These can occur in combination in ALS, as upper and lower motor neurons are affected at the same time. ALS can affect people of any age, though it usually strikes in late middle age. ALS typically announces itself with persistent weakness or spasticity in an arm or leg 80 percent of all casescausing difficulty using the affected limb. Sometimes in about 20 percent of all cases the problem presents first in the muscles controlling speech, producing alterations in the vocal quality, or swallowing, which may lead to coughing and choking.
The disease can also affect the muscles of the face, leading to problems such as incomplete eye closure and drooling. ALS can even manifest as inappropriate laughing, crying, or yawning pseudobulbar affect. It is not unusual for people to ignore such problems for some time at this stage, or to consult a physician who may be relatively unconcerned.
However, the disease, if it is truly ALS, generally spreads from one part of the body to another so that eventually the problem can no longer be ignored. It is at this point that people usually are referred to a neurologist, who will consider ALS among many other possible diagnoses.
The involuntary muscles involved in the heartbeat and sexual functions are not directly affected in ALS. Constipation, impairment of the stomach, bloating, and urinary urgency can occur in patients with ALS. Prolonged inability to move and other effects of ALS can have also an indirect impact on these organs. Hearing, vision, and touch generally remain normal. Some patients complain about excessive sweating, but the association between sweating and ALS remains controversial. Pain can occur as a result of immobility and its various complications, especially if precautions such as daily range-of-motion exercises are not undertaken.
Also pain due to nerve affection may occur in some patients with ALS. These persistent muscle twitches are generally not painful but can interfere with sleep. They are the result of the ongoing disruption of signals from the nerves to the muscles that occurs in ALS. Some with ALS experience painful muscle cramps, which can sometimes be alleviated with medication. However, memory loss, a hallmark of Alzheimer's-type dementia, is generally not a feature of ALS.
Instead, the person with ALS might be irritable, inconsiderate, apathetic, or impulsive or might otherwise act in uncharacteristic ways. Laughing or crying bouts, often triggered by the smallest of things, are more related to the disease process rather than to actual feelings of happiness or sadness. Skip to main content. Search MDA. I Will Donate Today. Search Donate. References Thakore, N. Laughter, crying and sadness in ALS.
Psychiatry Kihara, M. Sudomotor dysfunction in amyotrophic lateral sclerosis. Pain in amyotrophic lateral sclerosis.
The Lancet Neurology The last months of life of people with amyotrophic lateral sclerosis in mechanical invasive ventilation: A qualitative study. Lateral Scler. Looking for more information, support or ways to get involved?
I did stay on the Xanax taking about So I tried cold-turkey off the Xanax I felt pretty good that I could not see or feel any twitches yesterday from 5 a. I am scared to death of this.
I am concerned to because it appears to be confined to the one area, and I read somewhere here where that is where ALS starts, in one specific area or muscle group. I can not find any weakness in myself whatsoever, however there has been some muscle stiffness in the same area. I do push-ups 20 a day to determine if there is weakness there, but haven't found any.
There have been sporadic muscle twitches elsewhere in the body during this time, but nothing that is as persistent as this. Also, I have had sporadic muscle twitches in the LEFT ARM in the same are three times during this time period, but nothing that persists like my right arm.Muscle twitching occurs when nerves misfire, causing groups of muscle fibers to contract.
This is common to multiple sclerosis MSdue to nerve fiber damage that affects signaling between your nerves and muscles. But there are other possible causes of the various types of muscle twitching too, from fatigue and nutrient deficiency to thyroid disease and more. Some are benign, but others require medical attention. If you have MS, your muscle twitching may be due to your disease. Or it could be owed to one of these other causes that you may not realize you're living with as well.
It's important to sort out the why behind what you're experiencing. Likewise, for those who have not been diagnosed with MS, it's best not to ignore this symptom, as you may have a condition that requires treatment. Spasticity describes muscle tightness and stiffness, as well as spasms that can be constant or sudden; some people describe these as a twitch.
In other words, there is impaired nerve transmission from the brain and spinal cord to the nerves that control your muscles. Clonus describes the repetitive jerking or twitching of muscles and, like spasticity, is thought to be caused by the faulty nerve transmission characteristic of MS.
