What causes muscle spasms and twitching in body?

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Posted on Sat, 27 Sep 2014 in Brain and Spine
Question: Hi there. I am currently experiencing some unusual and frustrating symptoms.

I will first mention I have been to two nuerologist about 4-5 times since XXXXXXX and was always told no ALS.

I also had an EMG on August 6th (needle part was left arm and leg only) and it was clean.

I am still experiencing some frightening symptoms, and want to put my mind to ease. I have had every blood test done and ALL vitamin levels are normal. No thyroid issues and no lime disease.

My symptoms started in my right arm with just a little discomfort and twicthing, to now full on spasms, jerks and twitching throughout body.

I noticed when I lay down on my back, the symptoms get worse, which have made sleeping very difficult. I currently have most of the symptoms on right side. My right arm feels shaky and weak, also my right calf gets tight a lot and so does my foot and I feel right foot pain and discomfort as well.

I do get twitching and spasms on left arm, leg, and chest, but not as bad as the right. I sometimes even get twiches on face in the same spot and on abdomen. Sometimes I feel my tongue is twitching a lot, but the I look at it and I don't see much.

Also, I experience stiffness in right hand and palm and I feel fast twitching between thumb and index finger (I don't drink caffeine, so have ruled that out).

My neck also feels quite stiff throughout the day and I've been experiencing back pain that is predominately on the upper left part of back, but will move around whole back sometimes.

When this happens, sometimes I start to get pain in both forearms and legs. I have a lot of muscle fatigue as well.

I will mention I am taking one dose of diamox a day, celexa and propanolol (but my Neuro doesn't think that's the cause of my symptoms) I also had a brain mri and spinal tap and both were fine.

I am just trying to get an idea of what could be going on and hope it's not too serious. Thank you!
doctor
Answered by Dr. Dariush Saghafi 3 hours later
Brief Answer:
Persisting Symptoms without slowing down?

Detailed Answer:
Hi Ms. XXXXXXX We met the last time around on this network.....I'm baaaack! LOL.....sooooo, looks like things haven't slowed down a whole lot since we last talked or typed.

Well, let's quickly review things......#1- NO ALS. If I had a big button that you could wear then, that's what it would say. #2- the symptom complex you are referring to is inconsistent (along with your age; negative EMG/NCV- BTW, you should know that when one side gets a needle exam for ruling out a diagnosis such as ALS....it is not necessary to do the other side). Didn't know if you realized that fact or not but some people don't think they've had a complete study unless their whole body gets stuck like a pin cushion. You're HAPPY for that little detail, are you not?

Looking at the information in a different perspective we've got the following:

0. 25 year old female, no prior history of neurological disease and no family history of ALS or other neurodegenerative, musculoskeletal, or spinal cord diseases (Am I correct in this?)
1.EMG/NCV- Negative for electrical evidence for ALS
2. neurological examinations by 2 neurologists- Negative for evidence of upper and lower motor neuron signs
3. Imaging studies and labs- Unrevealing with regard to any evidence for inflammatory or neurodegenerative types of problems.
4. MRI is positive for Idiopathic Intracranial Hypertension.
5. Symptomatology inconsistent with most common presentation facets of ALS which would be large amounts of weight loss over short period of time, muscle mass decreases and weakness (often in the legs first to the point of stumbling, tripping, or falling).

Therefore, in my opinion ALS cannot reasonably be made part of the differential in your case. That's not to say that something is not happening. Rather, ALS is not behind any of it.

You say that your doctor doesn't believe medications could be causing the symptoms and that is entirely possible because I'm sure that your right arm (which is where you say everything began) was feeling things long before you were put on diamox, correct? Nevertheless, diamox does cause some patients to have nasty cramping, twitching, and jerking sensations. Remember, it causes loss of fluids in a very aggressive way from within the brain itself. If you ask your doctor to explain the actual pharmacology behind the medication and how it works to lower intracranial hypertension, you'll understand what I mean. Therefore, although I'm convinced that while Diamox didn't start all the symptoms, I remain entirely unconvinced that it couldn't be at least exacerbating SOME of your symptoms.

