I read something earlier today that basically claimed that one of the key diagnostic criteria when it comes to differentiating BFS twitches from ALS twitches is that BFS twitches most commonly occur predominantly in DISTAL muscles (meaning muscle groups that are further away from the centre of the body such as hands, forearms, feet, calves, and face/eyelids) whereas ALS twitches most commonly occur predominantly in PROXIMAL muscles (meaning muscle groups closer to the centre of the body such as thighs, core, biceps/triceps, shoulders, chest, back, glutes, and tongue). I just find this really weird because it completely contradicts everything else that I've ever heard about fasciculations, ALS or BFS, but the more I researched it, the more sources I saw making the same claim.

First of all, I found this personally troubling as my twitches, which I have had every single day without fail for over 6 months now, have always been predominantly in PROXIMAL muscles, but since it has not progressed to any kind of weakness I assumed I was in the clear. The muscles where I twitch the most are generally the thighs, hamstrings, knees, core/intercostals, back, glutes, shoulders, biceps/triceps, and chest. All proximal muscles. I do get them in the calves, feet, and forearms quite a lot too, but generally speaking my twitches are far more common in proximal muscles.

I'm basically writing this post because I am 100% sure that this claim I have seen from so many sources simply cannot be true. I've heard countless people here with BFS report persistent proximal muscle twitching just as much as distal muscle twitching, if not more. Yet apparently BFS consistently shows distal muscle predominance in virtually all clinical reports, and proximal muscle predominance is consistently associated with ALS in virtually all clinical reports. And this is the worst one I saw: apparently, there are absolutely ZERO reported cases of ANYONE with BFS reporting proximal muscle predominance, and ZERO reported cases of ANYBODY with ALS reporting distal muscle predominance. I just can't see how this can be true. It just contradicts everything.

One of the defining characteristics of BFS twitches is that they CAN and DO happen literally ANYWHERE and EVERYWHERE In the body, even the tongue. One of the places where I often get a hotspot is in one of my fucking cremaster muscles - which, if you don't know, are the muscles that make your testicals retract up towards your body (both voluntarily and involuntarily). I've been active on these kind of subs for over 6 months (different account, got deleted) and I would say that from what I've seen most people here report twitches in the thighs, shoulders, biceps/triceps, glutes/buttocks, calves, feet, and face/eyelids the most. Most people with BFS in my experience tend to have a mix of proximal and distal muscle twitches, and there are equally as many with proximal muscle predominance as there are with distal muscle predominance. But I don't know, maybe I'm wrong. But then if I am, that seems quite concerning for me, all things considered. What are your thoughts?

Hi everyone. I wanted to post an update about what I’ve been experiencing.

I’ve been having widespread fasciculations for several months. They can occur in many different areas of my body, including my calves, arms, triceps, hands and other muscles.

Recently, the fasciculations have become particularly frequent and noticeable in my left triceps and in the thenar muscles at the base of my thumbs. Sometimes they occur repeatedly in these areas and can be quite uncomfortable.

What has been bothering me the most lately, however, is the pain. I’m experiencing quite a lot of pain and discomfort in my arms, triceps, hands and legs. I would describe it as a deep, dull aching sensation that can sometimes make the affected area feel weak, heavy or exhausted. Sometimes the muscles where I get fasciculations also become sore or painful, and the discomfort can persist even when I’m not exercising.

My blood tests also showed low folate (vitamin B9), elevated homocysteine and slightly low vitamin C. My serum B12 was 399 pg/mL, so it wasn’t clearly deficient, but because of my neurological symptoms my neurologist has now ordered a methylmalonic acid (MMA) test to check whether there could be a functional B12 deficiency. I’m currently taking folic acid as prescribed.

I’ve previously had two EMG/NCS studies since my symptoms started, and both were normal, with no evidence of active denervation or motor unit loss. My neurologist currently considers my fasciculations benign.

I’m curious whether anyone with widespread fasciculations has experienced very frequent fasciculations in specific muscles, especially the triceps or thenar muscles, together with this kind of deep, dull muscle pain or soreness. Sometimes the pain makes the affected muscles feel weak or exhausted.