In more severe cases, the knee-jerk reflex is hyperactive and the muscle that controls the knee shakes rhythmically and uncontrollably. Lower motor neurons transmit nerve signals from your spinal cord to your muscles. When these nerve signals are disrupted, muscle weakening and wasting will eventually occur, along with uncontrollable muscle twitching called fasciculations.
Fasciculations are a hallmark symptom of diseases that affect the lower motor neurons, like ALS. Other lower motor neuron diseases that may cause fasciculations include post-polio syndrome, spinal muscular atrophy SMAand progressive muscular atrophy. Multiple sclerosis very rarely involves the lower motor neurons, which is why fasciculations are usually not a symptom of the disease. It's important to understand that a run-of-mill muscle twitch here and there is likely nothing to worry about.
Twitching can occur in healthy people and rarely signals the presence of an underlying disease, especially if it occurs without other symptoms. Muscle twitches that are unrelated to an underlying disease or abnormality can be triggered by a number of things, including:. In these instances, muscle twitches are benign and short-lived, meaning they are not a serious health concern, and come and go quickly.
Every disease and condition has its own set of established or widely accepted criteria for diagnosis. To determine the underlying cause of your muscle twitching, your doctor will likely do a physical examination and ask you questions such as:.
Remember: Even though it may be likely that muscle twitching is due to your MS, if you've been diagnosed, there's also a possibility that you could be dealing with a secondary issue that's causing this symptom.
Treating the underlying cause of muscle twitches is the primary concern, and it may stop the twitching. What that entails, of course, depends on what condition is at the root of the symptom. It's always disconcerting to develop a new or unexplained symptom. If you experience frequent or troublesome muscle twitches, especially if you are living with MSbe sure to see your doctor. There may be a simple explanation and relatively easy intervention to control this symptom.Edward Kasarskis, M.
If a person has muscle twitches a lot, or even daily, could it be the beginning of ALS? A: Muscle twitching is very common, especially when people have had too much coffee, too much stress, or not enough sleep. Does this sound familiar? Of course, the first thing many people do when they have a symptom is to run to the computer to see what Dr.
Google has to say about it. I just did that and I got 1, results in 0. One of the first items that popped up was a Wikipedia definition leading to the term "fasciculations," which means muscle twitchingsuggesting the symptoms could be associated with ALS.
So if you were not under stress at the start before you went to the Internet, you certainly would be after consulting Dr. But take a breath. There are many things that can cause muscle twitching, including fatigue, anxiety, or even a pinched nerve in the spine. Muscle cramps, too, are very common, and can be caused by such things as over-exertion or even dehydration. To diagnosis ALS, a physician needs to see signs of progressive muscle weakness.
What causes fasciculations? They originate at the very tips of the nerves, called axons, as they come close to being in contact with the muscle. The tips of the axons are thought to be overly sensitive to depolarizing electrical firingwhich is what triggers a muscle to contract. When a nerve fires, zillions of times a day upon request, an electrical impulse starts in the nerve, moves out toward the muscle, triggers the release of a chemical acetylcholine that "swims" across the gap between the nerve axon and the muscle, and binds to a receptor on the muscle causing it to fire.
The complicated process itself takes a small fraction of a second. If any of this happens involuntarily, then the muscle fiber contracts without your permission and behold, a muscle twitch or fasciculation! Some people with ALS wonder if the presence of muscle twitching means they have a bad or fast-moving version of the disease.
In fact, having fasciculations doesn't correlate with how rapidly the disease progresses. Often the twitching or cramping will just stop on its own. He or she may then want you to have a muscle test an EMG to better understand what could be going on. Blood tests might be needed as well. Often, the results will look normal but the doctor may suggest waiting a little longer to see if anything further develops over the next few months.
