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Is My Reflex Hyper? My Doctor (physician) Told Me I

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Posted on Mon, 3 Feb 2020
Question: Is my reflex hyper?

My doctor (physician) told me I have mild hyper reflex, but I have been to lot of doctors and no one has ever raised this issue. I also have other issues going on which is making me really stressed out and worried.

I have mild random and sporadic twitching all over body, they come and go. For most of the day they are absent but show up during the night or when I am super stressed. It could appear on my arm, elbow, eyelid, butt, calves, feet, back, hip, stomach, chin.

I also have had numbness in my left wrist and right feet. All these issues started after I hurt my back while exercising like 4 weeks ago, the symptoms all come and go. I also have tired feeling in my leg and feels like they are heavy. It feels like its shaking if I am standing for some time. I have never had such symptoms ever in my life. I am really afraid that this could be due to MS or ALS.

I have attached a video of me trying to test out my reflex at home, I know i should not be doing this but I tried to substitute a hammer with my phone and I am not sure if my reflexes are normal or as the doctor said hyper.

Does hyper reflex mean some MND disease or it could also be due to stress/anxiety as I have a lot of stress going on or due to spine issues? But my spine is not hurting now.

I also have vitamin D3 deficiency and borderline magnesium. All other chemicals are good, have not tested for Potassium.
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Follow up: Dr. Sudhir Kumar (0 minute later)
Is my reflex hyper?

My doctor (physician) told me I have mild hyper reflex, but I have been to lot of doctors and no one has ever raised this issue. I also have other issues going on which is making me really stressed out and worried.

I have mild random and sporadic twitching all over body, they come and go. For most of the day they are absent but show up during the night or when I am super stressed. It could appear on my arm, elbow, eyelid, butt, calves, feet, back, hip, stomach, chin.

I also have had numbness in my left wrist and right feet. All these issues started after I hurt my back while exercising like 4 weeks ago, the symptoms all come and go. I also have tired feeling in my leg and feels like they are heavy. It feels like its shaking if I am standing for some time. I have never had such symptoms ever in my life. I am really afraid that this could be due to MS or ALS.

I have attached a video of me trying to test out my reflex at home, I know i should not be doing this but I tried to substitute a hammer with my phone and I am not sure if my reflexes are normal or as the doctor said hyper.

Does hyper reflex mean some MND disease or it could also be due to stress/anxiety as I have a lot of stress going on or due to spine issues? But my spine is not hurting now.

I also have vitamin D3 deficiency and borderline magnesium. All other chemicals are good, have not tested for Potassium.
doctor
Answered by Dr. Sudhir Kumar (6 hours later)
Brief Answer:
Hyperreflexia is related to anxiety.

Detailed Answer:
Hi,

Thank you for posting your query.

I am Dr Sudhir Kumar, Neurologist, and would try my best to help you.

I have noted your symptoms. Hyper reflexia is most probably related to anxiety.

Muscle twitching are due to benign fasciculation syndrome (BFS). BFS symptoms can get exacerbated with stress and exhaustion.

I sincerely hope my reply has helped you.

I would be pleased to answer, if you have any follow up queries or if you require any further information.
     
Best wishes,     
Dr Sudhir Kumar MD (Internal Medicine), DM (Neurology) XXXXXXX Consultant Neurologist
Apollo Hospitals, XXXXXXX
For DIRECT QUERY to me: http://bit.ly/Dr-Sudhir-kumar
My blog: http://bestneurodoctor.blogspot.com/


Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
doctor
Answered by Dr. Sudhir Kumar (0 minute later)
Brief Answer:
Hyperreflexia is related to anxiety.

Detailed Answer:
Hi,

Thank you for posting your query.

I am Dr Sudhir Kumar, Neurologist, and would try my best to help you.

I have noted your symptoms. Hyper reflexia is most probably related to anxiety.

Muscle twitching are due to benign fasciculation syndrome (BFS). BFS symptoms can get exacerbated with stress and exhaustion.

I sincerely hope my reply has helped you.

