Twitching and now upper leg Muscle spasms in morning

[Dnfm23]

Hello and thank you for your time, I’ve been having weird symptoms since March 2022 and have been to several different Doctors. Started with muscle twitching in left leg that spread to more parts of the body. The initial Neuro appt went well and she ordered an EMG and NCS…both were negative. She wanted to rule out ALS and said that was ruled out.
The twitching has stayed constant, not too bad and is on and off through the day, everyday. In Nov 2022 I started getting another weird thing where my whole leg would spasm and kick my foot out any morning that I fully stretched my leg but I never thought much of it or worried about it.
Then around January 10th the scary symptom starts. Every time I wake up, whether it’s 3am to pee or 8am to start the day, my legs violently spasm, starting at the quad/hamstring and down through the foot, whenever I straighten either leg after waking up. The leg I straighten is the one that spasms.
Once I’m up for a couple minutes the legs are fine and I can fully stretch them all day with no spasms. The upper legs are a little tight/sore all day but zero spasms once I’m awake for a few minutes. But if I nap or when I sleep at night, the spasms start again.
Is this an MS symptom as I’m not sure what to do and I don’t have another Neuro appt until March. I’m going to see my Primary Dr tomorrow and would like to know what to ask him. Any suggestions would be greatly appreciated or has anyone else had similar symptoms or heard of this before. Thank you

[Scott1]

Hi,
The first rule is to look for something obvious. I would think an MRI of your brain and spinal cord, rather than the tests you had, would give you a definitive answer on whether the CNS is a matter for concern. Negative results for the tests you had are a good thing but nothing beats an MRI for detail.
An alternative non-MS issue might be an impingement coming from a small muscle called the periformis. see
That YouTube article talks about Periformis syndrome in terms of pain but sometimes it manifests itself as exactly the symptoms you have described.
If that's what it is then a shot of cortisone where the needle penetrates the muscle (rather than drizzling cortisone over the muscle membrane) usually provides long term relief.
If you ever have a 'numb bum' from sitting too long, difficulty sitting on a wallet in your back pocket for long, or a dull ache down the back of the thighs then it's probably a tight performis at fault.
Regards, Scott1

[Dnfm23]

Thank you for the response and the suggestion, I appreciate it. I mentioned this to my Dr and he thinks because it’s both legs and also that there’s zero numbness or pain that he doesn’t feel it’s from the Piriformis muscle. He did prescribe me Baclofin as the previous medication I was prescribed (benzocycloprine) didn’t help at all. I will start that today and see if that helps. I have a friend who’s a sports medicine Dr and I’ll message him to ask him about the Piriformis possibility since that’s more like his specialty than my primary Dr. I really hope you’re correct as that seems like an easier fix. My primary said if the Baclofin doesn’t help that I’ll need to see a neurologist again. Thanks again

[Scott1]

Hi,
The other thing to check is whether you have some tightness in the lumber region. A good remedial masseur can relieve that. So can dry needling (like acupuncture but it targets trigger points where the muscle is abnormally tight).
A referral from a sports medicine doctor should point you to the right people.
Baclofen works by targeting the CNS system to 'switch off' muscle tightness. Unfortunately, because it loves fat, the effective dose needs to be reasonably high. It does come with side effects, particularly drowsiness. I'm surprised that it has been prescribed given the limited testing that has been done.
Always check for the obvious before leaping to conclusions. Someone putting their hands on you can often be more insightful than someone just listening to your interpretation of discomfort.
Regards,

[jimmylegs]

hi - recopying from / adding to yesterday's (jan 23) post in a diff thread:

"it's weird - just this year something like this issue has started to creep up on me. i... not every day, is more like an involuntary 'cat-stretch' routine with my calves, and only first thing in the morning.
on bad days, i notice a definite postural effect on balance, too.
after the latest related search, am interested to read this old news:
Imbalance in Multiple Sclerosis: A Result of Slowed Spinal Somatosensory Conduction
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2789668/"

today's add-on:

also, am back to the occasional twitches that inspired the username years ago. at that time, defs zinc deficient. now, my zinc is low and my copper zinc ratio is high, in spite of taking copper out of my supplement regimen and boosting the supplemental zinc to 10x recommended daily amount.

my high cu zn ratio is consistent with (even worse than) ms patients' ratios, and has been associated with higher disability status. will keep up an even higher therapeutic zinc regimen than before, until i can get the ratio into line with healthy controls, and see where things end up with the spasticity and twitches
i'm finding that these days i can identify a mild, tiny itch sensation somewhere that could be interpreted as the trigger for the twitch. not sure if there's anything similar in your xp? either way, checking ratio can be applied with or without an msdx. just looking for consistency w healthy controls.

feb 20 update:

up to more like 20x daily recommended dose now. twitches gone - for now at least.