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Muscle twitching: causes, treatment and possible diseases

by Josephine Andrews
Published: Last Updated on 444 views

Muscle twitching is an involuntary, sudden contraction of the muscles. It can be more or less severe and affects almost every muscle in the body. Muscles in the extremities and face (e.g. eyelid) twitch particularly often. As annoying as muscle twitching can be, it’s mostly harmless. But there can also be a serious illness behind it. Read more about causes and treatment of muscle twitching here.

quick overview

  • Causes of muscle twitching: e.g. stress, lack of minerals, stimulants (such as caffeine ), various diseases such as ALS, Parkinson’s or diabetes mellitus
  • When is muscle twitching dangerous? If it is a symptom of a serious illness. This may be indicated by the fact that it does not only occur sporadically.
  • What can be done about muscle twitching? In the case of harmless muscle twitching, you can try to eliminate the cause (e.g. reduce stress, eat a balanced diet, not consume too much caffeine and alcohol). If underlying diseases are the cause, the doctor will initiate an appropriate therapy (e.g. with medication).
  • When to the doctor? If muscle twitching occurs more frequently and/or is accompanied by painful muscle spasms (such as in epilepsy ).
  • Diagnosis: consultation with the patient, physical and neurological examinations (ENG, EEG, EMG), if necessary further examinations such as imaging procedures (such as computed tomography , magnetic resonance imaging ) or analysis of a tissue sample ( biopsy )

Muscle twitching: causes and possible diseases

Muscle twitching can occur as an accompanying symptom of many neurological diseases. These include disorders in the nervous system, especially in the brain and spinal cord and in the nerve cells of the muscles. In some people, the entire musculature cramps, for example in epilepsy. The muscle twitches are clearly visible here (medical: myoclonus ) and are so extensive that there is a risk of injury.

But there is not always an illness behind the convulsions. Fasciculations , i.e. muscle twitching that can only be felt as a fine tremor under the skin , are often harmless. 70 percent of the population have so-called sleep jerks, which are medically completely harmless. Sometimes there is also a temporary nerve irritation behind the symptom.

In some cases, the muscle twitching can be intensified or activated by voluntary movements, in which case it is called action myoclonus. In other cases, external stimuli such as touch, light or noise trigger twitching of the muscles (reflex myoclonus).

Diseases that trigger muscle twitching

  • Essential tremor (ET): Involuntary tremor that is not a symptom of a disease but occurs as an independent clinical picture. ET is hereditary in 60 percent of patients. The trembling tends to show up in the hands and occurs above all when you want to hold something with them (e.g. a cup) or make movements (e.g. unlock a door).
  • Restless Legs Syndrome: A neurological disorder characterized by sensory disturbances and involuntary movements of the legs and, less commonly, the arms, especially when at rest.

Other factors that trigger muscle twitching

  • mental imbalance, for example lovesickness
  • stress
  • stimulating substances such as caffeine
  • alcohol and drugs
  • cold and hypothermia
  • magnesium deficiency
  • hypoglycaemia
  • nerve pinching
  • side effects of medication
  • direct nerve irritation after examinations (e.g. brain water examination)

Muscle twitching is usually painless. Painful muscle spasms can accompany it. Pronounced muscle twitching severely restricts those affected in everyday life, because targeted movements such as eating, drinking or writing become more difficult. Twitching is often exacerbated in stressful situations, stigmatizing patients as “nervous” or “insecure.”

Muscle twitching – dangerous or harmless?

Usually, muscle twitches are harmless and just a symptom of mineral deficiencies, stress, too much caffeine, lack of sleep, or what are known as sleep jerks. Doctors speak of such muscle twitching as benign ( benign) fasciculation syndrome .

Much less often, serious medical conditions cause muscle twitching. A sign of this can be if the twitching occurs more frequently. For example, muscle tremors at rest (resting tremor) are typically observed in Parkinson’s patients. Metabolic diseases such as diabetes mellitus can also manifest themselves through muscle twitching – as can amyotrophic lateral sclerosis (ALS). In such cases, the muscle twitching or the diseases behind it are to be classified as dangerous or at least as serious.

Muscle Twitching: What Can You Do About It?

