Muscle Twitches

While muscle twitches may occur with other symptoms, they are usually isolated events that do not have other symptoms. Sometimes, muscle twitches may accompany other symptoms, which vary depending on the underlying disease, disorder or condition. Symptoms may involve other body systems.

Everyday muscle twitches may accompany other symptoms affecting the muscles including:

• Body aches

• Fatigue

• Muscle cramps

Other symptoms with muscle twitches include:

• Anxiety

• Headache

• Increased arm or finger numbness or tingling while typing or writing

• Irritability in children

• Nausea with or without vomiting

• Tingling or other unusual sensations

• Weakness 

Although muscle twitches themselves are not serious, in some cases they may be a symptom of a life-threatening condition. Seek immediate medical care (call 911) for any of these life-threatening symptoms including:

• Absent or diminished pulses

• Change in level of consciousness or alertness, such as passing out or unresponsiveness

• Change in mental status or sudden behavior change, such as confusion, delirium, lethargy, hallucinations and delusions

• Difficulty with memory, thinking, comprehension, writing or reading

• High fever 

• Loss of muscle coordination

• Paralysis or inability to move a body part

• Seizures

• Severe headache

• Slurred or garbled speech or inability to speak

• Sudden change in vision, loss of vision, or eye pain

• Vomiting

There are many possible causes of muscle twitches, which vary greatly in severity. The location and duration of the twitch depends on the underlying cause.

Minor and short-lived twitches may be the result of exercise or caffeine consumption. Long-term muscle twitches may be due to a neurological condition. In some cases, muscle twitches may be the result of a serious condition, such as a traumatic brain injury or brain tumor.

Common events and lifestyle habits can cause muscle twitches including:

• Anxiety

• Dehydration (loss of body fluids and electrolytes, which can be life-threatening when severe and untreated)

• Exercise

• Lack of sleep

• Stress

• Vitamin deficiencies

Certain medications or drugs can cause or increase muscle twitches including:

• Amphetamines

• Asthma bronchodilators, such as albuterol

• Caffeine

• Decongestants, such as pseudoephedrine (Sudafed, others)

• Stimulant drugs for ADHD, such as methylphenidate (Ritalin)

Conditions affecting the nervous system can cause muscle twitches including:

• Amyotrophic lateral sclerosis (ALS)

• Brachial plexus injury (injury to the bundle of nerves that transmit signals from the spine to the shoulder, arm and hand)

• Damage to the nerve that supplies a muscle

• Multiple sclerosis (disease that affects the brain and spinal cord causing weakness, coordination, balance difficulties, and other problems)

• Muscular dystrophy (inherited disorder that causes a progressive loss of muscle tissue and muscle weakness)

• Myasthenia gravis (autoimmune neuromuscular disorder that causes muscle weakness)

• Nerve entrapment or compression, such as of the ulnar nerve in the arm

• Parkinson’s disease (brain disorder that impairs movement and coordination)

• Tourette’s syndrome (neurological disorder characterized by tics and vocal outbursts)

Muscle twitches may also be caused by:

• Benzodiazepine withdrawal

• Kidney disease, such as kidney stones, kidney failure, and kidney anomalies

• Metabolic and hormone disorders

• Transient tic disorder

In some cases, muscle twitches may be a symptom of a serious or life-threatening condition that should be evaluated immediately in an emergency setting. These include:

• Brain tumor

• Guillain-Barre syndrome (autoimmune-induced nerve disease)

• Stroke

• Transient ischemic attack (temporary stroke-like symptoms that may be a warning sign of an impending stroke)

• Trauma to the face, head or neck

• Traumatic brain injury

In most cases, muscle twitches are not serious and the problem resolves on its own. However, there are times when seeing a doctor is the safest option to diagnose underlying causes of muscle twitches.

Make an appointment to see your doctor for muscle twitches when:

• Twitching occurs in more than one area, such as muscle twitches in the legs and face, or affects several muscle groups, such as muscle twitches all over the body.

• Twitching is severe or persists for more than a couple of weeks.

• Weakness accompanies muscle twitching.

Call 911 or go to your nearest emergency room for muscle twitches when:

• You experience confusion, loss of coordination, paralysis, seizures or vomiting.

• You experience shortness of breath with leg or calf pain or with swelling in both legs.

• You have sudden changes in speech, vision, memory, thinking or comprehension.

• You have a high fever or severe headache.

To diagnose the cause of muscle twitches, your doctor will take a medical history, perform an exam, and possibly order testing. Questions your doctor may ask about muscle twitches include:

• Are you receiving hemodialysis?

• How long have you experienced muscle twitches?

• How severe are the twitches?

• Where are you having the twitches?

• Do you have muscle twitches in more than one location?

• Are the twitches constant or do they come and go? How long do they last?

• Do you have any other symptoms, such as weakness?

• What medications are you taking?

• What other medical conditions do you have?

During the physical exam, your doctor will likely test your reflexes and evaluate your nervous system. Your doctor may also test your muscle strength and overall musculoskeletal health. Depending on the results, testing may be necessary including:

• Blood tests to check your blood chemistry, electrolytes, and thyroid hormone levels

• Electromyography, which tests a muscle’s activity

• Imaging exams of the brain and spine, including CT (computed tomography) scans, and MRIs (magnetic resonance imaging)

• Nerve conduction study (NCS), which measures how well nerves carry impulses

It is not always possible to diagnose an underlying cause or condition. If the twitches persist and your provider is unable to determine a cause, seeking a second opinion may give you more information and answers.

It usually is not necessary to treat muscle twitches when there is no underlying medical cause. In most cases, the twitch will resolve within a few days with some self-care strategies. This includes getting rest, decreasing caffeine intake, staying hydrated, and reducing stress.

When a medical condition is responsible for muscle twitches, treating it may improve the problem. The specific treatment will depend on the underlying condition. If twitches are due to a tic that impairs quality of life, medications may help control them.

Generally, muscle twitches are naturally occurring events that may increase in frequency during times of stress or anxiety, but do not typically cause complications. However, muscle twitches can be a sign of more serious underlying conditions or diseases, some of which may be life-threatening. Because of this, failure to seek treatment can result in serious complications and permanent damage. Once the underlying cause is diagnosed, it is important to follow your treatment plan to reduce the risk of potential complications including:

• Brain damage

• Disability or difficulty performing daily tasks

• Impaired balance and coordination

• Loss of vision and blindness

• Neurological problems, such as memory loss, confusion, and encephalitis

• Paralysis or loss of strength

• Permanent loss of sensation or chronic pain