Muscle Twitches

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What are muscle twitches?

Muscle twitches are minor, involuntary, repetitive motions of a skeletal muscle. These motions are due to little contractions of the affected muscle. Muscle twitches occur in small muscle groups that are connected to a single motor nerve fiber. This differentiates muscle twitches from muscle cramps, which generally affect multiple muscle groups in a given area at the same time. For instance, many muscles in the calf cramp. It also makes them different from myoclonus—quick, involuntary muscle jerks like hiccups or sleep startles. The medical term for muscle twitches is fasciculations.

Twitches can occur in anyone and in any skeletal muscle in the body, including facial muscles. Facial tics or twitches commonly affect the muscles of the eyes or mouth. Facial tics include repetitive mouth spasms, wrinkling of the nose, grimacing, clearing of the throat, blinking, and squinting of the eyes. Facial tics are common during childhood.

Muscle twitches may be short-lived or permanent. They can sometimes be due to nervous system disorders or another underlying condition. However, most often, they are a normal body reaction to things like exercise, which can tire the muscles, or caffeine consumption. High levels of stress or anxiety can increase the frequency of muscle twitches. In some cases, the cause of muscle twitches is not known.

Sometimes, muscle twitches may be a symptom of a serious or life-threatening condition, such as a stroke or traumatic brain injury. Seek immediate medical care (call 911) if you have serious symptoms, such as numbness or weakness on one side of your body; a change in level of consciousness or alertness, such as passing out or unresponsiveness; or the worst headache of your life, as these can be signs of stroke.

Seek prompt medical care if your muscle twitches are persistent or cause you concern.

What other symptoms might occur with 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.

Muscle symptoms that may occur along with muscle twitches

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

Other symptoms that may occur along with muscle twitches

Other symptoms with muscle twitches include:

Serious symptoms that might indicate a life-threatening condition

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

What causes muscle twitches?

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 causes of muscle twitches

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

Medications or drugs that can cause muscle twitches

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)

Neurological causes of muscle twitches

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)

Other causes of muscle twitches

Muscle twitches may also be caused by:

Serious or life-threatening causes of muscle twitches

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

When should you see a doctor for muscle twitches?

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.

How do doctors diagnose the cause of muscle twitches?

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.

How do you treat muscle twitches?

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.

What are the potential complications of muscle twitches?

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
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Medical Reviewer: William C. Lloyd III, MD, FACS
Last Review Date: 2021 Aug 20
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THIS TOOL DOES NOT PROVIDE MEDICAL ADVICE. It is intended for informational purposes only. It is not a substitute for professional medical advice, diagnosis or treatment. Never ignore professional medical advice in seeking treatment because of something you have read on the site. If you think you may have a medical emergency, immediately call your doctor or dial 911.
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