In the case of harmless muscle twitching, there is a lot you can do yourself to stop the annoying symptom. If an illness is considered to be the cause of the twitching, medical examinations and usually treatment by a doctor are necessary.

Muscle Twitches: You can do this yourself

  • Relaxation: A common trigger of fasciculations is stress. Then try to avoid or reduce stress factors . You should also try relaxation exercises (such as autogenic training , yoga). These can also be helpful if essential tremor or other medical conditions are causing the muscle twitching.
  • No Stimulants : Avoiding caffeine, alcohol, and stimulants can often help prevent muscle twitching.
  • Balanced diet: Sometimes a balanced diet can also help reduce muscle twitching. Pay particular attention to adequate magnesium intake if painful cramps occur in addition to muscle twitching. Larger amounts of the mineral are found in green vegetables such as spinach, broccoli, beans or peas, but also in cereals such as oatmeal, wheat bran or rice. If you like fruit: Bananas contain a relatively large amount of magnesium .

Before taking magnesium tablets for muscle twitching, you should consult with your doctor.

Muscle twitching: That’s what the doctor does

Depending on which disease is causing the muscle twitching, the doctor can recommend various therapeutic measures – often in addition to the self-help measures mentioned above.


Often underlying diseases can be treated with medication, for example:

  • Tics and Tourette’s: On the other hand, so-called neuroleptics help – active ingredients that dampen the functions of the central nervous system.
  • Epilepsy: It is treated with, for example, carbamazepine , valproic acid or clonazepam .
  • Essential tremor: It can often be relieved with beta-blockers or anticonvulsants.

Sometimes muscle twitches are the side effect of certain medications. In this case, you should discuss with your doctor whether you need to continue taking the drug in question or whether it can be discontinued or replaced with a better tolerated drug.

occupational and physical therapy

If the muscle twitching is due to amyotrophic lateral sclerosis (ALS), regular physiotherapy and occupational therapy are very useful. This can have a positive impact on the progression of the disease. However, ALS cannot be treated and cured causally – neither through physiotherapy and occupational therapy nor through other therapies.


In some cases of disease-related muscle twitching, the doctor recommends surgery. For example, brain surgery can be useful for epileptics. In most cases, a region of the brain that repeatedly triggers the epileptic seizures is surgically removed.

Surgery is also sometimes used for essential tremor: With this disease, a certain area of ​​the brain sends a constant interference signal. This area can be deactivated by means of an operation.

Muscle Twitches: When Do You Need to See a Doctor?

If the muscle twitching occurs more frequently, you should have a medical examination by a doctor to rule out a medical condition that requires treatment. A doctor’s visit is also essential in the event of severe myoclonus, i.e. severe muscle twitching, which may be accompanied by painful cramps.

Since muscle spasms are often caused by nerve disorders, a neurologist is the right person to talk to.

Muscle twitching: investigations and diagnosis

The first step is a detailed discussion between you and the doctor to collect the medical history (anamnesis). The doctor will ask you, for example, when, how often, where and under what circumstances the muscle twitching occurs and whether you have any other symptoms (e.g. painful muscle cramps, fever , etc.).

Information about possible triggers for the twitches, such as an injury or a recent examination of the nerves, is also important. Also tell your doctor whether and what medication you are taking and whether you have any previous illnesses (e.g. epilepsy or diabetes).

This is followed by a physical and neurological examination . In the latter, the doctor checks nerve and muscle function as well as reflexes. The following methods can be used:

  • Electroneurography (ENG): The nerve conduction speed is measured using electrodes.
  • Electromyography (EMG): During this examination, the doctor uses electrodes to check the electrical activity in the muscle.
  • Electroencephalography (EEG): The electrical activity of the brain is examined, also using electrodes.

Depending on the findings or the suspected cause of the muscle twitching, further examinations may be useful:

  • blood and urine tests
  • orthopedic examinations
  • Imaging procedures such as X-rays , computed tomography (CT), magnetic resonance imaging (magnetic resonance imaging, MRI)
  • Removal of muscle tissue (biopsy) for more detailed examination in the laboratory
  • Removal of cerebrospinal fluid (liquor puncture) for a more detailed examination in the laboratory
  • L-dopa test (if Parkinson’s disease is suspected)
  • Blood vessel examination (angiography)
  • allergy testing
  • psychological or psychiatric examinations

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