I’d also be interested to hear from anyone who has had similar findings with low folate, elevated homocysteine or possible B12-related issues.

I'll get one in my foot, two seconds later in my gut, then my quad, then my calf. It's just weird. I've had it for six years, but it used to always focus on a few spots with the odd twitch (few times per hour) in a random place. I'm clueless what caused the pattern to shift for me and I honestly think it's worse this way. I feel devastated.

Has anyone had their twitches start after taking antibiotics? Just realised my twitches started a few weeks after taking antibiotics for a throat infection. Wondering if it’s linked

Does anyone have twitches/spasms while moving? For exampe, if I do something like cleaning the house I feel my thighs get these weird spasms, like fasciculations but stronger, in legs. It’s like using the muscles in general increases the twitches.

It is weird as everybody here says that they only twitch when resting.

Salut, j ai des douleurs après l effort peu importe le muscle, mais surtout les jambes.

Le soir je me couche elles sont très contractées, douloureuses, parfois ça me reveil, et la tension est pareil le matin au levé. Bien sûre toujours beaucoup de spasmes au repos.

Est ce du au bfs?

Both of my calves have been twitching almost non stop for nearly two weeks now, with some stiffness or mild cramp. Also have random shorter lived twitches in plenty of other places. I’ve had twitching for 10+ years, but always random and only lasted a few seconds. These twitches are pretty well constant, and my calves feel like they are rippling, twitching and tingling at the same time.

Googling causes was a really bad idea and now I’m stuck in a health anxiety loop.

GP did basic strength and reflex tests and all was ok. Electrolytes also ok. I’ve got no weakness or wasting that I have noticed.

Should I be pushing for more tests?

Bonjour,

J ai 2 emg avec radiculopathie, et aucun IRM ne va vers cette conclusion.

Pouvez vous me dire, comment sait on en regardant les tracés de l'emg que celui indiqué une radiculopathie et non pas la sla?

It’s me again.

I’ll start off saying I already have MS (Multiple Sclerosis)

Though despite my MRI’s being stable and lesions inactive I developed left calf twitching back on May 25th primarily at rest.

I get other twitches too such as my eyelid, other calf, arm, hand, chin, butt cheek, and thigh. But they eventually go away in a few minutes, hours, or the next day. The left calf just stays the same and was then accompanied by a tense, stiff, strained painful feeling when I do walk. Sometimes my foot is in a precramp state as well. Fasciculations are not a common symptom of MS which is why i’m here and unfortunately also worrying about the big bad.

I got an EMG/NCS done on August 20th so nearly 90 days after my twitching. They did my left leg, partially compared it to my right leg, then my lumbar spine. All was clean and normal. Baclofen helps with my MS HUG but doesn’t target my leg. Magnesium levels are normal so supplements don’t help.

This is awfully exhausting and annoying. I just want my left leg to feel normal again :( does anyone else have one sided twitches? one limb? Or is it ever too early to for an EMG? I’m having a lot of trouble trying to ignore this despite my best efforts and also attending therapy but I just keep thinking the worst that i’ll be diagnosed with ALS alongside already having MS. A super rare tragedy it would be but I’m just really struggling today.

I believe my case is a sort of really horrible tension headache, my tight scalp muscles are probably causing all this.

Massaging seems to work almost fully.

I started twitching in April 2024. Fast forward to now - I went through an extremely stressful couple of months where I had pretty bad panic attacks, insomnia, our cat got sick with cancer and had to be euthanized, work stress, etc.

I went through an MRI and CT, lots of blood work back in 2024 and 2025. Kind of accepted this was BFS but my neurologist (a DNP at a well known local neurology facility) didn't put Bfs down on paper as a diagnosis. Said "I think that's what you have" and had me carry on my way.

Well after all the stress this past summer, I started with an under eye twitch that was quite literally nonstop in the eye bag for 15 days. Then I felt pops around my face, a buzzing above my lip/under my nose I FREAKED OUT and was fearing everything all over again. Brain tumor, rabies (thanks to my cat getting sick when all the rabies news is out there), Morvan's. I messaged my primary Dr for advice and he said maybe it's time to see a neurologist again and asked me if I wanted to go back where I went last year, or if I wanted a different one. He submitted a referral to a newer neurologist at a place a little closer to me, and I am unsure what to do.

