Overview
Fasciculations are involuntary contractions or twitching of small groups of muscles. They can appear in any skeletal muscle and are frequently muscle or nerve injury symptoms.
Stress, anxiety, exhaustion, drugs, and neurological conditions, including multiple sclerosis, amyotrophic lateral sclerosis (ALS), and peripheral neuropathy, are only a few causes of fasciculations. Fasciculations are often harmless and may go away on their own. But, if they continue or are mixed with additional symptoms like numbness, paralysis, or trouble speaking or swallowing, these would require a visit to the clinic.
Let us discuss the fasciculations in detail in this article and look into their different aspects.
What is Fasciculations?
Patients can quickly feel fasciculations, which are uncontrollable, quick muscular twitches that are too feeble to move a limb but can be observed or palpated. Most healthy people sometimes experience fasciculations, especially in the eyelid muscles.
How Fasciculations Occur?
Fasciculations occur when a single motor unit, consisting of a nerve cell and the muscle fibres it controls, fires spontaneously without brain stimulation. This can happen due to various factors, such as muscle fatigue, metabolic imbalances, or nerve damage.
Usually, the brain sends electrical signals to the motor units, which causes the muscle fibres to contract and produce movement. However, in the case of fasciculations, the nerve cell that controls the motor unit becomes overactive, making it more likely to fire spontaneously.
When this happens, the muscle fibres controlled by the affected motor unit contract briefly and then relax, causing the characteristic twitching or rippling movement under the skin. These contractions can be seen or felt and may occur in one muscle or several muscles throughout the body.
Importance of Recognizing Fasciculations
Fasciculations are observed in patients with neurogenic disorders and healthy individuals. Depending on the associated clinical symptoms and signs, they may signify the presence of various lower motor neuron disorders.
What Causes Muscle Twitching?
Muscle twitching, or fasciculations, can be caused by multiple factors. Here are some common causes:
Medical conditions causing Muscle Twitches
Neurological Disorders
These can cause muscle twitching due to the involvement of the nervous system in muscle control. The nervous system communicates with the muscles through electrical signals that travel through nerves. Muscle twitching or fasciculations may result from neurological illnesses that injure or impair the nerves or parts of the brain that control muscle movements.
For example, in ALS (amyotrophic lateral sclerosis), a neurodegenerative disorder that affects the motor neurons in human’s the brain and spinal cord, muscle twitching is often an early symptom of the disease. In multiple sclerosis, muscle twitching can be caused by nerve damage due to the inflammation and demyelination of nerve fibres.
Similarly, in Parkinson’s disease, which affects the dopaminergic neurons in the brain, muscle twitching or tremors can be a prominent symptom. Other neurological disorders such as peripheral neuropathy, Huntington’s disease, and spinal muscular atrophy can cause muscle twitching due to nerve damage or dysfunction.
Autoimmune Diseases
When the body’s immune system unintentionally attacks healthy tissues and organs, it can cause inflammation and damage, resulting in autoimmune illnesses. Muscle twitching or fasciculations can be a symptom of certain autoimmune diseases that affect the neuromuscular system. Here are some examples:
Myasthenia gravis
This autoimmune disorder affects communication between the nerves and muscles, leading to muscle weakness and fatigue. Muscle twitching or fasciculations can be an early symptom of myasthenia gravis.
Polymyositis
This inflammatory autoimmune disease affects the muscles, causing weakness, pain, and inflammation. Muscle twitching can also occur in some cases.
Dermatomyositis
This rare autoimmune disorder affects the skin and muscles, causing rash, muscle weakness, and inflammation. Muscle twitching can be a symptom of dermatomyositis.
Lupus
Systemic lupus erythematosus, an autoimmune condition, affects various organs and tissues, including the muscles (SLE). Muscle twitching, weakness, and pain may occur occasionally.
Medications causing fasciculations
Certain medications can cause muscle twitching as a side effect. Here are some examples:
Stimulants
Medications that stimulate the central nervous system, such as caffeine, amphetamines, and cocaine, can cause muscle twitching or fasciculations.
Antidepressants
Muscle twitching can occasionally occur as a side effect of tricyclic antidepressants (TCAs) and selective serotonin reuptake inhibitors (SSRIs).
Antipsychotics
Some antipsychotic medications, such as haloperidol and chlorpromazine, can cause muscle twitching or dystonia, a movement disorder characterized by sustained muscle contractions.
Antibiotics
Certain antibiotics, such as metronidazole and fluoroquinolones, can cause muscle twitching or fasciculations as a side effect.
