Dr Melanie: Tics, tre­mors and twitches

in­vol­un­tary move­ments can be wor­ry­ing, or sim­ply an­noy­ing. Here’s what you need to know…

Woman's Weekly (UK) - - News -

Our bod­ies have more than 600 named skele­tal mus­cles. These con­tract in­di­vid­u­ally or in teams to help our bod­ies move in all di­rec­tions, per­form acts of great strength or fine pre­ci­sion, and sig­nal our emo­tions.

These vol­un­tary move­ments are con­trolled by the mo­tor cor­tex in the brain, which works out what we need to do and sends sig­nals down to junc­tion boxes in the spinal cord. These spread out along mo­tor nerves to our mus­cles, where they turn into chem­i­cal sig­nals, and trigger con­trac­tions that bend or straighten our joints. Our brains con­stantly mon­i­tor and ad­just our mus­cle ac­tiv­ity, so we of­ten no­tice a fine tremor, es­pe­cially af­ter an adren­a­line surge.

Our mus­cles are also co­or­di­nated by other brain ar­eas that help us to bal­ance, adapt our move­ments to our en­vi­ron­ment and carry out repet­i­tive, learnt or ex­ploratory move­ments. But when things go wrong, our mus­cles may ig­nore in­struc­tions, or even do their own thing.

Tics and twitches

Tics are in­vol­un­tary repet­i­tive move­ments that can oc­cur al­most any­where – blink­ing, cough­ing, fin­ger­drum­ming or even shout­ing out. They’re of­ten trig­gered by fa­tigue, stress or ex­cite­ment and may feel ir­re­sistible. In ex­treme cases (Tourette’s syn­drome) they may in­clude swear­ing. They can be ir­ri­tat­ing or dis­abling and em­bar­rass­ing; if nec­es­sary, psy­cho­log­i­cal treat­ments (dis­trac­tion, learn­ing to over­ride the urge) or med­i­ca­tion can help.

Repet­i­tive twitches af­fect­ing fa­cial mus­cles, hands or other sin­gle mus­cles are also com­mon, and of­ten oc­cur ran­domly for a while be­fore dis­ap­pear­ing again. Be­nign fas­ci­c­u­la­tion syn­drome can cause painful leg cramps and vis­i­ble spasm, of­ten at night, but it isn’t pro­gres­sive. Oc­ca­sion­ally twitches, cramps or mus­cle weak­ness are caused by chem­i­cal ab­nor­mal­i­ties in the blood, some­times linked to med­i­ca­tion such as wa­ter pills.


This is a con­di­tion af­fect­ing the brain and ner­vous sys­tem, but which rarely af­fects think­ing, rea­son­ing and mem­ory pro­cesses. It can, how­ever, cause ab­nor­mal, per­sis­tent or repet­i­tive spasms and con­trac­tions in a sin­gle mus­cle or group of mus­cles.

Dys­to­nia can be ge­netic or part of other neu­ro­log­i­cal con­di­tions in­clud­ing cere­bral palsy, Parkin­son’s dis­ease, Hunt­ing­ton’s dis­ease (a ge­netic con­di­tion), mul­ti­ple scle­ro­sis, strokes or brain tu­mours. It can also be trig­gered by in­fec­tion or in­jury, tox­ins in­clud­ing car­bon monox­ide, and med­i­ca­tion used for epilepsy or men­tal-health prob­lems. Writer’s cramp is a mi­nor form of the con­di­tion; rarer causes in­clude nerve trap­ping in the spine and mo­tor neu­rone dis­ease.

Dys­to­nia may be focal (af­fect­ing one mus­cle only), af­fect one side of the body, or tar­get dis­con­nected ar­eas, lead­ing to un­usual or un­com­fort­able pos­tures. It may be pos­si­ble to re­lieve

symp­toms with mus­cle re­lax­ant drugs, phys­io­ther­apy, Bo­tox in­jec­tions or surgery.

Tremor (shak­ing)

An over­ac­tive thy­roid, low blood sugar and caf­feine, smok­ing and al­co­hol with­drawal can all pro­voke shak­ing. It can also be a side-ef­fect of med­i­ca­tion used for asthma, epilepsy, heart con­di­tions, den­tal in­jec­tions and cancer treat­ment. Be­nign es­sen­tial tremor of­ten runs in fam­i­lies and gets worse as we get older.

You’ll no­tice a fine shak­ing, when car­ry­ing teacups for ex­am­ple, and your voice may be shaky too; it can be treated with beta-blocker drugs. Tremor can also be a sign of Parkin­son’s dis­ease, when it’s linked to mus­cle rigid­ity (stiff­ness) and slow move­ment.

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