But that would be a discussion you'd need to have with your treating neurologist in terms of how to determine for sure whether or not either the diamox or the celexa were at issue with any of these additional symptoms of cramping, twitching, etc. I doubt the propranolol has much to do with any of the symptoms right now so I'm not too concerned about that particular drug.

Back and neck pain as well as muscle spasms and twitching are more unusual symptoms of IIH but have been reported. Is it possible these are part of the bigger picture?

Well, I need to get to the hospital right now but if you would like to send back some information. Do you have the brain scan (MRI). Would love to see the scan for which the IIH was diagnosed if you could get it. Also, don't forget that I am on webcam status tonight at 3a-6a (ET) and every night for that night (Wed-Sat) and Sundays from 11p-3a (ET). If you wanted to contact me for a teleconference I'd be happy to TAKE A PHYSICAL PEEK at you as well. Maybe we can SEE some of this twitching or limb movement you're describing....or cramping. You can find me on that network at www.healthtap.com/drsaghafi

Otherwise, if these thoughts have helped you feel about the fact that I wholeheartedly believe in my heart of hearts that you DO NOT HAVE ALS then, your written feedback is greatly appreciated with a STAR RATING. I get more peanuts when the network sees I'm making people happy! HAHA!

Also, if you have no further questions or comments then, CLOSING THE QUERY on your end will allow the network people to process, archive, and credit this case properly and for future reference.

Hope to be chatting again soon......and all the best to you!

This query required 54 minutes of review, research, and documentation for final draft envoy.





Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Dariush Saghafi 30 minutes later
Thank you Dr. for getting back to me. I will say my symptoms haven't necessarily gotten worse since I last spoke to you, but haven't gotten better within these last 3-4 weeks.

The twitching between my thumb and index finger is the newest symptom I can think of along with the back pain (have been experiencing this for a week now) but, I did just recently cut down on my Diamox intake (it used to be twice a day) but haven't noticed much of an improvement with symptoms.

I guess I'm just concerned, because when I had my first EMG, I didn't have as many symptoms as I am having now..

Also, these twitches you can't always see. The one between my thumb and index finger, feels very fast, but also feels it's deep within the skin, if that makes sense.

The other twitches come and go very quickly. You can see the skin bounce up and down, but that's it. Also with the muscle jerks I have, they are very quick.

Also, I should add, I did lose a significant amount of weight 5 years ago. I lost around 80lbs and then I gained about 100 back within in about a year and a half - to two years after that. That's why they think I got the pseudotumor.

Could the extra weight be the predominant issue right now and be putting pressure on my spinal cord? I didn't know if that was a possibility. I am currently about 90-100 lbs overweight at this time. I have been this way for awhile and now just experiencing these symptoms this year.

I was wondering if that could be causing spinal issues, since I haven't had an MRI on back.

Unfortunately I am unable to locate my head and neck MRI at this time, but they only found a 1mm protrusion in the c5/c6 area I believe and then some fluid when doing the head MRI that they suspected to be caused by sinisitus and then later to find out it also could have been connected to the CSF.

Thank you for your time.
doctor
Answered by Dr. Dariush Saghafi 12 hours later
Brief Answer:
Twitch and Shout!

Detailed Answer:
Sounds like a song for a movie no?

You sure you don't want to do a teleconference? I'm on tonight from 3-6a tonight (ET). Where you at?

At any rate, here are some responses to your comments and questions:

1. Diamox is the type of medication which still causes side effects at the same level practically whether you are taking the pill 1, 2, or more times a day. So the fact, you've pulled back and haven't noticed a difference doesn't prove that it's not responsible for some or even a major portion of some of the symptoms.

2. Have your doctors said anything about the entity Benign Fasciculation Syndrome (BFS)?

3. So there is no imaging study of the head to really support the IIH (or pseudotumor?). I understand that the opening pressure was elevated at 35 but usually a diagnosis of PTC is done with an MRI of the brain.