Immunosuppressants
Corticosteroids and cyclosporine are immune-suppressing drugs that occasionally produce muscle twitching or myoclonus, an abrupt, involuntary muscular jerk.
Dehydration
It can cause muscle twitching or fasciculations because when the body is dehydrated, the electrolyte balance in the body can become disrupted. Electrolytes are minerals in the body, such as sodium, potassium, and magnesium, that help regulate the electrical activity in the muscles and nerves. Dehydration-related electrolyte imbalances can interfere with the proper operation of the muscles and nerves, causing muscular twitching.
Dehydration can also cause muscle fatigue and cramps, further contributing to muscle twitching. In addition, when the body is dehydrated, it can produce more stress hormones, such as cortisol, which can increase muscle tension and lead to muscle twitching.
Consult with our doctors If muscle twitching persists despite hydration.
Muscle Overuse
Muscle overuse can cause muscle twitching or fasciculations due to fatigue and muscle strain. When a muscle is overused or exhausted, it can cause tiny muscle fibres to contract involuntarily, leading to muscle twitching.
Muscle overuse can occur for various reasons, such as excessive exercise, repetitive movements, or prolonged sitting or standing in the same position. It can also occur due to specific occupations or hobbies that involve repetitive motions or prolonged muscle use, such as playing a musical instrument or typing on a computer.
Muscle twitching due to overuse is usually harmless and temporary, and it can often be relieved with rest and stretching. However, suppose the muscle twitching persists or is accompanied by other symptoms such as weakness, pain, or swelling. In that case, it may be a sign of an underlying injury or condition and should be evaluated by a medical professional.
Electrolyte Imbalances
Electrolyte imbalances can cause muscle twitching or fasciculations because electrolytes, such as sodium, potassium, calcium, and magnesium, play a crucial role in the normal functioning of muscles and nerves. An imbalance of electrolytes in the body can affect the electrical impulses that control muscle contraction and relaxation, leading to muscle twitching.
For example, low potassium levels, an essential electrolyte for proper muscle function, can cause muscle weakness and twitching. Low calcium levels can also cause muscle twitching, as calcium is necessary for the right nerve and muscle function.
Electrolyte imbalances can occur for various reasons, such as excessive sweating, vomiting, diarrhea, or certain medications. In addition, certain medical conditions, such as kidney disease, liver disease, or hormonal imbalances, can also affect electrolyte levels in the body.
Stress and Anxiety
Stress and anxiety can cause muscle twitching or fasciculations due to their effects on the body’s nervous system. When stressed or anxious, people produce stress hormones such as cortisol and adrenaline, increasing muscle tension and twitching.
Stress and anxiety can also lead to changes in breathing patterns, which can affect the oxygen supply to the muscles and cause them to twitch. Additionally, stress and anxiety can lead to poor sleep quality, contributing to muscle fatigue and further exacerbating muscle twitching.
What are the Symptoms of Fasciculations?
Fasciculations are involuntary muscle contractions or twitching occurring anywhere in the body. The spontaneous discharge of a single motor unit in a muscle fibre usually causes them. Fasciculations can be a normal phenomenon and a sign of an underlying neurological condition. The symptoms of fasciculations can vary depending on the cause and location of the muscle twitching.
Some common symptoms of fasciculations include:
- Visible muscle twitching or jerking
- The feeling of muscle twitching or twitching sensation
- Muscle weakness or fatigue
- Muscle cramps
- Numbness or tingling sensations
- Loss of coordination or balance
- Muscle stiffness or rigidity
- Pain or discomfort in the affected muscle or surrounding area
- Difficulty performing delicate motor tasks
- Difficulty swallowing (in cases of fasciculations affecting the throat or tongue muscles)
Duration of Fasciculations
The duration can vary depending on the underlying cause and other factors. In some cases, fasciculations may last only a few seconds or minutes and then resolve independently. In other cases, they may persist for hours, days, or even longer.
Transient fasciculations, not associated with any underlying condition, may last only a few seconds or minutes and may not recur. These types of fasciculations are usually harmless and do not require any treatment.
However, suppose an underlying neurological condition causes the fasciculations. In that case, they may persist for extended periods and may be associated with other symptoms such as muscle weakness, cramps, or numbness. The duration of fasciculations in these cases will depend on the severity and progression of the underlying condition.
Distribution of Fasciculations
The distribution can vary depending on the underlying cause and other factors. Fasciculations can occur in any muscle group in the body, including the arms, legs, face, and torso.
Unrelated to any underlying condition, transient fasciculations may occur in isolated muscle groups or be widespread but intermittent. These types of fasciculations are usually harmless and do not require any treatment.
