-reviewed by
 
Follow-up: Have twitching all over, mostly in legs, feet and arms. Blood test normal, put on bet blocker. Suggest? 3 hours later
Also, I forget a few other issues I have, I have horrible tension in my check, huge knots in my shoulders, and my hips are frequently out of place and I see a chiropractor every once in awhile but not as much as I should. The chiropactor did some sort of scan on me called an sEMG and my C2,C3, T1-T5, and my L3 columns are misaligned. Could any of this also add to my twitching and numbness? I'll also add I had a full neurological exam in the beginning of XXXXXXX when I had a massive headache and swore to the doctor I was going to die of an aneurysm ( which was all anxiety ). My B 12 and thyroid were also checked 2 weeks ago and they were all good. I'm sorry to continue this on and on, but ER doctors and walk in clinic doctors don't really take the time to sit and discuss everything with you and I really am not given the time to say every little thing that I want to. Do you have any other thoughts now?
 
 
Answered by Dr. Sudhir Kumar 1 hour later
Brief Answer:
Thank you for getting back

Detailed Answer:
I am pleased to hear from you again, and no, it is not annoying, it is my privilege if communicating with me and my replies make you feel better.

I agree you are a little anxious person, and some of these symptoms could be related to that.

Mis-aligned spine (as per the chiropractor) is not responsible for causing any of these symptoms. Yes, a little neck and back pain may occur due to that.

Normal neurological examination is a good news!

I would be pleased to hear from your again.

Best wishes,
Dr Sudhir Kumar MD DM (Neurology)
Above answer was peer-reviewed by
 
Follow-up: Have twitching all over, mostly in legs, feet and arms. Blood test normal, put on bet blocker. Suggest? 14 hours later
Hello again Dr. XXXXXXX

Yes, I am a VERY anxious person most of the time. I tend not to let on how bad my anxiety is to doctors right away as I fear they will overlook my symptoms and pass it off as anxiety. I worry about my my health constantly for some reason. Thank you for being so kind and taking the time to talk to me. Now with this peripheral neuropathy you mentioned, is it anything really serious? Am I able to just ask my doctor for an EMG? Also, I have to ask with your expertise, do see my symptoms as anything really serious or ominous. This constant worry about my twitching, numbness, pulsating feeling is exhausting. Anything you could tell me to calm my fears would be great. Again, thank you so much :)
 
 
Answered by Dr. Sudhir Kumar 2 hours later
Brief Answer:
Peripheral neuropathy is not serious

Detailed Answer:
Hi,

Thank you for getting back.

Peripheral neuropathy symptoms that you have are very mild and they do not suggest any serious illness.

You should be able to ask your neurologist for EMG and nerve conduction studies. This would prove or exclude any significant neurological disease.

I agree with your approach regarding not sharing your anxiety symptoms at the outset with your doctor.

In summary, I feel that your symptoms suggest a mild neurological problem, and there is no need to worry at present.

Best wishes,
Dr Sudhir Kumar MD DM (Neurology)
Above answer was peer-reviewed by
 
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