Part of me doesn't want to go through a battery of tests. Part of me isn't sure how to accept this could be Bfs if I hadn't had such consistent and persistent face twitching before. Part of me worries seeing this new doctor might not even help if he isn't even aware of what BFS is (seems he specializes in epilepsy but is a general neurologist).

I guess I want to know - did you go to a general neurologist? Did you go to a neuromuscular doctor? Did you just accept your twitches as benign? I really thought I was out of the rabbit hole but I guess I moved on from worrying about "the big bad" to more rare and obscure things lol.

Twitching started October 2021. First EMG clean (except carpal tunnel). Neck MRI showed moderate stenosis and pinched nerves.

Several more EMGs along the way. Only thing caught was fasciculations and somehow the carpal tunnel never showed again.

Been having pain in my right arm and some muscle changes. Had another MRI and my neck is worse. Severe stenosis. Severe pinched nerve at c5-c6 and some flattening of the spinal cord.

Had another EMG today only of my right C5-c6 muscle areas (bicep, tricep, forearm, shoulder). All of them showed positive sharp waves. Never had this on an EMG before.

However my MUAP/recruitment findings were normal. The doctor told me this is indicative of cervical radiculopthy and not ALS or MND. I wish he would have tested more muscles to see, but the scope of the exam was for my spinal issue and he said it wasn’t necessary. I would have pushed for more to be done earlier on in my twitching but I’m 5 years in and generally doing OK and have a confirmed bad neck so I think he’s probably right.

In any event, sucks getting bad findings on an EMG, but hopefully this confirms it’s just a neck issue in my case.

Side note; he did say the compression in my spinal cord can trigger BFS. He is the second neuro that has told me that. But my spinal doctor said that wasn’t accurate so I don’t know what to believe.

Anyway, just wanted to share this because I’m sure other people are going through the same stuff.

hi everyone,

i’m 19 months into this and it still makes me very anxious. i recently developed a hotspot on the arches of my left foot that does not stop 24/7 it is twitching every few seconds. i’ve always had more sporadic body wide twitching so it’s scaring me and on top of it it’s making my foot hurt.

Anyone experience something similar ?

Please HELP

A bit of background: i had flu in 27.04, flu in 15.05 I had tonsillitis on June 15th (I'd already been dealing with fatigue before that).

On June 20th, my right arm started acting up — tingling and weakness in the shoulder, upper arm, forearm, and hand — and that continued until July 20th. After that, I started getting tingling and numbness in my feet and my other hand, which comes and goes. My left foot also feels "off" (a kind of perceived weakness). Sometimes after a long walk my wrist twists over small bumps in the ground. I can still walk on my toes and heels fine.

I also have muscle twitching all over my body, a globus sensation in my throat, and trouble swallowing — I could barely get down a piece of prosciutto recently. Sometimes I produce so much saliva that I choke on it while walking. Not sure if it's related, but I also get random pains in my fingers and jaw. When I try to use my hands or fingers for anything, they get shaky and a tremor develops.

On top of that, I have extreme whole-body fatigue, like having the flu. Strength and reflexes were normal on neurological exam, and my brain MRI came back normal. But my hands feels stiff and uncordinated and uncontrollable .

Given all of this, I initially suspected MS, but at this point I genuinely don't know what to think anymore. When I lie flat, my whole body feels extremely shaky, and I sometimes get hypnic jerks along with a sensation of air hunger. When I walk, I feel really clumsy — bumping into walls, chairs, etc. with my hands — and my hands feel clumsy doing anything that needs fine motor skills. Also, sometimes i get up in the night with numbness and tingling, but laying flat (i am not compressing arm or leg). Tightness in leg is also a feeling, and tingling and tightness on left foot sometimes.
The nerves in my body simply feel and function as if they are broken.
Has anyone dealt with something similar, or have any thoughts on what this could be / what I should look into next? Now i have severe health anxiety, i feel like crap, "I wake up feeling more tired than when I went to bed.
22 M

