Strange Contraction Twitching

[Jz1872]

Hi, thank you whoever takes the time to read this- sorry I think I have another thread but I am unable to access it. My symptoms are a bit indifferent and I am struggling to find a diagnosis of what they are.

I do suffer from twitches body wide- in almost every muscle but my twitches are strange, they only occur when I flex/tense/contract the muscles, not at rest- once it starts in a muscle some over 2.6 years ago they haven’t subsided at all and it has progressed into new muscles- one that is really concerning me now is if I flex my forearm the exact same spot keeps twitching over and over again and has been ongoing for a while now/ it’s like it rapid contracts down then starts to twitch non stop till back in a relaxed way- in the other muscles like my nose if I scrunch it- the full area quivers or if I tense my quads you can see the full muscle twitch and ripple. I don’t know if anyone has any details if this has been heard of before.

My emg recently showed increased insertional activity in a lot of muscles not nothing else but my first one showed fibs and psw and crd in a couple but the second one was better apparently.

I do have some small dents in many muscles but as I’ve read here before the dents haven’t grown and they are just dents I think which is normal.

This constant contraction twitching is definitely concerning me and I don’t know if anyone has any idea surrounding this but i appreciate the time taken to read

 

[ShiftKicker]

Hi there-

What is the summary/conclusion from your most recent report? What did the neurologist say?

 

[Jz1872]

I am had a clinical today which was ok but the twitching pattern is a bit stumping me and everyone- was told some sort hyper excitability but no one has a clue right now, my neurologist said increased insertion activity isn’t a bad finding on emg and is ok ? I don’t really know much but any idea if you have ever heard of this twitching pattern before ? It just is continuous in every muscle on tension never subsiding, I guess with these small indentions i am finding it is hard to understand the scenario but they don’t believe it is MND, was more curious if this pattern has ever been seen before ? Also if I twitch in the exact same spot on tension over and over and over again is that a concerning issue/ but all only happens under flexion or tension

 

[lgelb]

Increased insertional activity with no other abnormalities on EMG isn't a concern for ALS. It can mean that nerves are unusually jumpy. Twitching "on demand" as you describe fits as well.

Widespread twitching argues strongly against ALS, because ALS cannot show up everywhere all at once.

 

[Jz1872]

Appreciate the reply, is their much knowledge surrounding these twitches- all it takes is voluntary contraction to create involuntary movement pretty much all over- one of two spots worry me more because it is just the same area that twitches over and over again- for example my forearm where a small area on flexion just twitches and it never moves and some you can see the full muscle ripple- only during tension/contraction however. Emg also showed some +1 and +2 (slow) fascicultions always wondered what does the slow mean and is it significant at all.

Many thanks

 

[lgelb]

Fasciculations that are seen on the EMG are not the same as whatever you may see or feel. There is no point in comparing them.

No, fascics on EMG are not notable for how slow or fast they are in themselves, but for whatever they add or don't to all the values, the total picture.

There are many ways to try to manage the cascade, from better sleep to hydration, certain kinds of bodywork, a shift in your diet, a drop of Mg lotion. A PT or physical rehab physician (physiatrist) may have more ideas by watching the process directly.

When a muscle gets over-activated, it's like a headache -- there are general approaches but many different kinds of headaches, too. I certainly wouldn't try to evoke the twitching, which is like hitting your head while it hurts, nor watching your muscles ripple. There are much better ways to spend your time, surely, now that you know ALS is not in the picture.

There are various hyperexcitability syndromes that I would imagine are being considered, and some do merit treatment, so it's good you're getting looked at. But keep in mind that even as they may progress into more muscles, that does not mean that they are more likely to keep you from normal activities.

 

[Jz1872]

Thank you, last question if that’s possible- these contraction twitches are they ever seen in als or not ? There is so little information on this anywhere regarding their appearance

 

[ShiftKicker]

Hi there-

You're really getting into the weeds with regards quality of twitches and what they might mean, which, frankly, is coming across as an unhealthy fixation on ALS despite being cleared by knowledgeable medical professionals. Twitching is like coughing, it could mean anything- from throat irritation to anxiety to something deeper in the lung. It's the accompanying symptoms that provide a more complete story.

Please consider not continuing your search for reasons why your twitching means a terminal disease (despite being cleared) and start taking the advice you've received from lgelb about how to mitigate.