However, if an underlying neurological condition causes the fasciculations, they may be localized to specific muscle groups or widespread and involve multiple muscle groups. The distribution of fasciculations in these cases will depend on the particular neurological condition and other factors, such as the location and severity of nerve damage.
It’s important to note that stress, fatigue, caffeine, or certain medications can also trigger or worsen fasciculations. In these cases, the distribution of fasciculations may be related to specific triggering factors.
How to Diagnose Fasciculations?
Diagnosis of fasciculations can be challenging, as they can be a normal phenomenon or a symptom of a wide range of medical conditions. Here are some of the steps that may be taken to diagnose fasciculations:
Medical History and Physical Examination
Medical history is an essential aspect of diagnosing fasciculations. Your symptoms, medical history, and any prescription drugs or dietary supplements you may take will be discussed with your doctor. Here are some of the questions that may be asked during your medical history:
- When did you first notice the fasciculations?
- How often do the fasciculations occur?
- Do the fasciculations occur in specific muscle groups, or are they widespread?
- Are the fasciculations associated with other symptoms, such as weakness, numbness, or pain?
- Do you currently use any new drugs or supplements?
- Have you been exposed to any toxins or chemicals?
- Have you recently travelled to an area where certain infections are common?
- Do you have a family history of neurological conditions?
- Have you ever had any medical conditions that could be related to the fasciculations, such as thyroid disease, multiple sclerosis, or ALS?
- Do you have any other medical conditions or chronic illnesses?
Your doctor may also ask about your lifestyle habits, such as your diet, exercise routine, and stress levels, as these factors can sometimes contribute to the development of fasciculations.
A detailed and accurate medical history can help your doctor determine the underlying cause of your fasciculations and develop an appropriate treatment plan.
Physical examination is another important aspect of diagnosing fasciculations. During the physical examination, your doctor will assess your muscle strength, reflexes, and coordination. Here are some things that may be done during a physical examination for fasciculations:
Muscle strength testing
Your doctor will test the strength of your muscles by asking you to perform specific movements or resist pressure. This can help determine if the fasciculations are associated with muscle weakness.
Reflex testing
The doctor will test your reflexes using a reflex hammer to tap your tendons. This can help determine if the fasciculations are associated with abnormal reflexes.
Coordination testing
Your doctor may test your coordination by asking you to perform specific movements, such as touching your finger to your nose or walking heel-to-toe. This can help determine if the fasciculations are associated with coordination problems.
Observation of fasciculations
The doctor will observe the fasciculations to determine their distribution, frequency, and duration.
Sensory testing
The doctor may test your sensation by asking you to identify the location of the touch or pinprick. This can help determine if the fasciculations are associated with numbness or other sensory abnormalities.
Examination of other systems
The doctor may also perform a general physical analysis to assess other body systems, such as your cardiovascular or respiratory systems, to evaluate for other potential underlying conditions.
Blood Tests
Blood tests are commonly used to help diagnose fasciculations and evaluate for underlying medical conditions that can cause them. Here are some of the blood tests that may be ordered:
Electrolyte panel
An electrolyte panel measures the levels of different electrolytes in your blood, such as sodium, potassium, calcium, and magnesium. Abnormal levels of these electrolytes can cause muscle twitching or fasciculations.
Thyroid function tests
TFTs measure the levels of thyroid hormones in your blood. Abnormal levels of these hormones can cause muscle twitching or fasciculations.
The Creatine kinase (CK)
This test measures the CK level, an enzyme released into the blood when muscle tissue is damaged. Elevated levels of CK can indicate muscle damage or disease.
Complete blood count (CBC)
A CBC measures the levels of different blood cells in your blood, including white blood cells, red blood cells, and platelets. Abnormal levels of these cells can indicate an underlying medical condition.
Vitamin and mineral levels
Blood tests can also measure the levels of different vitamins and minerals in your blood, such as vitamin D, B12, and calcium. Deficiencies in these vitamins and minerals can cause muscle twitching or fasciculations.
Inflammatory markers
Your blood can be tested for inflammatory markers, such as C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR), to see whether an infection or underlying inflammation may be the root cause of the fasciculations.
Autoimmune markers
Blood tests can also measure the antibodies associated with autoimmune conditions, such as lupus or myasthenia gravis, which can cause fasciculations.
Electromyography (EMG)
Electromyography (EMG) is a diagnostic test that can be used to evaluate muscle and nerve function. It is often used to diagnose fasciculations and other muscle disorders. During an EMG, a thin needle electrode is inserted into the tested muscle. The electrode records the electrical activity of the power, which can be analyzed to evaluate for abnormalities. EMG testing is generally safe and well-tolerated, although some patients may experience mild discomfort or pain during the procedure. EMG testing is usually performed by a neurologist or an electromyograph, who will interpret the results and provide a diagnosis based on the findings.