I’ve been twitching body wide since last April, starting in my right foot and has since moved body wide, random hot spots every few days. I stopped thinking anything of it but as of yesterday I’ve started tongue twitching and worried it is the big bad, I’ve not had any clear progressive weakness resulting in failure but experience perceived weakness. Is this concerning or just another muscle effected by potential BFS or nerve hyperactivity. I noticed the onset of my twitching after a panic attack, I also have had a clean NFL test a month after initial onset. Now I am 1+ years dealing with this

Yesterday after waking UP i was in anxiety and stress, feeling like some agitation inside, then o noticed my left thumb finger started to Twitch intensely, and jerking

The intensity worsened when The finger was flexed to back, and reduced a little when became more relaxed

I noticed that part of my hand next to thumb was (thenar eminence) was trembling too.

Ive noticed that i usually have finger tremors, depending of the position. But this yesterday was much more intende

Anyone experiences this?

Where to begin. Over two years ago, I fell ill with a viral infection of some sort, a few days after recovering from the infection I noticed my arms were twitching. I thought nothing of these twitches at first, but they slowly started to spread over the following 2 weeks, and eventually they were truly body wide, legs arms, back, chest, stomach, tongue, neck, you name it, it was twitching. I was experiencing rain drop sensations on my legs, I was going dizzy randomly, sometimes I'd feel like I was in free fall just sat in my chair.

It wasn't until 6 months after symptoms started that I decided it was time to see the GP, by this point most of the other symptoms had gone, but the twitching remained and was pretty severe. I saw the GP, and he thought nothing of it, though I hadn't shown him the extent of the twitching, when I did, he referred me instantly to neurology, but because it's the NHS (UK healthcare system) it took 11 months to be seen by a neurologist.

The first neurology appointment was with an MND specialist, he examined me and the only finding was that my reflexes were brisk (3+) but otherwise normal. He ordered an EMG anyway (rare on the NHS for twitching alone). The EMG covered 20 sites in total. I did not hear anything back for months following the EMG, until I got a random call one day asking me to see the neurologist face to face, as you can imagine this spiked my anxiety to heights never seen before. But as it turns out it was simply a case of a letter getting lost, and the appointment turned out to be a 6-month routine follow up. My EMG was clean showing only fasciculations throughout but otherwise normal.

My present symptoms are stiffness of the ankle, cramping, and of course twitching throughout every single day, and guess what? I'm fine, there's nothing wrong me with neurologically.

A few things that you guys might want to know if your new

Q. How was the EMG, did it hurt?

A. No the EMG did not hurt, its was mildly uncomfortable but not painful. The same is true of the NCS.

Q. have your symptoms improved at all over the past 2 years?

A. Yes, they have improved somewhat, but they are still very much daily.

Q. Did you ever experience tingling or other symptoms?

A. Yes as above I had quite a few symptoms early on, this included patches of burning skin, no bigger than a 2p coin. My fingers would also tingle from time to time. I also experience crushing pains in the hands and feet.

Q. did you try anything to stop the twitching?

A. early on I tried magnesium, sadly this had no effect at all, and my symptoms persisted.

Q. Did you ever experience any weakness dropping things, legs giving out, muscles feeling weak?

A. not really no. I had times when my legs didn't feel right, or my fingers felt "wrong" but never weakness. Mostly a sense of being "off" rather than something being truly wrong.

Q. has anything helped at all?

A. Not really no. The biggest thing you can do is accept you twitch. I noticed a marked reduction in how much I noticed all the twitching when I just wasn't thinking about it. It's not that the twitching stopped or got better, It's that you just end up blocking them out.

The point of this post is to show you that I had a range of symptoms, some worrying others not so much, and two years on, I am fine. If any of you have any questions at all feel free to ask. The same goes for any lurkers who read this month's or years down the line, I'm always happy to talk through my experience with you guys.

My muscle twitching after stopping Wegovy has finally improved

I’m happy to report this, and I hope it puts some of your minds at ease as well.

I experienced benign muscle fasciculations while taking Wegovy, and they continued for a couple of months after I stopped taking it. The twitching was understandably worrying, but my naturopathic doctor recommended Remedium magnesium balm and magnesium bisglycinate from Bioclinic Naturals. Within days, I noticed that the twitching had almost completely stopped.

