Muscle twitching can be a completely harmless symptom, but it can also be related to various serious illnesses. The intensity of the muscle twitches is highly variable according to the different causes. It ranges from barely perceptible convulsions of individual muscle fibers and bundles to twitching of the whole muscle with a movement effect.
A medical examination of the complaints is urgently recommended especially with repeated occurrence and with muscle twitch with movement effect.
Muscle twitching in the broadest sense is to be understood as meaning all involuntary contractions of individual muscle fibers, muscle bundles, muscles and the simultaneous contraction of numerous muscle groups, for example in the context of an epileptic seizure.
The different forms are distinguished in so-called fibrillations (twitching of individual muscle fibers, without movement effect), fasciculations (twitching of individual muscle bundles, noticeable but without significant movement effect), myoclonus (twitching of the muscle, with or without movement) and tremor (twitching of several muscle groups with regular tremors as a movement effect). Even the so-called myocymia, in which a wave of contraction through individual muscles, without triggering a movement, can be assigned to muscle twitching.
Depending on the extent of muscle twitching, the symptoms may vary considerably. For example, while fibrillations can only be detected with the aid of special examination methods, a tremor can often be easily recognized by the pronounced tremors of individual parts of the body, even for medical laymen. The fasciculation often manifests itself in a twitching of individual muscle bundles in the facial area, such as twitching of the eyelid. The myoclonus usually appear as twitching of several muscles and are often accompanied by a significant movement effect.
They can be observed, for example, in epilepsy, but also at a tick. A tremor is caused by the increased involuntary rhythmic contraction of different muscle groups and their opponents, but here too clear differences between the various tremor forms can be observed. For example, a distinction is made between the resting tremor and the action tremor, depending on the circumstances under which the symptoms mainly occur. The extent of muscle twitching and possibly accompanying symptoms often provide important clues as to the cause of the symptoms. Therefore, in conjunction with the description of the causes of muscle twitching, a more detailed explanation of the respective symptoms will follow.
First, a distinction must be made between the pathological forms of muscle twitching and the rather harmless muscle twitches, such as the so-called benign fasciculation. While the former are an expression of a disease, the latter often assume a connection with mental factors such as increased stress. Muscle twitches without underlying disease are uncomfortable for those affected, but harmless from a health point of view.
Ticks on the face
One of the most well-known forms of muscle twitching is the so-called tick, in which the contraction of individual muscles or muscle groups leads to involuntary movements such as blinking the eyes, raising the eyebrows or even more complex movements. The cause of a tick is suspected to be malfunctioning of the nervous system or especially in disorders of the basal ganglia, which is why the symptoms of the so-called extra pyramidal hyperkinesia (movement disorders that do not arise in the pyramidal system) are assigned. In rare cases, however, also develop patients who suffer from inflammation of the brain, a tick.
In addition, a connection with the so-called striatofrontal dysfunction is discussed, which describes a disturbance of the control loop in the frontal brain and striatum. As a rule, the tick is not associated with further health threats. More pronounced forms of a tick, which in addition to the involuntary movements may also be accompanied by involuntary vocalizations (for example in the context of Tourette’s syndrome), are usually a considerable burden for those affected in everyday life, which can bring about further psychological complaints.
In an epileptic seizure, the muscles in the entire body suddenly start to twitch uncontrollably and cramp.
Epilepsies as causes
Uncontrolled, attack-like muscle twitching is one of the leading symptoms in the various forms of epilepsy. Muscles begin to cramp suddenly due to previously unknown causes. There is a veritable fireworks of neuron discharges in the brain of those affected, which leads to false signals to the muscles. What causes the disturbances in the brain, remains – despite significant research successes in recent years – until today largely unclear. It is certain that special neurotransmitters play an essential role here.
But under what circumstances an epilepsy develops from single convulsions remains uncertain. However, a genetic disposition seems to be important in all epileptics. Among the possible causes of so-called symptomatic epilepsy include, for example, congenital brain damage, malformations of the brain tissue or brain tumors. For example, if patients have a severe craniocerebral trauma in an accident, it may also lead to the development of symptomatic epilepsy. Inflammations of the brain, such as those caused by viral (eg, measles, FSME, hepatitis C) or bacterial (eg Lyme disease, meningococcal) infectious diseases, may also be associated with epileptic seizures.
In addition, pathological changes in the blood vessels in the brain, as they occur, for example in the context of arteriosclerosis, as a possible cause of symptomatic epilepsy into consideration. Occasional seizures, although associated with significant muscle twitching, but in the strict sense not to be assessed as epilepsy, These can be caused for example by high fever, massive hypoglycaemia in diabetes or by the abuse of drugs, medicines and alcohol. In alcohol, acute alcohol poisoning as well as withdrawal after many years of use are sometimes accompanied by epileptic episodes. Another cause of occasional seizures are shifts in mineral content in the organism.
