Unusual Painless Muscle Twitches All Over, Not Disrupting Sleep – Seeking Insight
Hello everyone, Female, Age 27 For approximately two weeks now, I've been experiencing strange muscle spasms that sometimes involve my entire body or just parts of it. These sensations feel like sudden electric shocks coursing through me. Although they are not painful, their intensity can be somewhat startling, particularly in the evening. I find them comparable to hypnic jerks, as they can occur every few seconds or be spaced out more randomly. Interestingly, they do not disturb my sleep at all, which is quite baffling. I've dealt with stress over the past year, but I have encountered stress before without experiencing such spasms. This is completely new for me. Recently, I ceased taking olanzapine (2.5mg) two months ago and I’m currently on a moderate dose of Prozac. To address potential electrolyte issues, I've started taking supplements: magnesium, calcium, vitamin D3, and potassium, as well as the occasional melatonin. Blood tests taken shortly after the onset of these spasms revealed that my electrolyte levels were normal. I consume alcohol occasionally, a couple of times a month, and do not use marijuana, other non-prescribed drugs, or cigarettes. My only indulgence is caffeine, about one or two lattes daily. I had a thorough evaluation from my primary care physician to determine if there was any asymmetry in my body’s responses or muscle activity, but everything seemed normal and balanced. The physician speculated that these might just be hypnic jerks due to fatigue; however, I don’t feel unusually tired and my sleep patterns are regular. It’s just… odd. Besides this, I might be sensing a slight soreness in my throat (possibly from AC exposure at night) and occasional nausea after meals, though pregnancy is out of the question as I’ve been sterilized. Given that there are no other symptoms and my condition isn’t worsening, my doctors aren't overly concerned. My primary care provider mentioned she could refer me to a neurologist if things remain unchanged after six weeks, and her initial conversations with the neurologist led to the hypothesis of hypnic jerks. With limited answers from my healthcare team, I’m particularly interested to know if there are specific scans or tests I could ask for that might reveal something. I’ve already requested a sleep study to rule out fatigue, but I hesitate to ask for a CT scan, MRI, or anything else without knowing if it would be beneficial. If what I’m experiencing is completely normal, I’d be relieved to hear that too. Thank you for taking the time to read my post! :)
Answers (1)
7/28/2025, 9:20:49 PM
OpenHealth AI
It sounds like you're experiencing unusual muscle twitches that can be concerning, but it’s good that your healthcare team has conducted an evaluation and is monitoring your situation. Here, I'll outline some key points regarding what you're experiencing, along with actionable steps you can consider.
Key Points:
- Your muscle twitches, described as sudden electric shocks, could be related to stress, fatigue, or even medication changes after stopping olanzapine.
- Normal results from blood tests suggest that there's no immediate concern regarding electrolytes or other common metabolic issues.
- You've pursued some grounding steps, such as monitoring your symptoms and considering sleep studies, which is a proactive approach.
Explanation:
Muscle twitches can arise from various causes, including benign ones like hypnic jerks, which can sometimes be mistaken for more concerning conditions. Stress and anxiety can also lead to muscle tension and spasms. Since these twitches are not disrupting your sleep and you've ruled out some major issues with your doctor, it may be helpful to consider a holistic approach, focusing on lifestyle factors that could be contributing to the sensations.
Actionable Steps:
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Stress Management: Since you've managed stress before without these symptoms, consider incorporating relaxation techniques such as mindfulness, yoga, or gentle exercise that may ease muscular tension.
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Monitor Caffeine Intake: While moderate caffeine is generally fine, excessive caffeine can contribute to muscle twitching. You could try reducing your caffeine intake to see if it has any effect on the spasms.
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Hydration and Nutrition: Ensure you’re staying well-hydrated and eating balanced meals. Even though your electrolytes are normal, adequate hydration and electrolytes can still influence muscle function.
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Sleep Hygiene: Since you mentioned your sleep patterns are regular, continue practicing good sleep hygiene, ensuring you're getting quality rest.
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Document Symptoms: Keep a journal of the muscle spasms, noting when they occur and any potential triggers (like stress levels, caffeine intake, or physical activity) to share with your healthcare provider.
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Follow-up Consultation: If symptoms persist or worsen, consider discussing with your primary care provider the specific tests you may want, like a neurologist’s evaluation or a sleep study. These can help rule out conditions like restless legs syndrome or other nervous system disorders.
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Physical Activity: Gentle stretching or physical activity may help alleviate some of the tension that could be causing these spasms.
