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What causes muscle twitching in body and face?

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Internal Medicine Specialist
Practicing since : 1980
Answered : 1357 Questions
Hi - I am planning to book an appointment with my physician tomorrow but am extremely scared about a developing condition. Trying to be succinct; I am 40 years old, non-smoker, moderate drinker (bottle of wine per week max) and have had a left facial twitch / spasm for a number of year (6 maybe?) - I have a deep set phobia of dentists and the facial twitch started with a cracked wisdom tooth and cyst that followed. I linked the two as they felt linked and I know nerves run along the lower jaw line. I stupidly left both the dentistry and twitch / spasm undiagnosed and untreated. However, of recent weeks I have felt small twinges / XXXXXXX twitches in my right eyelid, calf muscles (often feels like tiny bubbles), palms of my hands, buttocks and forearms. None of these are visible (except the original facial twitch) but they drove me to the dentist this afternoon who said the twitches are almost certainly unrelated (this burst my hope bubble!!). I have a wife, 3 small children and a business and are really scared now as my mum has PCP (progressive supranuclear palsy, diagnosed incorrectly as Parkinson's at the start) but with no treatment or cure) and my dad died from skin cancer that spread to lungs and brain, his brother had throat cancer (but has recovered) and his mother died of ovarian cancer. My father also had type two diabetes. My father died 18 months ago at which point I started nightly exercise and dieting to reduce from the 118KG I was then, to 77KG that I reached in July 2013. Since then I have moderated my lifestyle, reduced the exercise but retained the healthier diet and have maintained my weight between 75KG and 80KG (have no issue with gaining weight if I let my diet loose!). I have no other symptoms that I can determine, no lumps, bumps, speech issues, headaches, blood in urine, stools, depression, etc. I know I need to go through a proper diagnoses and will, but good / or bad I just need some idea now of the most likely causes / prognosis given the above - please help!
Posted Tue, 11 Feb 2014 in Brain and Spine
Answered by Dr. Rakesh Karanwal 2 hours later
Brief Answer: Seek a direct appointment with a Neurologist Detailed Answer: Hi there, Thanks for your query. It is difficult to reach to a conclusion, given the fact that your only symptom is gradually progressive generalized twitches. More information such as, any abnormality of sensations, generalized muscular pain, fatigue, dizziness, change in handwriting, difficulty in kneeling/climbing or descending stairs, muscle cramps, stiffness of muscles etc. However, the following possibilities come to the mind :- 1. Chronic Inflammatory Demyelinating Polyradiculopathy (CIDP) : It is a chronically progressive disorder involving nerves, spine and lower part of brain (brainstem). It causes abnormality of sensations (such as tingling and numbness of hands and feet/lower legs) and muscle weakness. Majority of the cases improve with specific treatment, though the symptoms may progress gradually. 2. Motor Neuron Disease (MND), particularly Amyotrophic Lateral Sclerosis(ALS):- is a progressive degeneration of nerves supplying the muscles, leading to twitches, cramps, weakness of muscles. However, the sensations are not involved. 3. Polymyositis :- is a gradually progressive disease of muscles, leading to weakness of different muscles. Twitches, weakness of muscles around the pelvis or shoulder joints are the initial manifestations. No further comments can be offered on the basis of sketchy information. It is therefore recommended that you DIRECTLY seek an appointment with a Neurologist, who will examine you thoroughly, advise relevant investigations, and- based on the tests' reports- will you of the best course of action / management. Hope I have addressed to your concerns to your complete satisfaction and you find my response helpful and informative. I will be happy to answer further queries, if any. Fond regards and have a nice day, Col (Dr.) Rakesh Karanwal
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Follow-up: What causes muscle twitching in body and face? 1 hour later
Hi, I intend to do as you suggest ASAP. However I can confirm that I have experienced no pain, no weakness, no numbing and no muscle wastage. In fact aside from the twitches / spasms I have not experienced any of the symptoms you mentioned. Does this inform your opinion at all, or indeed suggest a condition with a better or worse prognosis? It will likely take a week or more to get a referral and appointment arrange with a consultant so any guidance will help prepare me for the worst or reduce my anxieties given the age of my family and their dependence on me. Thank you for you help, it is much appreciated. XXXXXXX
Answered by Dr. Rakesh Karanwal 9 hours later
Brief Answer: Low Blood Calcium is an additional possibility Detailed Answer: Hi Mr. XXXXXXX Nice hearing back from you. Thanks for the invaluable input, which tips the balance slightly in favor of CIDP or MND. Your condition is in its very early stage. All possibilities mentioned above, start with twitches. There being no other symptoms, as confirmed by you, a thorough Neurological examination by the Neurologist, aided by several tests, will help identifying the exact cause. I am afraid that the prognosis is different for each possibility given above. The other possibility is intermittent low Calcium in the blood, which can easily be treated with calcium + Vitamin D supplements. Please relax, as anxiety or worry is NOT the solution. I can fully understand the mental agony you are passing through. I would love to follow your case and render helpful advice as and when required. Take care, Col (Dr.) Rakesh Karanwal
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