If, for example, the potassium levels in the blood rise sharply (hyperkalaemia) or, in the context of hyperparathyroidism (dysfunction of the parathyroid glands with increased hormone release), the calcium concentration in the blood increases, muscle twitching and seizures are a possible consequence. In people with pronounced photosensitivity, occasional epileptic seizures are also triggered by extremely bright light pulses or the rapidly changing light-dark contrast (eg camera flash or stroboscope in discotheques). The intensity and duration of the epileptic seizure can be marked according to the different causes ranging from localized seizures without any impairment of consciousness to severe convulsions of the whole body, with temporary loss of consciousness and unwanted discharge of urine and stool.
After a few minutes, the acute attack is usually over, in severe cases, however, this can last significantly longer than 20 minutes. In the course of seizure, patients often suffer secondary injuries from sudden uncontrolled fall to the floor and / or extreme tension in the muscles. Brain damage is also threatened by the massively increased concentration of neurotransmitters. Diseases of the nervous systemThe most well-known neurological disease, which is accompanied by muscle twitching and consequent tremors (tremor), is Parkinson’s disease. Damage to the extrapyramidal motor nervous system causes symptoms such as general slowing of movement (bradykinesis), stiffness of the muscles (rigor), changes in posture and abnormal tremor.
In the course of the disease, the complaints become more severe and it can be added to other ailments such as muscle and joint pain or so-called abnormal sensations (numbness, tingling in the limbs). Even in the early stages of the disease many sufferers show an impairment of the sense of smell. Bladder dysfunction and indigestion are other commonly observed concomitant symptoms of Parkinson’s disease. There are also various physical complaints, depending on the individual disease process. In addition to the physical impairments Parkinson’s patients often suffer from various mental symptoms, such as a general listlessness, a slowing of thought processes and limitations of cognitive skills to dementia. Another neurological disease that can lead to muscle twitching is amyotrophic lateral sclerosis (ALS ), whose cause remains largely unclear to this day. In the course of this luckily extremely rare illness the nerve cells, which serve to control the muscle movement, become increasingly irreversibly damaged.
Musculoskeletal disorders may be dependent on the affected nerve cells, muscle weakness or muscle wasting, or increased muscle tension or even spasticity. Frequently the affected persons show concomitant symptoms such as difficulty swallowing, speech problems and an unsteady gait. In the further course, paralysis of the musculature also leads to impaired respiratory function. Those affected have no hope for a cure and after diagnosis usually only a few years to live.
As a disease of the central nervous system, the Creutzfeldt-Jakob disease can cause muscle twitching to epileptic seizures. So-called pathological prions lead to pathological changes in the tissue structures in the brain and subsequent death of the nerve cells. The disease has become known in the wake of the BSE scandal, which overtook the United Kingdom in the 1980s and 1990s and subsequently also Germany. In cattle, the prions had triggered the so-called mad cow disease and it quickly came to the conclusion that a newer variant of transmissible Creutzfeldt-Jakob disease could be related to the consumption of BSE-contaminated beef.
In general, three different variants of Creutzfeldt-Jakob Disease are distinguished: Sporadic Prion Disease, Genetic Prion Disease, and the Transmissible Creutzfeldt-Jakob Variant. Both the sporadic and the transmissible variant of the disease usually lead to the death of the patient within a few months. In the genetic variant, the course of disease may extend beyond a much longer period of time (usually several years). In the early stages of Creutzfeldt-Jakob disease sufferers often suffer initially from mental problems such as anxiety and panic attacks, mood swings or even depression. Even delusions may occur in the course of Creutzfeldt-Jakob disease.
Over time, sufferers are increasingly limited in their cognitive and motor skills. Memory disorders are one of the typical mental impairments and muscle twitching is considered a characteristic of motor disorder. The eyesight of those affected is also often affected. Later in the transmissible variant, many sufferers also suffer from painful dizziness, dizziness, nausea and vomiting. The extent of the motor impairments usually increases continuously and the muscle twitching increases in the course not uncommon to regular epileptic seizures. Due to the incorrect control of the muscles, many sufferers also suffer from severe body aches.
In the course of Creutzfeldt-Jakob disease, the brain is increasingly destroyed and appears in the final stage spongy perforated. The affected persons are at this stage no longer able to communicate with their fellow human beings and are often completely unable to move.
Vegetative dystonia as a cause
Also disorders of the autonomic nervous system in the form of so-called vegetative dystonia are associated with muscle twitches. The interaction between the sympathetic and parasympathetic and the information processing in the diencephalon is impaired in those affected, which in addition to the muscle twitch can lead to many different ailments such as heart problems in the form of heart stuttering, palpitations, heart pain and tightness of the chest or even shortness of breath, headache and dizziness , Stomach problems – especially indigestion, gastric pressure and stomach ache or abdominal pain – are also considered as possible symptoms of vegetative dystonia.
