medhelp posting on BFS/Xanax/etc. ...

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medhelp posting on BFS/Xanax/etc. ...

Postby tewest99 on February 23rd, 2007, 11:04 pm

Subject: Re: Muscle twitching
Forum: The Neurology and Neurosurgery Forum
Topic Area: Neuromuscular
Posted by CCF MD mdf on June 02, 1998 at 14:15:08:
In Reply to: Muscle twitching posted by Mary on June 01, 1998 at 15:09:34:


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: Well, I have just spent another sleepless night. I am a 42-year-old woman, and
: just started suffering muscle twitches -- at first in my hands, then in both feet,
: legs and along the torso -- about three weeks ago. The only possible triggers for
: this that I can think of were some stress on my job (which is continuing) and
: an infection with a cold sore (on my upper lip) which lasted for about a week before
: the twitching began. I was afraid of something like MS or ALS, and went to
: my doctor immediately, but he did a series of reflex tests, and nothing
: seemed abnormal. He says he wants to "keep an eye on it," though. He gave me Xanax to
: help me sleep, but it only worked for a couple of nights. I stayed on the Xanax for about
: a week, hopeful that it might help, but then experienced horrible withdrawal and anxiety attacks when I went off it (never
: again will I take such a drug!!). I then tried melatonin, which had no soprific effect
: even when I took quite a large dose (8 mg.) and an over-the-counter sleeping pill (Unisom), which
: knocked me out but left me feeling unrested. The problem is that the moment I lie down
: and start to relax, the little twitches begin -- hands, feet, legs, sides, back -- like little
: electrical surges that come every 30 seconds or so. It makes me so worried that I get anxious,
: which contributes to the sleeplessness. About two weeks ago, my right shoulder trapezoid muscle
: went into a painful spasm, which does not seem to have gotten better. Massage therapy
: helped a little, but the pain (and knot in my muscle) came back the next day.
: My doctor is calling this "myofascial pain syndrome," but are the twitches
: part of this?? Sometimes in the morning, my muscles are extremely tired and
: achey, as if they have been twitching all night. I can feel the twitching in
: the daytime, too, but usually my mind is occupied with other things and I don't
: pay as much attention to it. I should also mention that I hit "early menopause" (at age 41) about
: six months ago. Can that have anything to do with it? What the heck is wrong with
: me? I have never had any health problems in my life before this! And I seriously
: need some sleep! If anyone knows what this could be, please email me at [email protected].
: Many thanks!! :-) Mary
=

This is a hard one to figure out. There is no substitute for getting the story in person and having a chance to examine you.

That said, however, at least I might be able to reassure you about ALS or MS. The diagnosis of either of those is more complicated than just symptoms, of course, but the pattern and onset of symptoms, and their subsequent progression, is a critical part. Your symptoms don't quite match either of those illnesses.

There is something called benign fasciculations. However, whether your muscle twitches are fasciculations depends on a trained observer seeing you. Also, benign fasciculations don't typically have pain as a part of the syndrome.

I wonder about some sort of dystonic syndrome. Again, that would require specific examination (by a neurologist).

In my experience, we often see patients who have symptoms that don't match a specific anatomic or physiologic pattern. In those cases, the best we can do is to rule out "bad" diseases. I think for your peace of mind, you should see a neurologist and have this looked into. At least part of your sleep problem may be worry about what you might have. Even if you don't get a definite diagnosis, you could know what you don't have. Of course, if they find some specific problem, you are that much ahead in terms of starting to treat and/or deal with the problem.

I hope this helps. As you know, this information is for your general medical education only. Specific comments regarding your diagnosis, prognosis, and treatment options must come from your doctor after appropriate evaluation. CCF MD mdf.

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I think we've learned a lot about BFS since this posting in 1998. I disagree that pain is not typically a part of the BFS experience. I believe that a considerable number of BFSer's have pain symptoms that they can at least reasonably associate with their BFS. I'd venture to say that close to 20% but that's just a guess ... Could be that the pain is also totally unrelated to BFS and the article is very accurate.

Anyway, I though the part about taking symptoms out of context and out of order was very important for us to read...

God bless all
tewest99
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medhelp posting on BFS/Xanax/etc. ...

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