I would be pleased to answer, if you have any follow up queries or if you require any further information.
     
Best wishes,     
Dr Sudhir Kumar MD (Internal Medicine), DM (Neurology) XXXXXXX Consultant Neurologist
Apollo Hospitals, XXXXXXX
For DIRECT QUERY to me: http://bit.ly/Dr-Sudhir-kumar
My blog: http://bestneurodoctor.blogspot.com/


Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Sudhir Kumar (16 hours later)
Based on my symptoms and my twitching which comes and goes and there are some days where I don’t even feel them does this all point away from ALS? I want to share the video of my reflexes not sure how to do them.

I also have dry mouth and pressure on my cheeks? Is this a symptom to be worried about? Or this is due to anxiety or cold as I have both.

I also have a region in my leg which feels weird more like the muscles are stiff and also sometimes feel blunt object under my feet. I have shared the image in the thread, kindly have a look at it and let me know.

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Follow up: Dr. Sudhir Kumar (0 minute later)
Based on my symptoms and my twitching which comes and goes and there are some days where I don’t even feel them does this all point away from ALS? I want to share the video of my reflexes not sure how to do them.

I also have dry mouth and pressure on my cheeks? Is this a symptom to be worried about? Or this is due to anxiety or cold as I have both.

I also have a region in my leg which feels weird more like the muscles are stiff and also sometimes feel blunt object under my feet. I have shared the image in the thread, kindly have a look at it and let me know.

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Follow up: Dr. Sudhir Kumar (42 minutes later)
https://jumpshare.com/v/0x6yJYVeGKOkRc8sqNMj = This is the video, where I tried to test my reflexes by my own. Do you think this is hyperreflexive or normal. I checked on my sister and her reflexes barely moved.

https://jumpshare.com/v/qoCIK37wXn50W6GZhVa0
This is the link to the image of my feet where it feels weird, like the muscles are doing something not sure how I can describe it but more like jelly feeling and also feel like a blunt object underneath my feet, this sensation comes and goes and it also twitches a lot in this area.

I also want to point out one thing, most of my twitching are on the left hand side of the body.

Is there something to worry about? Or is this just anxiety/stress?


I have tested for B12,D3,magnesium,calcium,thyroid all normal but D3 for which I am taking pills. Do you think, D3 deficiency could be the cause of my spoardic twitching?

Should I go and see a neurologist for the same??
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Follow up: Dr. Sudhir Kumar (0 minute later)
https://jumpshare.com/v/0x6yJYVeGKOkRc8sqNMj = This is the video, where I tried to test my reflexes by my own. Do you think this is hyperreflexive or normal. I checked on my sister and her reflexes barely moved.

https://jumpshare.com/v/qoCIK37wXn50W6GZhVa0
This is the link to the image of my feet where it feels weird, like the muscles are doing something not sure how I can describe it but more like jelly feeling and also feel like a blunt object underneath my feet, this sensation comes and goes and it also twitches a lot in this area.

I also want to point out one thing, most of my twitching are on the left hand side of the body.

Is there something to worry about? Or is this just anxiety/stress?


I have tested for B12,D3,magnesium,calcium,thyroid all normal but D3 for which I am taking pills. Do you think, D3 deficiency could be the cause of my spoardic twitching?

Should I go and see a neurologist for the same??
doctor
Answered by Dr. Sudhir Kumar (14 hours later)
Brief Answer:
Video looks normal.

Detailed Answer:
Thank you for getting back with more details.

Yes, I agree that your symptoms do not look like ALS.

Video shows normal reflexes and mild hyper-reflexia can be seen with anxiety. I would not call this as abnormal.

Vitamin D deficiency can cause pains, however, twitching does not occur with vitamin D deficiency.

The twitching is most likely due to benign fasciculations syndrome, which is getting aggravated with anxiety.

Best wishes,

Dr Sudhir Kumar MD DM
Above answer was peer-reviewed by : Dr. Vaishalee Punj
doctor
doctor
Answered by Dr. Sudhir Kumar (0 minute later)
Brief Answer:
Video looks normal.

