Brief overview
- Causes of muscle twitching: e.g. stress, mineral deficiency, stimulants (like caffeine), various diseases like ALS, Parkinson or diabetes mellitus
- When is muscle twitching dangerous? When it is a symptom of a serious disease. This may be indicated by the fact that it does not occur only sporadically.
- What can be done against muscle twitching? In the case of harmless muscle twitching, you can try to eliminate the cause (e.g. reduce stress, eat a balanced diet, do not consume too much caffeine and alcohol). If underlying diseases are the cause, the doctor will initiate a suitable therapy (e.g. with medication).
- When to see a doctor? If the muscle twitching occurs more frequently and/or accompanies painful muscle spasms (such as in epilepsy).
- Diagnosis: patient interview, physical and neurological examinations (ENG, EEG, EMG), if necessary further examinations such as imaging procedures (such as computer tomography, magnetic resonance imaging) or analysis of a tissue sample (biopsy)
Muscle twitching: causes and possible diseases
But there is not always a disease behind the twitching. Fasciculations, i.e. muscle twitching that is only perceptible as a fine tremor under the skin, are often harmless. For example, 70 percent of the population have so-called twitching to fall asleep, which is completely harmless from a medical point of view. Sometimes a temporary nerve irritation is hidden behind the symptom.
In some cases, the muscle twitching can be intensified or activated by voluntary movements, in which case it is referred to as action myoclonus. In other cases, external stimuli such as touch, light, or sound trigger twitching of the muscles (reflex myoclonus).
Diseases that trigger muscle twitching
- Tics, Tourette’s syndrome
- Epilepsy
- Febrile convulsions
- Multiple Sclerosis (MS)
- Amyotrophic lateral sclerosis (ALS)
- Parkinson’s disease
- Creutzfeldt-Jakob disease
- Wilson’s disease
- Diabetes mellitus
- Brain inflammation or cerebral hemorrhage
- Circulatory disorders, viral diseases and bacterial infections
- Orthopedic diseases with nerve irritation
- Restless Legs Syndrome: A neurological disorder in which sensory disturbances and involuntary movements of the legs and, less commonly, the arms occur, especially at rest.
Other factors that trigger muscle twitching
- emotional imbalance, for example, lovesickness
- stress
- stimulating substances such as caffeine
- Alcohol and drugs
- cold and hypothermia
- Magnesium deficiency
- hypoglycemia
- pinching of nerves
- Side effects of medications
- direct nerve irritation after examinations (e.g. cerebrospinal fluid examination)
In most cases, muscle twitching progresses without pain. However, painful muscle spasms may accompany it. Pronounced muscle twitching severely restricts affected persons in everyday life, because purposeful movements such as eating, drinking or writing become more difficult. The twitching often intensifies in stressful situations, so that patients are stigmatized as “nervous” or “insecure”.
Muscle twitching – dangerous or harmless?
Much more rarely, serious diseases cause muscle twitching. A sign of this can be when the twitching occurs more frequently. For example, muscle tremor at rest (resting tremor) is typically observed in Parkinson’s patients. Metabolic diseases such as diabetes mellitus can also manifest themselves through muscle twitching – as can amyotrophic lateral sclerosis (ALS). In such cases, the muscle twitches or the diseases behind them are to be classified as dangerous or at least serious.
Muscle twitching: What can be done about it?
In the case of harmless muscle twitching, you can do a lot yourself to put a stop to the annoying symptom. If a disease comes into consideration as the cause of the twitching, medical examinations and usually treatment by a doctor are necessary.
Muscle twitching: What you can do yourself
- No stimulants: Muscle twitching can often also be avoided by staying away from caffeine, alcohol and stimulant drugs.
- Balanced diet: Sometimes a balanced diet can also help reduce muscle twitching. Pay particular attention to adequate magnesium intake if painful cramps occur in addition to muscle twitching. Larger amounts of the mineral are found, for example, in green vegetables such as spinach, broccoli, beans or peas, but also in cereals such as oatmeal, wheat bran or rice. For those who like fruit: bananas contain a relatively large amount of magnesium.
Before taking magnesium tablets for muscle twitching, check with your doctor.
Muscle twitching: What the doctor does
Depending on the condition underlying the muscle twitch, the doctor may recommend various therapeutic measures – often in addition to the self-help measures mentioned above.
Medication
Often underlying conditions can be treated with medication, for example:
- Tics and Tourette’s: So-called neuroleptics – active substances that dampen the functions of the central nervous system – can help.
- Essential tremor: It can often be relieved with beta blockers or anticonvulsants.
Sometimes muscle twitching is a side effect of certain medications. In this case, you should discuss with your doctor whether you need to continue taking the medication in question or whether it can possibly be discontinued or replaced with a better-tolerated preparation.
Occupational and physical therapy
If the muscle twitching is due to amyotrophic lateral sclerosis (ALS), regular physiotherapy and occupational therapy are very useful. This can have a positive influence on the course of the progressive disease. However, ALS cannot be treated and cured causally – neither by physical and occupational therapy nor by other therapies.
Surgery
In some cases of disease-related muscle twitching, the doctor recommends surgery. For example, brain surgery can be useful for epileptics. This usually involves surgically removing a region of the brain that repeatedly triggers the epileptic seizures.
Surgery is also sometimes performed for essential tremor: In this disorder, a certain area of the brain sends a constant interfering signal. This area can be deactivated by means of surgery.
If the muscle twitching occurs more frequently, you should have a medical examination by a doctor to rule out a condition that requires treatment. A visit to the doctor is also indispensable in the case of violent myoclonia, i.e. violent muscle twitching, which may be accompanied by painful cramps.
Since muscle twitching is very often caused by diseases of the nerves, a neurologist is the right person to consult.
Muscle twitching: examinations and diagnosis
The first step is a detailed discussion between you and the doctor to obtain a medical history. The doctor will ask you, for example, when, how often, where and under what circumstances the muscle twitching occurs in your case and whether you have any other complaints (e.g. painful muscle cramps, fever, etc.).
Information about possible triggers for the twitching, such as an injury or a recent nerve exam, is also important. In addition, tell your doctor if and what medications you are taking and if you have any known pre-existing conditions (e.g., epilepsy or diabetes).
- Electroneurography (ENG): This uses electrodes to measure nerve conduction velocity.
- Electromyography (EMG): In this examination, the doctor uses electrodes to check the electrical activity in the muscle.
- Electroencephalography (EEG): Here the electrical activity of the brain is examined, also via electrodes.
Depending on the findings or the suspected cause of the muscle twitching, further examinations may be useful:
- Blood and urine tests
- Orthopedic examinations
- Imaging procedures such as X-rays, computer tomography (CT), magnetic resonance imaging (MRI)
- Removal of muscle tissue (biopsy) for more detailed examination in the laboratory
- Extraction of cerebrospinal fluid (CSF puncture) for a more detailed examination in the laboratory
- L-dopa test (for suspected Parkinson’s disease)
- Blood vessel examination (angiography)
- allergy tests
- psychological or psychiatric examinations
