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I have been asked this question many times before; this fluttering sensation is a common complaint among patients of all ages. It is often caused by muscle twitches, although sometimes it can be confused with palpitations and arrhythmias. Muscle twitching is caused by one muscle fiber contractions in the area, or uncontrollable twitching of a group of muscle fibers that is served by a single nerve cell.

Muscle twitches are usually minor issues and often go unnoticed but they can be signs of a nervous system disorder.

Nervous system conditions that present with muscle twitching:

Amyotrophic lateral sclerosis (Lou Gehrig's disease) is a progressive, fatal neurological disease caused by the degeneration of the nerve cells responsible for controlling voluntary muscles.

When the nerve that leads to a muscle is damaged the muscle becomes overexcited producing tiny muscle contractions.

Muscular dystrophy. A group of genetic diseases that present with muscle twitching and eventually degeneration.

Myopathy. This is the medical term used for weak muscles.

Causes not related to neurological disorders

Autoimmune disorders. Such as (continuous muscle fiber activity syndrome.) This syndrome is characterized by abnormal nerve impulses from the nerve cells. These impulses cause continuous contractions in muscle fibers.

Stimulants. Such as caffeine, amphetamines and energy drinks.

Many drugs can produce muscle twitching as a side effect (diuretics, corticosteroids, or estrogens)

Stress or hard exercise

Lack of specific nutrients in the diet

  • Minerals: Every cell in your body needs calcium. Clacium plays an important role in muscle contraction as well as conducting impulses through nerve fibers. Calcium deficiency is associated with muscle twitching and muscle spasms.
  • Vitamin D: Deficiency of this vitamin results in low calcium levels which cause muscle twitching, you might experience muscle spasms, cramping and tingling in your extremities.
  • Vitamin B6: Vitamin B6 deficiency is rare in the USA. Vitamin B6 deficiency is an important cause of muscle twitches in alcoholics who don't eat a balanced diet.
  • Vitamin B12: Deficiency of this vitamin cause muscle weakness, unsteady gait, low blood pressure and mood disorders. Anemia is a common side effects of B12 deficiency needed to produce healthy red blood cell.


Benign twitches. Can affect any part of your body most often the eyelids, calves, or thumb. These twitches are normal and common; they are often triggered by anxiety or stress. They come and go in brief episodes. No treatment is required for benign muscle twitching.

It is recommended to call your general practitioner if you have long-term or persistent muscle twitches.

Your doctor will take a medical history and perform a physical examination.

The most important questions that could be asked by your doctor:

  1. When did you notice the twitching first time?
  2. How long does the episode last?
  3. How often do you have the twitching?
  4. What locations are affected?
  5. Is it always in the same muscle?

Tests are ordered based on the suspected cause, and may include:

  • Blood tests to sort out problems with electrolytes.
  • Thyroid hormone levels
  • CT and/or MRI scan of the spine or brain
  • Electromyogram and Nerve conduction studies to evaluate the functions of the muscle and the nerve.

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