4. If your BMI is above 35 (and it certainly sounds like it is) then, it is true that the obesity itself IS CAUSING a lot of pressure in the back and certainly spinal nerve compression would not be impossible to believe in this setting. So YES, the increase in your weight may be very related to symptoms you are describing in the back which prevent from sleeping comfortably.

However, MRI of the spinal cord and column itself may not be absolutely necessary at this time. Anyways, if we are looking for skeletal and disc abnormalities a CT scan with contrast may do just as well.

5. 1 mm. disc protrusion is clinically insignificant so there's nothing there to explain your systems.

6. Still no ALS showing up on my radar screen from what you've added.

As always young lady.....if you think the information I've provided you is useful would you do me a grand favor but sending a written piece of feedback along with a STAR RATING and also consider CLOSING THE QUERY so that it may be processed, archived, and credited properly.

BTW, many thanks for your last feedback comments.....I wish I could wave a magic wand and have both a diagnosis and a cure all in one fell swoop.

This query required 24 min. physician specific time for review, research, and final draft compilation for envoy.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Dariush Saghafi 6 hours later
Hi Dr. It might be best to do a teleconference, so I can show you where I'm having the most trouble. I live in XXXXXXX The Sunday schedule might work best for me.

Regarding the Diamox, can that be a type of medication that my body never adjusts to? I ask, because I've been on it for about three months now and didn't start noticing the more "major" symptoms until about a month ago.

Also, like you had mentioned in a previous post, most of the more minor twitching began, a few days before I even started to take the Diamox and Celexa.

I am just becoming very annoyed with these symptoms haha!

My neurologist on my last visit, finally and for the first time, brought up the possibility of it being BFS. I just got worried, since I had read Internet stories where people thought it was that, later to find out it was worse (I know not to go on the Internet now, looking up symptoms!)

When I got the brain MRI done, they did see some fluid. At the time they weren't sure about the causes. When I went to go see my eye Dr. a few weeks later, that is when they noticed pressure behind my optic nerve on right side, which then led to the diagnoses of PTC by my Neuro opthomologist.

Also, I ask about the weight, because like I said in the previous post, I noticed my back has a lot of twitching and spasms (also my neck sometimes) throughout the day and it's gets worse when I lay down and put pressure on it.

Also one more question, is it possible the stiffness/pain I feel in my right foot and the knee/calf pain and tightness I get in right leg, more due to weight then something more serious? I didn't know if there was a possibility of developing drop foot slowly.

Thank you for your time!










doctor
Answered by Dr. Dariush Saghafi 9 hours later
Brief Answer:
Diamox does not get adapted to by body.

Detailed Answer:
Thanks for your return message. I look forward to us chatting by WebCam if possible on Sunday evening. You can catch me from 11 PM until 3 AM.

I will share with you a cute little poem regarding BFS once I see you on WebCam Sunday night. But essentially that is a diagnosis of interest in my opinion but it is slightly confiunded by your presumptive pseudotumor cerebri condition as well.

I do not believe that ALS needs to be under concern anymore and looking for other reasons and other explanations is the way to go. The drug Diamox will cause cramping and muscle aching as well as twitching for as long as you take it. The body does not adapt to it mainly because of the fact it is a very potent diuretic which actually dehydrates the Brain in a very aggressive way.

However, it is considered one of the mainstays of treatment for pseudotumor cerebri. it would be great if you could at least get some sort of report from your last MRI of the brain if you had one in the past just to see if they made the call of pseudotumor cerebri although your opening pressure of 35 is certainly suggestive.

At this point since the plan will be to continue our conversation on Sunday evening I hope it's okay to leave the discussion as is and so I'd appreciate it if you could simply provide your usual form of feedback with a star rating and close the query so that the network can properly process and credit The efforts.

I look forward to meeting you on Sunday evening and hope the rest of the week goes well for you.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Dariush Saghafi

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Practicing since :1988

Answered : 2380 Questions

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