Furthermore, those affected often suffer from the feeling of inner restlessness, they are easily irritable and often nervous. Sometimes a general listlessness and the increased occurrence of panic attacks or existential anxiety are added. In the case of vegetative dystonia, the symptoms are still relatively unclear, which makes it difficult to make a clear diagnosis and has often given rise to criticism in specialist circles. An organic cause of the symptoms can not be found in the vegetative dystonia and serious health impairments are not expected in the rule.
More causes of muscle twitches
Next to the already mentioned causes of muscle twitch numerous other factors can be considered as a trigger of the complaints into consideration. For example, high fever can cause involuntary muscle contractions in the form of so-called febrile convulsions. Furthermore, fasciculations can be observed as late effects of polio as part of the so-called post-polio syndrome. If the liver is impaired in its detoxification function, this may lead to damage to the brain due to the increased concentration entration of chemical compounds such as ammonia or gamma-aminobutyric acid in the organism (hepatic encephalopathy).
This in turn causes discomfort such as muscle twitching in the form of myoclonus and tremor or progressive muscle loss. The cause of muscle twitching is the so-called serotonin syndrome, which is caused by a long-term increased concentration of the neurotransmitter serotonin and similar substances. Cognitive impairments as well as motor dysfunctions, such as muscle twitching and tremors, are the result. Not infrequently, the syndrome is caused by the interaction between different drugs. Long-term therapies with special psychotropic drugs (neuroleptics) are already considered a potential cause of motor disorders in the form of so-called tardive dyskinesia, which in turn may be accompanied by involuntary muscle contractions.
Opiate addiction may also cause massive muscle twitches if properly deprived. Unfortunately, people with severe magnesium deficiency may experience impaired muscle function such as muscle cramps (usually calf cramps) and muscle twitching. Most sufferers are plagued by numerous other symptoms, such as chronic fatigue, headaches, regular falling asleep of the hands and feet or back pain due to the magnesium deficiency. Sodium deficiency or too low sodium content in the blood (hyponatraemia) can also be associated with muscle twitching in the form of myoclonus, tremor and, in extremely severe cases, even epileptic seizures. However, not only is the lack of required minerals to be considered as a possible cause of muscle twitching, but too high a concentration of certain substances can cause the discomfort.
For example, in the hereditary disease Wilson’s Disease, copper metabolism in the liver is disturbed, resulting in an increase in copper concentration in the organism. This in turn brings with it numerous complaints, which may include muscle twitching in the form of tremor, rarely even epileptic seizures. Increases the carbon dioxide concentration in the blood (hypercapnia), muscle twitching and muscle spasms in addition to the changes in the appearance of the skin (conspicuous redness) and cardiac arrhythmia to the possible consequences. A massive increase in the carbon dioxide content leads to disturbances of consciousness up to the coma. Furthermore, a pinched nerve due to the disturbed signal transmission can cause twitching of the muscles in the supply area of the affected nerve. In the case of severe hypothermia, the body tries to stabilize its temperature by shaking its muscles (trembling) and, finally, chills are just a special form of muscle twitching.
A possible cause for the twitching of individual muscles, such as a nervous twitching of the eyelid, are also psychic stresses, such as severe grief or stress, call. Diagnosis by a detailed survey of patients to the intensity of muscle twitching, the affected muscles, already known pre-existing conditions, the ingestion of drugs and other potentially nerve-damaging substances are often already first indications of the cause of the complaints. As part of a subsequent physical examination, tests of the reflexes, stimulus transmission or sensitivity, balance, coordination and muscle strength can provide further important clues to the diagnosis.
A blood test in the laboratory is used to identify possibly present metabolic diseases, deficiencies or high concentration of certain substances in the organism and can also provide important evidence of possible infections or inflammatory processes. Special additional examination methods are used depending on the suspected cause of muscle twitching. For example, the so-called L-Dopa test is used to detect Parkinson’s disease.
In order to identify damage to the nerves, electroneurography (ENG) and electromyography (EMG) are used. Electroencephalography (EEG) can be used to determine electrical activity in the brain and thus, for example, the brain’s readiness for epileptic discharges. Modern imaging techniques such as functional magnetic resonance imaging (fMRI) allow a more detailed analysis of brain functions and other specialized examination methods, such as Positron emission tomography (PET), are used for the targeted verification of neurological deficits. Magnetic resonance imaging and computed tomography can generally make a significant contribution to the diagnosis.
Numerous other naturopathic treatment approaches are possible, ranging from relatively easy to implement nutritional therapy and hydrotherapy methods to more complex methods that, for example, generally strengthen the immune system.