Detailed Answer:
Thank you for getting back with more details.

Yes, I agree that your symptoms do not look like ALS.

Video shows normal reflexes and mild hyper-reflexia can be seen with anxiety. I would not call this as abnormal.

Vitamin D deficiency can cause pains, however, twitching does not occur with vitamin D deficiency.

The twitching is most likely due to benign fasciculations syndrome, which is getting aggravated with anxiety.

Best wishes,

Dr Sudhir Kumar MD DM
Above answer was peer-reviewed by : Dr. Vaishalee Punj
doctor
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Follow up: Dr. Sudhir Kumar (7 hours later)
So my reflexes seem normal to you right?

Couple of questions:
1. Is BFS common, do you see people come to you with the same presentations?

2. I have pain in both my wrists and sort of stiffness in my left hand which has been there for almost 1 week now, what could be causing this?

3. I also have stiffness and numbness in my left leg where in the stiffness spreads from Feet to butt and balmy low back feels weird like something is being pushed against it, is this something to worry about?

4. I am asking these questions because most of my twitching in on the left side and the stiffness and numbness is mostly on the left.

What can I or should I do to check them out?
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Follow up: Dr. Sudhir Kumar (0 minute later)
So my reflexes seem normal to you right?

Couple of questions:
1. Is BFS common, do you see people come to you with the same presentations?

2. I have pain in both my wrists and sort of stiffness in my left hand which has been there for almost 1 week now, what could be causing this?

3. I also have stiffness and numbness in my left leg where in the stiffness spreads from Feet to butt and balmy low back feels weird like something is being pushed against it, is this something to worry about?

4. I am asking these questions because most of my twitching in on the left side and the stiffness and numbness is mostly on the left.

What can I or should I do to check them out?
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Follow up: Dr. Sudhir Kumar (44 minutes later)
My feet also feels cold for no reason and warm while walking when it’s cold outside, not sure what’s the issue, is it some nerve issue or just anxiety
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Follow up: Dr. Sudhir Kumar (0 minute later)
My feet also feels cold for no reason and warm while walking when it’s cold outside, not sure what’s the issue, is it some nerve issue or just anxiety
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Follow up: Dr. Sudhir Kumar (7 hours later)
I also have extreme dry lips and weird pressure on the left side of my face, is this to do with MND or it’s more like cold?
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Follow up: Dr. Sudhir Kumar (0 minute later)
I also have extreme dry lips and weird pressure on the left side of my face, is this to do with MND or it’s more like cold?
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Follow up: Dr. Sudhir Kumar (1 minute later)
My dr has ordered some blood tests, I am not sure why I just had a variety of blood tests in December like less than 3 weeks ago. I am scared, will a physical and EMG be good enough to rule out ALS?
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Follow up: Dr. Sudhir Kumar (0 minute later)
My dr has ordered some blood tests, I am not sure why I just had a variety of blood tests in December like less than 3 weeks ago. I am scared, will a physical and EMG be good enough to rule out ALS?
doctor
Answered by Dr. Sudhir Kumar (2 hours later)
Brief Answer:
BFS is common.

Detailed Answer:
1. BFS is common. I see 3-4 patients per month with BFS.

2. Pain and stiffness could be local issue with joints/muscles. A rheumatologist consultation would help.

3. No need to worry. If symptoms persist, an MRI of lumbar spine may be done to rule out a pinched nerve in lower back region.

4. Sure.

Dry lips and pressure on face are not neurological. Can be evaluated by a GP.

A normal physical examination and EMG rules out ALS.

Dr Sudhir Kumar MD DM
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
doctor
Answered by Dr. Sudhir Kumar (0 minute later)
Brief Answer:
BFS is common.

Detailed Answer:
1. BFS is common. I see 3-4 patients per month with BFS.

2. Pain and stiffness could be local issue with joints/muscles. A rheumatologist consultation would help.

3. No need to worry. If symptoms persist, an MRI of lumbar spine may be done to rule out a pinched nerve in lower back region.

