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Dr. Rick
Dr. Rick, Board Certified MD
Category: Eye
Satisfied Customers: 8350
Experience:  Ophthalmology since 1994 with Retina sub-specialty interest
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Hi I have been having a constant twitch on my left elbow it

Customer Question

Hi I have been having a constant twitch on my left elbow it comes in if i feel anxious, problem is I am feeling anxious easily about anything playing a game on my mobile, going for breakfast even trying to relax makes me anxious or so it feels like it have been suffering from tension headaches on and off for some time now, its wierd to explain sort of unless i suck or bite into my lip my jaw will just spasm like i see some addicts do :( also my eyes Its as if i forget to blink and become too consious of blinking it seems like unless i tense a part of my face the little twitches happen all over :( last couple of days i have been smelling burnt hair for about a minuite too
Submitted: 1 year ago.
Category: Eye
Expert:  Dr. Rick replied 1 year ago.

Dr. Rick :

Hi. I'm online and happy to answer your question today.

Customer: Im worried about all this twitching
Dr. Rick :

I can understand that...

Customer: I seem unable to relax. If i tense a part of my face the twitching stops. If not its an area at a time my eyes feel as if i werent blinking and suddenly need to squint to stop them
Customer: feeling this way etc
Customer: Hi I have been having a constant twitch on my left elbow it comes in if i feel anxious, problem is I am feeling anxious easily about anything playing a game on my mobile, going for breakfast even trying to relax makes me anxious or so it feels like it have been suffering from tension headaches on and off for some time now, its wierd to explain sort of unless i suck or bite into my lip my jaw will just spasm like i see some addicts do :( also my eyes Its as if i forget to blink and become too consious of blinking it seems like unless i tense a part of my face the little twitches happen all over :( last couple of days i have been smelling burnt hair for about a minuite too
Dr. Rick :

I know what is causing your twitching and, the good new? You will be ok :)

Dr. Rick :

The most likely cause of your symptoms is called myokymia. Myokymia is an involuntary, local twitching of a few muscle fibers in the body of a muscle. This twitching, if it occurs in a limb, is not strong enough to actually move a joint but can be felt and sometimes seen as an area of quivering.

Myokymia commonly involves the eyelids and muscles around the orbit. It often appears and resolves for no apparent reason and has not been linked to any underlying significant pathology. What causes myokymia? Studies have shown that it is associated with anxiety, stress, lack of good sleep, high caffeine intake and the use of some drugs.

The best way to treat myokymia is to get more sleep, decrease caffeine intake and decrease stress. The good news is that myokymia is not a sign of serious underlying pathology and often resolves on its own.


Here is an excellent article on this topic:


http://emedicine.medscape.com/article/1213160-overview

Dr. Rick :

I also feel that you would benefit from talking to your doctor and getting some treatment/medication to help with your anxiety. This is a very common problem and is nothing to be embarrassed about, especially since there is very effective therapy available.

Dr. Rick :

Does this make sense to you?

Customer: Yes the elbow is starts quivering but if i move it it goes away. Would this also affect the jaw? Also the phantom smells?
Dr. Rick :

The burning hair smell, I must admit, I don't know what is causing that. One thing I can tell you.....it is not a brain tumor.

Dr. Rick :

Yes. Myokymia can affect the jaw too.

Customer: My eyes dont twitch as such its just as if i forget to blink and suddenly i get the urge to shut them tight feeling gies away until i seem to space out for a fee secs again etc
Customer: Great good news :) didnt suspect a tumor
Customer: but was worried of other possibilty like partial seizures etc i did suffer from mengiococol septiceamia as a child
Dr. Rick :

That goes along with the anxiety you are experiencing. It can be treated and you will feel better, but you need to see your GP for an evaluation.

Dr. Rick :

I just said that since it seems most everyone is worried that they have a brain tumor lol!

Dr. Rick :

From what you have posted I do not think your symptoms are from seizure activity, but that was a very good thought.......

Customer: Thanks will go see GP :) its like spasms
Dr. Rick :

That sounds like a great idea. I do however, think you will be OK in the long run.

Customer: in my head and i do tend to space out quite a bit though i realise very soon thank god lol
Dr. Rick :

Just as an aside, do you live in Gibralter, as in the White Cliffs Of?

Customer: Gibraltar in europe as in the Rock /)
Dr. Rick :

In in the Midwest of USA, where is it currently snowing outside my window :(

Dr. Rick :

I would like to visit your town someday.......

Dr. Rick :

Anyway, good to chat with you and I hope you feel better soon.

Customer: Nice and sunny here though we have had a lot of rain lately never snowed thiugh:(
Dr. Rick :


I hope this information was helpful for you. But I do work for tips so I want to make sure you are happy with me before rating me. If you have another question on this or a related issue feel free to fire away. You may also receive an email survey after our chat, if you don’t feel that I have earned a “10” rating in all areas, please let me know what I can do to meet your expectations.

Thanks in advance,

Dr. Rick MD FACS

Dr. Rick :

Snows here a lot...but I like snow

Customer: Thank you
Dr. Rick :

My pleasure. I'm always happy to help my friends across the Atlantic :)

Dr. Rick, Board Certified MD
Category: Eye
Satisfied Customers: 8350
Experience: Ophthalmology since 1994 with Retina sub-specialty interest
Dr. Rick and other Eye Specialists are ready to help you
Expert:  Dr. Rick replied 1 year ago.
Our chat has ended, but you can still continue to ask me questions here until you are satisfied with your answer. Come back to this page to view our conversation and any other new information.

