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Had Tonsils And Adenoids Out. Started Twitching On Leg And Upper Body. What Is The Cause?

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Posted on Fri, 19 Oct 2012
Question: tonsillectomy my daughter had her tonsils and adenoids out yesterday. she now has some leg and upper body twitches. what is the cause?
she is on pain medication and antibiotics. history of febrile seizures.
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Answered by Dr. Sumit Bhatti (44 minutes later)
Hi,

Thank you for your query.

1. Twitching or Muscle Fasciculations are usually benign. However this is a diagnosis of exclusion.

2. I would recommend discussing with her physician to rule out the following:
a. Drug induced including intra-operative general anesthetic and current medication.
b. Metabolic such as changes in calcium, potassium and magnesium levels.
c. Neurological: Grisel's Syndrome. During the tonsilloadenoidectomy operation, the Rose's position is given. The head is hyper-extended on the neck and the neck is hyper-extended on the shoulder. This may cause a mild subluxation of the upper vertebral joints of the cervical spine. The ligaments holding the skull and spine together may also be weakened by the tonsil and adenoid disease. Sometimes aggressive blind curetting of the adenoids may also be a cause. Get Cervical spine X-rays and CT Scan done.
d. Exhaustion or weakness following surgery and medication may also be a cause.

3. Serious causes will have many other symptoms such as fever, neck stiffness, pain, non-resolving fasciculations and so on.

4. Kindly let me know the results of your investigations. This will help in suggesting further treatment.

I hope that I have answered your queries. If you have any further questions, I will be available to answer them.

Regards.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Sumit Bhatti

Otolaryngologist / ENT Specialist

Practicing since :1991

Answered : 2664 Questions

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Had Tonsils And Adenoids Out. Started Twitching On Leg And Upper Body. What Is The Cause?

Hi,

Thank you for your query.

1. Twitching or Muscle Fasciculations are usually benign. However this is a diagnosis of exclusion.

2. I would recommend discussing with her physician to rule out the following:
a. Drug induced including intra-operative general anesthetic and current medication.
b. Metabolic such as changes in calcium, potassium and magnesium levels.
c. Neurological: Grisel's Syndrome. During the tonsilloadenoidectomy operation, the Rose's position is given. The head is hyper-extended on the neck and the neck is hyper-extended on the shoulder. This may cause a mild subluxation of the upper vertebral joints of the cervical spine. The ligaments holding the skull and spine together may also be weakened by the tonsil and adenoid disease. Sometimes aggressive blind curetting of the adenoids may also be a cause. Get Cervical spine X-rays and CT Scan done.
d. Exhaustion or weakness following surgery and medication may also be a cause.

3. Serious causes will have many other symptoms such as fever, neck stiffness, pain, non-resolving fasciculations and so on.

4. Kindly let me know the results of your investigations. This will help in suggesting further treatment.

I hope that I have answered your queries. If you have any further questions, I will be available to answer them.

Regards.