Ask a doctor on the topic of Neurology

Muscle twitches

September 16, 2021 | 35,00 EUR | answered by Dr. med. Frauke Gehring

Good evening,
I have been suffering from muscle twitches for a few weeks. It started about 10 weeks ago in a spot above my knee. It twitched in the evenings and stayed in the same spot for about 3 days before going away.
After a month, it came back and then spread throughout my entire body. Sometimes it twitches in my leg, then in my arm, stomach, and rarely in my head.
When the area between my big toe became numb repeatedly in the mornings and evenings last week, I went to see my general practitioner. She ordered a blood test (results pending) and a prescription for a skull MRI.
Now that I'm back home, I am worried because I read some "scary" things like ALS on the internet.
Due to a very stressful and unpleasant time last year, I experienced a few panic attacks which I was able to overcome with the help of a psychologist. I was hoping that the muscle twitches were just residual effects of that.
My question now is, are the changing muscle twitches I described typical for more serious conditions like ALS? Or could this be related to the previous "healed" panic disorder? Otherwise, I am healthy, 33 years old, and female.
Thank you.

Dr. med. Frauke Gehring

Good evening,

First of all, ALS is an extremely rare disease, especially in women and people under 50. The likelihood of you developing it is therefore approximately 1 in a million.

Furthermore, in ALS, diffuse brain tissue is lost, leading not only to muscle twitches but also to paralysis. Paralysis typically occurs (especially in the hand, often in the thumb) before the twitches. If you do not have paralysis, you can be completely relaxed, as you would have noticed it by now after a month!

Muscle twitches do occur in ALS, but they are much more pronounced than you describe. There could be numerous other reasons for them, such as magnesium deficiency, stress, internal restlessness, or misalignment of the back muscles (which could also explain the numbness in your toes)… I would not be concerned at all.

Best regards, Dr. Gehring