4. Sure.

Dry lips and pressure on face are not neurological. Can be evaluated by a GP.

A normal physical examination and EMG rules out ALS.

Dr Sudhir Kumar MD DM
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Sudhir Kumar (13 hours later)
1.Can the dry lips be due to vitamin deficiency? Can stress/Anxiety cause dry mouth/lips and bad stomach? I have been having bad stomach for almost 10 days due to stress and anxiety.

2. Why do I have stiffness in both my left hand and leg?

3.I havent twitched at all last day, maybe small ones here and there. This really points away from ALS and the stiffness in both hand and legs at the same time also points away right?

4. Is weight loss one of the symptom of ALS or is it due to my anxiety? I have lost like 1 Kg in 10 days.

So could stress/anxiety be my real issue here? I have had a bad health anxiety since last year.
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Follow up: Dr. Sudhir Kumar (0 minute later)
1.Can the dry lips be due to vitamin deficiency? Can stress/Anxiety cause dry mouth/lips and bad stomach? I have been having bad stomach for almost 10 days due to stress and anxiety.

2. Why do I have stiffness in both my left hand and leg?

3.I havent twitched at all last day, maybe small ones here and there. This really points away from ALS and the stiffness in both hand and legs at the same time also points away right?

4. Is weight loss one of the symptom of ALS or is it due to my anxiety? I have lost like 1 Kg in 10 days.

So could stress/anxiety be my real issue here? I have had a bad health anxiety since last year.
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Follow up: Dr. Sudhir Kumar (7 minutes later)
Also, why do i feel stiffness in my feet and something under my feet when i walk?

Is this nerve issue like lumbar nerve? I feel some stiffness on both legs coming down from lower back to butt all the way down to my legs
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Follow up: Dr. Sudhir Kumar (0 minute later)
Also, why do i feel stiffness in my feet and something under my feet when i walk?

Is this nerve issue like lumbar nerve? I feel some stiffness on both legs coming down from lower back to butt all the way down to my legs
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Follow up: Dr. Sudhir Kumar (4 hours later)
Also, it pains where it twitches. I have muscle pain in the areas where it twitches. The pain comes and goes with the twitches. I am not sure if its connected in any way. The pain on the scale of 10 I would say would be 2. When pressed on the region, the pain spreads to my wrist/hands or elbow/shoulder.
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Follow up: Dr. Sudhir Kumar (0 minute later)
Also, it pains where it twitches. I have muscle pain in the areas where it twitches. The pain comes and goes with the twitches. I am not sure if its connected in any way. The pain on the scale of 10 I would say would be 2. When pressed on the region, the pain spreads to my wrist/hands or elbow/shoulder.
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Follow up: Dr. Sudhir Kumar (2 hours later)
Also, dr my left foot big toe and the surrounding muscles are stiff and that’s where I have had a lot of twitching, is this a sign of ALS?
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Follow up: Dr. Sudhir Kumar (0 minute later)
Also, dr my left foot big toe and the surrounding muscles are stiff and that’s where I have had a lot of twitching, is this a sign of ALS?
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Follow up: Dr. Sudhir Kumar (25 minutes later)
Dr, I apologize for writing things separately but I am writing them as I feel them.

I also have a weird feeling like some pressure on my forearm while using my right arm and it twitched almost the entire afternoon in that area
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Follow up: Dr. Sudhir Kumar (0 minute later)
Dr, I apologize for writing things separately but I am writing them as I feel them.

I also have a weird feeling like some pressure on my forearm while using my right arm and it twitched almost the entire afternoon in that area
doctor
Answered by Dr. Sudhir Kumar (21 minutes later)
Brief Answer:
Dry lips need to be evaluated by physician/dermatologist

Detailed Answer:
1. Please consult a GP/dermatologist for evaluation of dry lips. Anxiety seems to be there too, and it would help to meet a psychiatrist/psychologist.

2. Most likely related to anxiety.

3. Yes, they do not point to ALS.

4. Weight loss is not a sign of ALS.

Yes, anxiety seems to be the main issue.