Causes of muscle twitches and how to relieve them
Even in the 21 st century, there is sometimes no instant test or procedure that can give you a clear answer about a problem. With fasciculations, this is certainly the case. Waiting is a challenge for most people, but the odds are heavily in your favor that you don't have ALS. As they say, "common things are common," and ALS is not common, especially when compared to excessive caffeine use and stress.A fasciculationor muscle twitchis a small, local, involuntary muscle contraction and relaxation which may be visible under the skin.
Deeper areas can be detected by electromyography EMG testing, though they can happen in any skeletal muscle in the body.
Fasciculations arise as a result of spontaneous depolarization of a lower motor neuron leading to the synchronous contraction of all the skeletal muscle fibers within a single motor unit.
An example of normal spontaneous depolarization is the constant contractions of cardiac musclecausing the heart to beat. Usually, intentional movement of the involved muscle causes fasciculations to cease immediately, but they may return once the muscle is at rest again.
Fasciculations have a variety of causes, the majority of which are benignbut can also be due to disease of the motor neurons. They are encountered by virtually all healthy people, though for most, it is quite infrequent.
In some cases, the presence of fasciculations can be annoying and interfere with quality of life.
If a neurological examination is otherwise normal and EMG testing does not indicate any additional pathologya diagnosis of benign fasciculation syndrome is usually made. The most effective way to detect fasciculations may be surface electromyography EMG. Surface EMG is more sensitive than needle electromyography and clinical observation in the detection of fasciculation in people with amyotrophic lateral sclerosis.
Risk factors for benign fasciculations may include the use of anticholinergic drugs over long periods. Persons with benign fasciculation syndrome BFS may experience paraesthesia especially numbness shortly after taking such medication; fasciculation episodes begin as the medication wears off.
Muscle Twitches (Fasciculations?) In Right Arm
Stimulants can cause fasciculations directly. These include caffeinepseudoephedrine Sudafedamphetaminesand the asthma bronchodilators salbutamol brand names Proventil, Combivent, Ventolin. Medications used to treat attention deficit disorder ADHD often contain stimulants as well, and are common causes of benign fasciculations. Since asthma and ADHD are much more serious than the fasciculations themselves, this side effect may have to be tolerated by the patient after consulting a physician or pharmacist.
The depolarizing neuromuscular blocker succinylcholine causes fasciculations. Even if a drug such as caffeine causes fasciculations, that does not necessarily mean it is the only cause. For example, a very slight magnesium deficiency by itself see below might not be enough for fasciculations to occur, but when combined with caffeine, the two factors together could be enough.
Inadequate magnesium intake can cause fasciculations, especially after a magnesium loss due to severe diarrhea. Over-exertion and heavy alcohol consumption  are also risk factors for magnesium loss. Treatment consists of increased intake of magnesium from dietary sources such as nuts especially almondsbananasand spinach. Magnesium supplements or pharmaceutical magnesium preparations may also be taken.
However, too much magnesium may cause diarrhearesulting in dehydration and nutrient loss including magnesium itself, leading to a net loss, rather than a gain. It is well known as a laxative Milk of Magnesiathough chelated magnesium can largely reduce this effect.
Fasciculation also often occurs during a rest period after sustained stress, such as that brought on by unconsciously tense muscles. Reducing stress and anxiety is therefore another useful treatment. There is no proven treatment for fasciculations in people with ALS. Among patients with ALS, fasciculation frequency is not associated with the duration of ALS and is independent of the degree of limb weakness and limb atrophy.
No prediction of ALS disease duration can be made based on fasciculation frequency alone. From Wikipedia, the free encyclopedia. Muscle contraction. See also: Twitch disambiguation and Tremor. This article possibly contains original research. Please improve it by verifying the claims made and adding inline citations.
Statements consisting only of original research should be removed. December Learn how and when to remove this template message.Muscle twitching in arm is normally a result of following a rigorous exercise routine.
Neurological disorders such as cerebral palsy and multiple scelerosis and even vitamin B deficiency can cause this involuntary muscle movement. Muscle twitching is nothing but involuntary palpitations of any part of the muscle. An area of the muscle keeps on moving jumping up and down under the skin for some time few seconds or minutes. Anxiety Anxiety is the leading cause for involuntary muscle movement.