Two types of EMG tests may be used to diagnose fasciculations:
Needle EMG
An electrode is placed into the muscle being examined during a needle EMG. The electrode records the electrical activity of the power while it is at rest and when it contracts voluntarily. This can assess nerve dysfunction, muscular weakness, and injury.
Nerve conduction study
During a nerve conduction study, small electrodes are placed on the skin overlying the nerve being tested. A small electric shock is then delivered to the nerve, and the response is measured. This can help evaluate for nerve dysfunction or damage.
Magnetic Resonance Imaging (MRI)
A powerful magnetic field and radio waves are used in the diagnostic imaging procedure known as magnetic resonance imaging (MRI) to produce precise body images. It can assess the muscles, nerves, and other structures responsible for fasciculations.
An MRI can find structural issues causing brain, spinal cord, or peripheral nerve fasciculations. Moreover, it can locate any muscle abnormalities, such as injury or inflammation.
You will lay on a table during an MRI that glides inside a sizable tube-shaped machine. You must remain still during imaging, which might take 30 minutes to an hour or more. A contrast dye may be injected into the body of some people to help improve the images.
MRI is generally a safe and non-invasive procedure. However, some patients may experience discomfort from lying still for an extended period or from the noise produced by the machine. Additionally, some patients may be unable to undergo an MRI if they have certain medical conditions or implants, such as a pacemaker or metal implant.
How to stop muscle twitching?
Muscle twitching, also known as fasciculations, can be caused by various factors, including stress, anxiety, dehydration, electrolyte imbalances, nerve damage, and certain medications. Here are some ways to stop muscle twitching:
Addressing Underlying Causes:
The first step in stopping muscle twitching is identifying and addressing any underlying medical or lifestyle factors contributing to the problem. For example, drinking plenty of fluids and eating a balanced diet can help if your quiver is due to dehydration or electrolyte imbalances. You may benefit from stress management techniques if your twitching is due to stress or anxiety.
Medications to Reduce Twitching:
Drugs may occasionally be recommended to help curb muscular twitching. They might include benzodiazepines, muscle relaxants, and anticonvulsants. These drugs should only be used under a healthcare professional’s supervision because they may have adverse effects. Muscle Relaxation Techniques: Techniques such as massage, stretching, and gentle exercise can help to reduce muscle tension and twitching. Relaxation techniques such as deep breathing, yoga, or meditation can also be helpful.
Stress Management Techniques:
Stress can contribute to muscle twitching, so managing stress is essential to preventing and reducing twitching. Techniques such as mindfulness meditation, cognitive-behavioral therapy, and biofeedback can help to reduce stress and anxiety.
Good Sleep Hygiene:
Lack of sleep can also lead to muscle twitching, so getting enough sleep and establishing good sleep hygiene can help to reduce twitching. This includes going to bed and waking up simultaneously every day, avoiding caffeine and alcohol before bedtime, and creating a relaxing bedtime routine.
Complications of Fasciculations
Fasciculations, involuntary muscle cramps or spasms, are usually benign and not associated with severe complications. However, in some cases, fasciculations may be a symptom of an underlying neurological disorder that requires further evaluation and treatment.
Complications of fasciculations can include
- Muscle fatigue: Fasciculations can cause muscle fatigue due to the constant contractions of the affected muscles.
- Pain: In some cases, fasciculations can cause muscle pain, mainly if they are persistent or occur frequently.
- Anxiety: Fasciculations can be a source of concern for some people, mainly if they are worried that they may be a symptom of a more severe condition.
- Sleep disturbances: Fasciculations can occur during sleep, disrupting sleep and leading to daytime fatigue.
- Reduced mobility: In some cases, fasciculations can cause weakness or reduced mobility in the affected muscles, which can impact a person’s ability to perform daily activities.
Effects on Quality of Life
The effects of fasciculations on quality of life can vary depending on the severity and frequency of the symptoms. For some people, fasciculations may be mild and infrequent and have little impact on their daily life. However, fasciculations may be more severe and disruptive for others, leading to anxiety, sleep disturbances, and reduced mobility.
Increased Risk of Injury
Fasciculations can also increase the risk of injury, mainly if they affect muscles involved in balance or coordination. For example, fasciculations in the legs can increase the risk of falling, while fasciculations in the hands can affect dexterity and fine motor skills.