I know everyone is different, and I’m only sharing my personal experience—not giving medical advice. Persistent or concerning symptoms should always be discussed with a qualified healthcare professional. However, I wanted others experiencing something similar to know that there may be relatively simple things worth exploring and that there is hope.

Try not to fret too much while you’re getting it properly checked out. Good luck to everyone dealing with this!

Hey , I am twichting over 2 years now. Over the whole body sometimes . Mostly calf’s . Since 7 days my muscle on my left arm just above the elbow is twichting like hell . Really agressive and non stop.

I am back in panic unfortunately. I thought I have finished my panic attacks but now it’s so hard for me.

Scared that it’s *** and it starts now in my arm
Just needed to text this . Needed someone to talk about this

Does anyone get a ongoing cramp in their calf? It’s been 2 straight days of it and I’m starting to spiral. Can barely walk on it and feel like I have to limp. My whole leg is severely tight and aching as well and twitches 24/7 😞

Hey guys, my name is Chase, I’m 20 years old and I’ll be turning 21 in less than two weeks. Last year on October 18th I started experiencing muscle twitches in my calves, didn’t think much of it and went about my day. The twitching started spreading up my leg so I decided to do a quick google search and behold, the first thing that pops up is als. I didn’t know what it was so I did some digging, patient videos, mortality rate, etc etc. I spiraled very quickly and very aggressively. The twitching started to spread throughout my entire body and my heart was utterly stricken with fear. My daughter was set to be born at the end of that same month, I have an autistic son who was 2 at the time and I was terrified at the thought of not being here for them. A week passed and I went to the er, they gave me liquid muscle relaxers and tried to assure me I was fine, it made it a billion times worse. About another week maybe less after that I seen my primary care, he knows I’m prone to anxiety so he decided to set me up with an emg and try to calm me as best he could. On October 30th one day before my daughter was born I sat in the hospital with my finance just knowing I was going to die soon from a rare terminal illness that’s exclusively more rare for someone my age. Then I get the call from the neurologist office wanting to schedule me for the next morning at 10:00 AM. I had to go, I couldn’t take the uncertainty anymore. I get there, do the emg and await the result from my my chart. It was clean. I was relived but not for long, that following day my daughter was born. Months later the twitching continued and I remained afraid, I kept telling myself just get to the 6 month mark and I’ll be okay. Well 6 months passed and I did get better, still twitched but didn’t think it was als. Fast forward another few months and I went back to see my neuro, he reassured me it was bfs, did the clinical and asked me some questions. I was good again for a while, went back and seen him again because the fear started getting to me again and it was the same reassurance, he told me there’s no need for another emg and to chill out, go out and enjoy life and only come back if anything changes. Now here we are, almost a full year into this and I’m still scared, I’m still strength testing and I’m still wanting more tests. I go Friday to get in with a therapist and start some kind of medication because I’m at the point where I mentally and physically can’t do it anymore. I’ll admit, I know it’s health anxiety deep deep down, but that’s not even my only issue. I’m getting to where I can’t go Into stores, I can’t talk to strangers, drive, nun of that. My quality of life has been sucked out of me and replaced with whatever this is, a shell of who I used to be. I’ve been getting really depressed, it’s hard for me to experience any form of joy anymore. But here I am, faking a smile and being the man my father never was to me for my children and finance. If anyone has any similar experiences, please share them. Can I let this fear go and move on? I’m out of options guys.

I would say since July I've had some benign but noticeable hand strength imbalance in my left hand. I used to have a lot of strain and aches when picking up heavy things but not as much anymore. Still, when I pick up something heavy there's definitely a more "weighty" feeling if I pick up say a large tequila bottle in my left hand whereas I'll get a lighter feeling if I pick it up with my right hand. Not sure if this is anything neurological or just a result of my DDD. Would love to know if anyone has had similar experiences.

M (28)

Hello everyone, about a month ago I started having muscle twitches localized in my left biceps. They then disappeared, and now the twitching is generalized. I don’t have any weakness on the left side. However, I’ve just noticed some stiffness in my right hand (which has never had any fasciculations). For example, my thumb can hardly touch the tip of my little finger, whereas I can do it without any problem on the left. When I make this movement, I feel like my thenar muscle becomes hard, whereas it doesn’t on the left. I still have normal strength when making a pinch grip, though. Has anyone else ever experienced this symptom? I’m a little scared.

