[37F] With muscle twitching, jerking, and daily headaches

Patient Description

A 37-year-old female has been experiencing muscle twitching and jerking on and off for a couple of years. These episodes sometimes feel like the bed is vibrating, and the patient describes involuntary movements as if responding to dropping something while sitting still. The twitching and jerking occur throughout the day and are particularly noticeable when falling asleep. The patient is concerned about these movements while driving. Additionally, she wakes up with numb or tingling hands that last for a bit after waking up. The patient reports increased headaches that have turned into migraines almost every day for about a year, sometimes accompanied by blurry vision. She also experiences brain zaps, insomnia, and extreme fatigue. Her medical history includes bronchial asthma diagnosed at age 12 and an unspecified autoimmune disease diagnosed about 8 years ago. Current medications include Abilify (10mg), Gabapentin (400mg), Xanax (.25mg), Trileptal (dosage unknown), and Wellbutrin (dosage unknown). She also takes Biotin (1000mg) and Benadryl (2 tablets as needed). No known drug allergies.

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Arora's Assessment

What might be happening

Based on the information you've provided, here are some possible explanations for your symptoms:

  • Restless Legs Syndrome (RLS): This condition causes uncomfortable sensations in the legs and an irresistible urge to move them. Symptoms often occur in the evening or nighttime hours when you're sitting or lying down. Moving eases the unpleasant feeling temporarily.

    • Treatment typically includes lifestyle changes, such as establishing good sleep hygiene, and medications to reduce symptoms.
  • Peripheral Neuropathy: This condition results from damage to the peripheral nerves and can cause numbness, tingling, and pain in the hands and feet. It can be associated with autoimmune diseases.

    • Treatment focuses on managing the underlying condition causing the neuropathy and may include medications to relieve pain.
  • Essential Tremor: This is a nervous system disorder that causes involuntary and rhythmic shaking. It can affect almost any part of your body but most often occurs in your hands.

    • Treatment may include medications, physical therapy, and sometimes surgery.
  • Migraine: Frequent headaches that can be severe and are often accompanied by nausea, vomiting, and sensitivity to light and sound. Blurred vision can also occur during a migraine.

    • Treatment includes medications to relieve symptoms and preventive medications to reduce the frequency and severity of migraines.
  • Sleep Disorders: Insomnia and other sleep disorders can cause a range of symptoms, including fatigue, headaches, and muscle twitching.

    • Treatment includes improving sleep hygiene, cognitive behavioral therapy for insomnia, and sometimes medications.

What you can do

While you should consult a healthcare professional for a formal diagnosis and treatment plan, here are some steps you can take to manage your symptoms:

  1. Maintain Good Sleep Hygiene: Establish a regular sleep schedule, create a comfortable sleep environment, and avoid caffeine and electronics before bedtime.
  2. Stay Hydrated and Eat a Balanced Diet: Proper nutrition and hydration can help manage headaches and overall health.
  3. Exercise Regularly: Gentle exercises like walking or yoga can help reduce muscle tension and improve overall well-being.
  4. Manage Stress: Practice relaxation techniques such as deep breathing, meditation, or progressive muscle relaxation.
  5. Limit Alcohol and Caffeine: These can exacerbate symptoms of restless legs syndrome and other conditions.

What you should look out for

Seek medical attention if you experience any of the following:

  • Sudden, severe headaches or migraines that are different from your usual pattern
  • Persistent or worsening numbness and tingling in your hands or feet
  • Episodes of sudden muscle weakness or loss of consciousness
  • Any new or unusual symptoms that concern you

Remember, it's important to consult with a healthcare professional to receive a formal diagnosis and appropriate treatment. Your symptoms could be related to multiple conditions, and a healthcare provider can help you determine the best course of action.

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8 mo ago

Top picked over-the-counter products for Tingling or Cold Sensations at the Back of Your Head

People Also Ask


What could be causing the muscle twitching and jerking, especially when falling asleep?

Muscle twitching and jerking, particularly when falling asleep, could be related to conditions like Restless Legs Syndrome or sleep disorders. These involuntary movements are often benign but can be disruptive. It's important to consult a healthcare provider for a proper diagnosis.


How can migraines with blurry vision be managed effectively?

Migraines with blurry vision can be managed with a combination of lifestyle changes, such as maintaining a regular sleep schedule and avoiding known triggers, and medications that relieve symptoms or prevent migraines. Consulting a healthcare provider for a tailored treatment plan is recommended.


What are the potential causes of waking up with numb or tingling hands?

Waking up with numb or tingling hands could be due to peripheral neuropathy, which is often associated with autoimmune diseases, or other conditions like carpal tunnel syndrome. It's important to address the underlying cause with a healthcare provider.


How can sleep disorders like insomnia contribute to extreme fatigue and headaches?

Sleep disorders like insomnia can lead to extreme fatigue and headaches due to insufficient restorative sleep. Improving sleep hygiene, managing stress, and possibly using medications or therapy can help alleviate these symptoms. A healthcare provider can offer guidance on the best approach.


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1 Comments


Leo#3962

8 mo ago

Does gapapentin help at all with the twitching and jerking?

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