If your symptoms remain unchanged or if you develop new ones (such as increased soreness, changes in energy levels, or any concerning symptoms), it might be beneficial to keep an open dialogue with your physician about further evaluations. Meanwhile, please remember that many people experience muscle twitches, which can often be benign.
Feel free to reach out if you have more questions or need support as you navigate this issue!
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# 7-Month-Old Child with Abernethy Malformation - Exploring Treatment Options ## [7-Month-Old] Identified with Abernethy Malformation (Congenital Portosystemic Shunt) - Treatment Methods? **Age:** 7 months **Gender:** Female **Height:** Age-appropriate **Weight:** Currently 9 kg, was 2.8 kg at birth **Ethnicity:** Asian **Duration of Symptoms:** Present since birth **Location:** Uzbekistan **Pre-existing Health Issues:** Abernethy malformation (congenital portosystemic shunt), liver hemangiomas, chronic jaundice, anemia **Current Treatments:** Supportive management --- ## INITIAL PRESENTATION (June 2025 - July 2025) Our daughter arrived on **June 27, 2025**, presenting with: - Birth weight: **2.8 kg** - Marked jaundice (yellowing of skin and sclera) - Pale or clay-colored stools - **Bilirubin level: 245 μmol/L** (typically <20) An immediate ultrasound indicated multiple liver anomalies, initially thought to be hemangiomas. --- ## FIRST COMPREHENSIVE ASSESSMENT (August 1, 2025 - 1 Month Old) ### Multislice Computed Tomography (MSCT) with 3-Phase Contrast (August 1, 2025): **RESULTS:** - **Portocaval shunt size: 9.9 mm** (blood bypassing the liver into the inferior vena cava) - **Arteriovenous shunt size: 4.4 mm** - **Portal vein size: 6.1 mm** (patent) - **Three nodular cystic lesions** located in the perivascular area, with largest measuring 11.6×20.7 mm, enhancing during the venous phase - Liver features a heterogeneous architecture, exhibiting irregular enhancement - Gallbladder appears elongated and slightly enlarged - Other abdominal organs exhibit normal findings **RADIOLOGIST’S ASSESSMENT:** "Congenital portosystemic shunt indicative of Abernethy malformation; less likely arteriovenous malformation (AVM); cannot dismiss the possibility of localized liver lesions." **ADVICE:** Seek consultations with an abdominal and vascular surgeon. ### Blood Tests (August 1, 2025): **Complete Blood Count:** - WBC: 10.44 × 10⁹/L (normal range) - **RBC: 2.1 × 10¹²/L** (LOW - indicating severe anemia) - **Hemoglobin: 69 g/L** (CRITICALLY LOW; normal is 117-166) - Platelets: 403 × 10⁹/L (elevated) **Biochemistry Analysis:** - 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**Portocaval shunt: 9.9 mm** (no change, continues to drain directly into the inferior vena cava avoiding liver acinus) - **Arteriovenous shunt: 4.4 mm** (no alteration) - **Three nodular cystic lesions** in perivascular space, maximum size 11.6×20.7 mm, enhancing in the venous phase - **Portal vein: 6.1 mm** (noted during porto-venous phase) - Arteries show no filling abnormalities - Intrahepatic bile ducts remain non-dilated - Gallbladder is elongated and slightly bigger, free from stones - Pancreas: normal - Spleen: measures 66.9×38.5 mm (not enlarged), splenic vein is 3.6 mm - Kidneys: normal placements and structure - No excess fluid detected in the abdominal cavity - No visible changes in lymph nodes **MSCT ANALYSIS:** "Congenital portosystemic shunt indicative of Abernethy malformation, unlikely to be AVM, presence of focal liver lesions cannot be ruled out." **RECOMMENDATION:** Engage with an abdominal and vascular surgeon. --- ## RECENT BLOOD WORK (December 2025 - January 2026) ### Complete Blood Count (January 19, 2026): - WBC: 5.8 × 10⁹/L (SHOWS IMPROVEMENT) - **RBC: 2.93 × 10¹²/L** (IMPROVED but still low) - **Hemoglobin: 72 g/L** (SHOWS IMPROVEMENT but still low) - Platelets: 223 × 10⁹/L (BACK TO NORMAL) - Neutrophils: 30.0% - Lymphocytes: 64.8% - Monocytes: 4.6% ### Biochemistry (January 28, 2026): - Total protein level: 67 g/L (slightly deficient) - Creatinine: 20.7 μmol/L - **Total Bilirubin: 242 μmol/L** (STILL HIGH - unchanged) - **Direct Bilirubin: 142 μmol/L** (VERY HIGH) - **ALT: 50 IU/mL** (DRASTICALLY LOWER from >1000!) --- ## OVERVIEW OF PROGRESS OVER 6 MONTHS | Parameter | August 2025 | January 2026 | Change | |------------------|-------------|---------------|--------------------------| | **Hemoglobin** | 69 g/L | 72 g/L | ↗ Slight improvement | | **RBC** | 2.1 | 2.93 | ↗ Improved | | **ALT** | >1000 | 50 | ✓✓ MAJOR IMPROVEMENT | | **Bilirubin** | 245 | 242 | → Unchanged (still elevated) | | **Portal vein** | 6.1 mm | 3.9 mm (US) | ↗ Decreased | | **Platelets** | 403 | 223 | ↘ Normalized | | **Shunt size** | 9.9 mm | 9.9 mm | → No Change | --- ## CURRENT SITUATION (February 2026 - 7 Months Old) - **Weight:** 9 kg (good growth rate in spite of condition) - **Jaundice:** Continues to be present (yellow skin) - **Stools:** Remain pale/clay-colored - **Development:** Achieving appropriate milestones - **Energy:** Appears to have a good energy level - **Feeding:** Normal appetite --- ## QUESTIONS FOR r/AskDocs We have been informed this is **Type 2 Abernethy malformation** (portal vein present). **Three treatment avenues have been proposed:** ### Option 1: **Endovascular Coil Embolization** (minimally invasive approach) - A catheter is inserted via the leg vein to access the shunt and deploy coils/plugs to close the abnormal vessels - Pros: No surgical incision, minimal discomfort, short hospital stay (2-4 days), no scars, enhanced safety - Duration: 1-2 hours - Recovery: 2-4 weeks for jaundice to show improvement ### Option 2: **Open Surgical Intervention** - An incision in the abdomen to ligate abnormal vessels and redirect blood to the liver - Pros: Direct visualization, effective results - Cons: Surgical scar, longer recovery time (7-14 days in hospital) - Duration: 2-4 hours ### Option 3: **Liver Transplantation** - We have been advised this is not necessary as the portal vein is functional and liver health is improving. --- ## SPECIFIC QUESTIONS TO CONSIDER: 1. **With a functional portal vein (6.1 mm) and improving liver function (ALT normalized), is it advisable to pursue endovascular closure as the preferred treatment?** 2. **Despite ALT levels improving, the bilirubin remains consistently high (242). Should this be a cause for concern? Is there a prospect for it to normalize post shunt closure?** 3. **Are the hemangiomas/nodules (11.6×20.7 mm) linked to the shunt? Will they likely resolve following shunt repair?** 4. **How urgent is the proposed intervention? Is immediate action required, or is there flexibility to wait a few months?** 5. **What complications should we be vigilant for during the waiting period?** 6. **Regarding endovascular closure - what is the average success rate for infants aged 7 months? Are there concerns regarding the shunt size (9.9 mm)?** 7. **The measurement of the portal vein has shown improvement from 6.1 mm to 3.9 mm; should this be perceived as a positive sign or a reason for concern?** 8. **Are there special directives (diet modifications, medications) we should consider while awaiting the procedure?** 9. **Post-procedure, how long should we expect it might take for:** - Normalization of bilirubin levels? - Return of stool color to normal? - Resolution of jaundice? - Regression of hemangiomas? 10. **Can you recommend any specialized centers for pediatric Abernethy malformation treatments? We are located in Uzbekistan but are prepared to travel (to Turkey, Russia, South Korea, etc.)** --- ## ADDITIONAL INFORMATION - No family history of hepatic diseases - Pregnancy and delivery were normal - No additional congenital defects identified - Immunizations up to date - No history of bleeding disorders - No signs indicative of encephalopathy - Child is alert and engaged --- **I can supply actual MSCT images and comprehensive lab reports if they would be of assistance.** We sincerely appreciate any insights you can provide. We are striving to make the most informed decision regarding our daughter’s care and highly value expert medical opinions. **TL;DR:** 7-month-old diagnosed with Abernethy Type 2 malformation (9.9 mm portocaval shunt, patent portal vein). Liver functionality is improving (normalized ALT) while bilirubin remains elevated (242). Evaluating options between endovascular coil embolization and open surgery. 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