Lumbar nerve compression in lower back needs to be excluded. This could cause pain in leg.

Dr Sudhir Kumar MD DM
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
doctor
Answered by Dr. Sudhir Kumar (0 minute later)
Brief Answer:
Dry lips need to be evaluated by physician/dermatologist

Detailed Answer:
1. Please consult a GP/dermatologist for evaluation of dry lips. Anxiety seems to be there too, and it would help to meet a psychiatrist/psychologist.

2. Most likely related to anxiety.

3. Yes, they do not point to ALS.

4. Weight loss is not a sign of ALS.

Yes, anxiety seems to be the main issue.

Lumbar nerve compression in lower back needs to be excluded. This could cause pain in leg.

Dr Sudhir Kumar MD DM
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Sudhir Kumar (27 hours later)
Thank you for the answers dr.

Couple of more questions:
1. I have stiffness in the arches of my left feet and under my feet which goes on till my shin and knee. The left feet arch is where it has twitched the most. My feet feels different and worried, is this sign of muscle weakness.
Do you think its a sign of muscle weakness?

2. My left wrist and hands are also stiff and I find gripping something to be bit painful, is this also a sign of muscle weakness?

3. My right hand also hurts, but its the forearm which hurts but this comes and goes, this is also where I have had some muscle twitches. Also, is this sign of muscle weakness?

4. To summarize, have stiffness in arch of left feet and under feet and shin, leg feels weird. Left hand and wrists both hurt and are stiff, right hand and forearm hurt. All these regions have had some degree of twitching, does this point towards ALS?

I dont have any weakness as such just the stiffness and pain is making things uncomfortable.

5. Does any of my symptoms listed about sound like ALS?

6. I have also had twitching around spine, is this common in BFS?

7. All of these episodes started after I hurt my back during exercise and my back has been bad for couple of years, do you think my hand and leg issues could be related to my spine?
If not something crazy would could be causing numbness/stiffness in both my hands and legs?

Thank You once again for answering and helping me out.
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Follow up: Dr. Sudhir Kumar (0 minute later)
Thank you for the answers dr.

Couple of more questions:
1. I have stiffness in the arches of my left feet and under my feet which goes on till my shin and knee. The left feet arch is where it has twitched the most. My feet feels different and worried, is this sign of muscle weakness.
Do you think its a sign of muscle weakness?

2. My left wrist and hands are also stiff and I find gripping something to be bit painful, is this also a sign of muscle weakness?

3. My right hand also hurts, but its the forearm which hurts but this comes and goes, this is also where I have had some muscle twitches. Also, is this sign of muscle weakness?

4. To summarize, have stiffness in arch of left feet and under feet and shin, leg feels weird. Left hand and wrists both hurt and are stiff, right hand and forearm hurt. All these regions have had some degree of twitching, does this point towards ALS?

I dont have any weakness as such just the stiffness and pain is making things uncomfortable.

5. Does any of my symptoms listed about sound like ALS?

6. I have also had twitching around spine, is this common in BFS?

7. All of these episodes started after I hurt my back during exercise and my back has been bad for couple of years, do you think my hand and leg issues could be related to my spine?
If not something crazy would could be causing numbness/stiffness in both my hands and legs?

Thank You once again for answering and helping me out.
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Follow up: Dr. Sudhir Kumar (1 minute later)
1. Also, what is a sign a of muscle weakness?
2. Things listed by me are they a sign of muscle weakness or something to do with some nerves?
3. Will a physical exam by a neurologist be enough to rule out muscle weakness?
4. Could this be caused by BFS as I have read that people with BFS do suffer from stiffness and numbness but that usually goes and comes.
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Follow up: Dr. Sudhir Kumar (0 minute later)
1. Also, what is a sign a of muscle weakness?
2. Things listed by me are they a sign of muscle weakness or something to do with some nerves?
3. Will a physical exam by a neurologist be enough to rule out muscle weakness?
4. Could this be caused by BFS as I have read that people with BFS do suffer from stiffness and numbness but that usually goes and comes.
doctor
Answered by Dr. Sudhir Kumar (0 minute later)
Brief Answer:
Not a sign of muscle weakness.