What happens now?

If you haven’t already done so, please rate your answer above. Or, you can reply to me using the box below.
Customer: replied 1 year ago.
Hi I need to know how to calculate the serum sodium potassium ratio, also does high c reactive protein mean cancer? Finally had tests done now I'm worried
Expert:  Dr. Rick replied 1 year ago.
C Reactive protein is a test for generalized inflammation in your body.

It is not a sign of cancer. :)


I'm not sure what you mean by serum potassium ratio. Do you have a lab result on potassium or do you want to know what techniques are used in the lab to come up with a number for potassium?

Let me know...

Customer: replied 1 year ago.
My crp has come up as 6.8mg/l which I am told is very high:(. Sodium 136 range 136-145. Potassium 3.9 range 3.6 -4.9. Was wondering what the ratio was as certain ratios seem to indicate certain conditions etc
Expert:  Dr. Rick replied 1 year ago.
That is actually a normal CRP when expressed in mg/l when using the standard sensitivity testing protocol.

Potassium and sodium are fine.

I'm not aware of any ratios involving potassium might indicate but,then, I am a retina surgeon and not as smart as my internal medicine colleagues in this area ;)

Does this make sense to you?

It's safe for you to press the positive feedback button now if you so desire. And, never fear, even after you press that button I don't go up in a puff of smoke -- I'll still be right here to continue helping you, but, as I do work for tips, I want to make sure you are happy before rating me.

Customer: replied 1 year ago.
Thanks what exactly do you mean by normal crp though my lab tests have 3 asterisk marking it as very high range is 0-3
Expert:  Dr. Rick replied 1 year ago.
Darn those asterisk marks :(

Look closely at the CRP result.

Does it say mg/l or mg/dl? Does it mention hs or high sensitivity protocol?

I will standby...
Expert:  Dr. Rick replied 1 year ago.
For a value of normal being less then 3 that sounds like you had the high sensitivity (hs) CRP test done.

If this is the case then, yes, that is very high.

What does this mean? It is a very non specific test and can be elevated for many, many reasons. All this really means is that your doctor might want to look for causes of inflammation in your body.

The hs-crp is also being used in many areas as an indicator of the future risk for heart problems...

Does this make sense to you?

I'm sure you know how much fun it is to mash the excellent feedback button :)

Let me know if I can do anything else to help you. Have a great day :-)
Customer: replied 1 year ago.
Im asthmatic and have pcos could those influence the result??
Expert:  Dr. Rick replied 1 year ago.
I don't think the PCOS would but the asthma sure could elevate your CRP
Customer: replied 1 year ago.
Sirry just rechecked everywhere online it says 3 here it actually says INFECTION MARKERS:
C reactive protein 6.8mg/l

Range 0-5
Expert:  Dr. Rick replied 1 year ago.
Yes...infection, inflammation, lots of things can bring this up... It is very non specific.

As we discussed your asthma can even cause this number to go up....

Did you see if your lab sheet says mg/dl or high sensitivity (hs)?

Dr. Rick, Board Certified MD
Category: Eye
Satisfied Customers: 8350
Experience: Ophthalmology since 1994 with Retina sub-specialty interest
Dr. Rick and other Eye Specialists are ready to help you
Customer: replied 1 year ago.
Nope dosnt say High sensitivity only c reactive protein and its
In mg/l
Expert:  Dr. Rick replied 1 year ago.
We have to assume the test done is a standard CRP. Normal for this test, which I use all the time in my practice, is up to 10 mg/l. This being the case we have to assume that is a normal value.

I have no idea why they put all those asterisks next to it...

The only thing to do at this point is call the lab, tell them about our thought processes and get confirmation of what test, exactly, they did

Does that make sense?

Don't be afraid of the excellent feedback button. No one has ever been harmed by pushing it.... ;-)
Dr. Rick, Board Certified MD
Category: Eye
Satisfied Customers: 8350
Experience: Ophthalmology since 1994 with Retina sub-specialty interest
Dr. Rick and other Eye Specialists are ready to help you
Customer: replied 1 year ago.
Thanks called hosp the range is 0-5 crp mg/l it is not high sensitivity. :) range here is pretty wierd lol i have been investigated for kidney disease as creatine range was up ti 60 and i had 69. Now i have 71 and range is up to 85 lol so go figure usually range here is slightly shorter than anywhere else:)
Expert:  Dr. Rick replied 1 year ago.
That is a weird range..but you have to go with the specific labs data, so,yes, you are high :(

I do not like that your creatine is going up....what ever is causing that could be responsible for your elevate CRP.

Let me know how things go.

I see you had so much fun that you mashed the button twice lol!

Thanks :)
Customer: replied 1 year ago.
Hi though id let u know had my insulin tested privately and came back at 58.3 mu/l been told
Expert:  Dr. Rick replied 1 year ago.
Thank you for that information.

What does your doctor think of that value?
Customer: replied 1 year ago.
Nothing yet i checked my symptoms online asked doc and as glucose tolerance test was normal they said it couldnt be insulin so i did test privately
Expert:  Dr. Rick replied 1 year ago.
That sounds like a good idea. Let me know what you find out.

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Dr. Rick
Dr. Rick
Eye Doctor
8350 Satisfied Customers
Ophthalmology since 1994 with Retina sub-specialty interest