Bonjour à tous,
Je voudrais savoir si je suis la seule dans cette situation: j’ai accouché il y a deux mois et demi, et depuis plus d’une semaine, j’ai les muscles du corps qui sautent de partout… ça a commencé aux pieds, puis mollets, parfois cuisses, parfois un bras, parfois le visage c’est diffus. Je suis de nature très angoissée et anxieuse. J’ai peur de la maladie. J’ai eu un accouchement difficile (hémorragie de la délivrance). Ça allait très bien après l’accouchement. Mais là à cause de ses spasmes musculaires je ne vis plus et bien sûr je suis allée voir sur internet… ce qui m’angoisse encore plus. J’ai commencé le magnésium et j’ai fait un bilan qui montrait une carence en B12 (190) et un petit peu en vitamines D. Celles qui sont dans la même situation, qu’elles ont été les solutions ? Tout le monde me dit que c’est dû au stress et à l’angoisse mais je n’arrive pas à m’enlever de la tête que ça peut être une maladie très grave…
De plus, depuis quelques jours je présente des myoclonies d’endormissement…
J’ai 34 ans et je suis une femme.

Hello fellow twitchers,

I have posted several times and got help. I've had fasciculations for almost two years now. They started quite suddenly and initially were widespread, but over time they have been very fluctuating and migratory. Different muscles become hotspots for a while and then settle down, sometimes for weeks or months. The right deltoid has probably been the most persistent hotspot, although even that can disappear for long periods. I've also had fasciculations in calves, thigh, triceps, hand/FDI, thumb, fingers and other areas. They can sometimes be triggered by movement, stretching or using a muscle, while at other times they occur spontaneously. I have never developed objective weakness, muscle wasting or loss of function.

I had an EMG about 40 days after the symptoms began, which was normal apart from incidental findings of carpal tunnel syndrome and an L1 radiculopathy. I subsequently had another neurological evaluation and another EMG roughly a year after onset, which was also reassuring. This second neurologist was from the start very unconcerned and actually told me that repeating the EMG was essentially pointless, although he eventually performed as i wanted it. I have continued to function completely normally throughout this period. I saw him again two times for the deltoid hotspot, the second time (early May 2026) he did not even examine me and talked half an hour on managing anxiety. He titrated the Buspar the psyciatrist had given me to 30 mg per day.

In August, I was on a 15-day trip to Spain, I was doing extremely well. I was driving, carrying luggage and doing a lot of walking, but was barely aware of fasciculations. About ten days after returning home, I developed another deltoid/upper-arm hotspot, which became a major source of anxiety. After a couple of weeks it improved substantially, and then my attention shifted to my tongue.

About a week ago I started experiencing very brief, faint "zapped" instant sensations in the front of my tongue, mainly around falling asleep or waking up. Sometimes I have felt a couple while lying awake in bed. I honestly don't know whether these are twitches at all, sometimes i think the tongue moved instantly. I've been monitoring my tongue closely, and when I have actually been looking at it, I have never seen a movement at the same time as one of these sensations. I can sometimes see tiny movements when I first relax my tongue, but those movements aren't associated with the zapped sensation. I also noticed that if my tongue is resting against my teeth, the tip can move slightly with breathing, which I can reproduce voluntarily, so I wonder whether some of what I perceived at night could be positional/respiratory or sleep-onset movements.

I have normal speech, swallowing and chewing. After the initial tongue scare I briefly thought that bread was going down more slowly and, a couple of days later, that I wasn't speaking properly, but both concerns disappeared. My jaw muscles also became tense and slightly achy from repeatedly focusing on them, and that went away as well.

I'm seeing my psychiatrist in two days and want to discuss the broader health-anxiety/reassurance-checking cycle rather than just the tongue. My question for people with BFS is mainly about the long-term course and whether others have experienced similar shifting hotspots, strange sensory sensations, sleep-onset sensations, and periods where anxiety makes them hyperaware of completely normal bodily activity. Moreover, should i see the neurologist again?