Have Twitching All Over, Mostly In Legs, Feet And Arms. Blood Test Normal, Put On Bet Blocker. Suggest?
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
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)
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)
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 :)
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)