Psychological Effects
Fasciculations can have psychological effects, mainly if they are a source of anxiety or worry. Some people may become hypervigilant about their symptoms, constantly monitoring their body for signs of twitching, increasing pressure, and stress. In some cases, psychological counseling may be recommended to help manage the psychological effects of fasciculations.
How to Prevent Fasciculations?
Fasciculations can be uncomfortable or bothersome for some individuals, mainly if they occur frequently or in sensitive areas of the body. By preventing fasciculations, individuals can reduce their occurrence and improve their comfort and quality of life. Here are some tips that may help avoid fasciculations:
Healthy Lifestyle Choices
Adopting a healthy lifestyle can help prevent fasciculations in several ways:
Proper nutrition
Prevent fasciculations by eating a balanced diet high in vitamins, minerals, and other vital components.
Regular exercise
Regular exercise can help improve muscle function, reduce stress, and improve overall health, reducing the likelihood of fasciculations.
Hydration
Staying adequately hydrated can help prevent muscle spasms and cramps, including fasciculations.
Stress management
Chronic stress can cause Fasciculations. Therefore engaging in stress-relieving practises like yoga, meditation, or deep breathing techniques might help prevent them.
Sleep
Whole health depends on getting enough sleep, which can also help reduce weariness and muscular twitching, including fasciculations.
Avoiding Triggers
Avoiding triggers that can increase the likelihood of fasciculations is integral to preventing them. Here are some common triggers to avoid:
Caffeine
Caffeine is a stimulant that can cause muscle twitches and spasms, including fasciculations. Limit your caffeine intake by avoiding or reducing your consumption of coffee, tea, soda, and other caffeinated beverages.
Alcohol
Alcohol can disrupt the balance of electrolytes in the body, leading to muscle twitches, including fasciculations. Avoid alcohol totally or consume it in moderation.
Dehydration
Dehydration can result in fasciculations as well as muscle twitches and spasms. Keep hydrated throughout the day by consuming lots of water.
Stress
Stress that is ongoing can make muscles tenser and cause twitches, including fasciculations. To assist in relieving stress, try stress-relieving exercises like yoga, meditation, or deep breathing.
Lack of sleep
A lack of sleep can increase fatigue and stress, leading to muscle twitches, including fasciculations. Establish a regular sleep pattern and create a sleeping environment to ensure that you receive adequate sleep each night.
Stress Management Techniques
Stress management techniques can help reduce stress levels, which can help prevent muscle twitches and spasms, including fasciculations. Here are some effective stress management techniques:
Deep breathing exercises
Deep breathing exercises can help reduce stress by calming the body and mind. Try taking slow, deep breaths through your nose and out through your mouth, focusing on your breath and taking breaks throughout the day to practice this technique.
Meditation
Meditation involves focusing on the present moment, which can help reduce stress and anxiety. There are many types of meditation, such as mindfulness, guided, and ethereal. Experiment with different types to find one that works for you.
Exercise
Exercise can help reduce stress levels and improve mood by releasing endorphins in the brain. Try to engage in regular physical activity, such as walking, running, cycling, or yoga.
Time management
Poor time management can contribute to stress levels. Try to prioritize your tasks and use time management tools like calendars or to-do lists to help manage your time effectively.
Relaxation techniques
Many relaxation techniques, such as progressive muscle relaxation, visualization, or aromatherapy, can help reduce stress levels and promote peace. Experiment with different strategies to find one that works for you.
Social support
Spending time with family and friends can reduce stress and provide emotional support. Make time for social activities like dinner with friends or a movie night with the family.
FAQs bout Fasciculations Answered by Your Doctors Online Team.
Do fasciculations always mean ALS?
Although ALS (amyotrophic lateral sclerosis) is frequently linked to fasciculations, it can also be caused by other conditions. Fasciculations causes are often benign on by exhaustion, stress, or coffee consumption. In other cases, fasciculations may indicate underlying neurological disorders such as multiple sclerosis, spinal muscular atrophy, or peripheral neuropathy. Although fasciculations can be a precursor of ALS, ALS patients do not always have them. Atrophy, stiffness, and muscle weakness are further typical ALS symptoms.
Why do people twitch in their sleep?
Various reasons for twitching in sleep include hypnic jerks, periodic limb movement disorder (PLMD), medical illnesses like restless leg syndrome, seizure disorders, and nerve injury. Specific medications or substances like alcohol, caffeine, or nicotine can also cause you to twitch while asleep. Twitching when you sleep might disturb your sleep and make you tired or sleepy the next day. Consult with a doctor if you experience twitching or fasciculations in sleep.