This is because anxiety builds tension in the muscles. Prolonged exposure to anxious situations or an anxiety attack can contract the muscle for a considerable period of time. Incorporating relaxation techniques such as yoga and meditation into your daily schedule can certainly help to ease muscle twitches. Weightlifting routines can put a lot of strain on the arm muscles, which can then lead to muscle twitching. People in a hurry to build muscles perform strenuous exercises for a long duration of time.
This overuse of muscles often leads to muscle twitching, in arms especially. A strenuous aerobic exercise is also most likely to trigger muscle twitching. Exercises that are known to cause muscle palpitations in arm are as follows:. Caffeine Too much caffeine or alcohol in the diet can also lead to muscle twitching.
Caffeine is present in coffee, tea and cola. Caffeine is known to stimulate the nerves that regulate muscle movement. Thus, the hyper excited nerves due to excess intake of caffeinated beverages can trigger rapid palpitations of muscles. Skipping Warm Ups Ignoring a warm up before starting a vigorous workout routine can also cause twitching in any part of the body including arms.
A warm-up increases blood flow and make your muscles more receptive to exercise. Without a warm-up, your muscles find it difficult to handle excessive strain during a workout, which may lead to twitching. Exercise that is preceded by a warm up is unlikely to cause any muscle twitching. Nutritional Deficiency Many people who experience muscle twitching show a deficiency of magnesium and calcium in their diet. Neurological Disorders The dense network of nerves that run throughout the body relay signals from the brain to coordinate muscle movement.
Nerve endings are connected to muscle fibers that help to regulate movement of muscles. Multiple Sclerosis MS Intermittent episodes of muscle twitching in arms and legs have also been associated with people suffering from multiple sclerosis. Nerve damage is the hallmark of multiple sclerosis. As we all know, the nerves originating from the brain are coated with myelin sheath that ensure electrical signals through the nerves are transmitted efficiently.
This electrical activity of the brain regulates movement of the muscles. As a result, the electrical impulses through the nerves do not propagate properly. Eventually the nerves also start deteriorating gradually. These electrical disturbances resulting from damage to the myelin sheath and the nerves, can trigger involuntary contraction of muscles.
Muscle twitches in MS patients may aggravate at night. The twitching in arms may come and go but in some cases, it may continue for the entire day.Experiencing a muscle twitch can be uncomfortable and irritating.
But what causes a muscle twitch, and could it indicate an underlying health condition? Nerves control muscle fibers. When something stimulates or damages a nerve, it causes the muscle fibers to contract, resulting in a twitch. A person can often see or feel these twitches below the skin. In this article, we explore the numerous causes of muscle twitches. Most of the reasons for them are harmless though some are more serious. We also discuss how to treat and prevent muscle twitches.
Research suggests this muscle twitching may happen after exercise for two reasons:. The arms and legs are common places to experience muscle twitching that overexertion causes. The most worked muscles are most likely to twitch, which can include the calf, thigh, or biceps, depending on the exercise.
Brain chemicals, or neurotransmitters, play a role in transmitting information from the brain to the nerves that control muscle contraction. Sleep deprivation may affect how neurotransmitter receptors work. This means excess neurotransmitters may build up in the brain. Drinking too much coffeetea, or energy drinks that contain caffeine may cause muscle twitching.
Caffeine is a stimulant. When a person has too much of it, caffeine can stimulate muscle twitching anywhere in the body.Hand tremor, tongue and perioral fasciculation in a patient with Kennedy disease
The body needs calcium to support proper muscle function. Having a calcium deficiency may cause muscle twitching. Calcium deficiency is known as hypocalcemia. Magnesium also plays a role in keeping the nerves and muscles healthy. Magnesium helps to transport calcium across cell membranes to support nerve and muscle function. Having a magnesium deficiency may cause muscle twitching anywhere in the body, including the face.
Magnesium deficiency is known as hypomagnesemia. If people do not address a magnesium deficiency, it may increase their risk of cardiovascular disease. Having a vitamin D deficiency may cause muscle weakness and twitching. Muscle mass is up to 75 percent water. Water also helps to carry nutrients and minerals to muscles to support their function.