Detailed Answer:
1. Not a sign of muscle weakness

2. No

3. No

4. No

5. No

6. Yes

7. Could be related to spine

1. Sign of muscle weakness is inability to perform routine daily activities due to less strength

2. Not related to nerve weakness

3. Yes

4. Yes

Best wishes,

Dr Sudhir Kumar MD DM
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
doctor
Answered by Dr. Sudhir Kumar (0 minute later)
Brief Answer:
Not a sign of muscle weakness.

Detailed Answer:
1. Not a sign of muscle weakness

2. No

3. No

4. No

5. No

6. Yes

7. Could be related to spine

1. Sign of muscle weakness is inability to perform routine daily activities due to less strength

2. Not related to nerve weakness

3. Yes

4. Yes

Best wishes,

Dr Sudhir Kumar MD DM
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Sudhir Kumar (45 hours later)
Update: went to see a neurologist. He did the strength and reflex test and all normal. I forced him to give me a EMg which is sometime next week.

I forgot to tell him about my wrist numbness, that wrist and forearm feels warm and achy, I am not sure what’s going on with that arm.
Is this something to do with muscle weakness or ALS?

I have had numbness in the hand 2-3 times now. What should I tell the doctor when I see him next week?
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Follow up: Dr. Sudhir Kumar (0 minute later)
Update: went to see a neurologist. He did the strength and reflex test and all normal. I forced him to give me a EMg which is sometime next week.

I forgot to tell him about my wrist numbness, that wrist and forearm feels warm and achy, I am not sure what’s going on with that arm.
Is this something to do with muscle weakness or ALS?

I have had numbness in the hand 2-3 times now. What should I tell the doctor when I see him next week?
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Follow up: Dr. Sudhir Kumar (1 minute later)
I told him about my feet and leg, he seemed to be ignoring it and said it’s something local which he thinks is not muscle related but something less significant, I told him if we should check my lower spine.

He did not care about my stiffness or pain symptoms what’s so ever.

I hope these are not signs of muscle weakness or something to do with ALS.

He also said this that this is BFs and very common and that he sees 4-5 patients every month
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Follow up: Dr. Sudhir Kumar (0 minute later)
I told him about my feet and leg, he seemed to be ignoring it and said it’s something local which he thinks is not muscle related but something less significant, I told him if we should check my lower spine.

He did not care about my stiffness or pain symptoms what’s so ever.

I hope these are not signs of muscle weakness or something to do with ALS.

He also said this that this is BFs and very common and that he sees 4-5 patients every month
doctor
Answered by Dr. Sudhir Kumar (28 hours later)
Brief Answer:
Thank you for informing the details of consultation.

Detailed Answer:
I am glad to note that your neurological examination was normal and doctor agreed with a diagnosis of BFS.

A normal EMG would exclude ALS.

You can mention about numbness to the doctor to ascertain that it is not something to be concerned of.

Numbness is not a clinical symptom seen in ALS.

Dr Sudhir Kumar MD DM
Above answer was peer-reviewed by : Dr. Nagamani Ng
doctor
doctor
Answered by Dr. Sudhir Kumar (0 minute later)
Brief Answer:
Thank you for informing the details of consultation.

Detailed Answer:
I am glad to note that your neurological examination was normal and doctor agreed with a diagnosis of BFS.

A normal EMG would exclude ALS.

You can mention about numbness to the doctor to ascertain that it is not something to be concerned of.

Numbness is not a clinical symptom seen in ALS.

Dr Sudhir Kumar MD DM
Above answer was peer-reviewed by : Dr. Nagamani Ng
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Is My Reflex Hyper? My Doctor (physician) Told Me I

Is my reflex hyper? My doctor (physician) told me I have mild hyper reflex, but I have been to lot of doctors and no one has ever raised this issue. I also have other issues going on which is making me really stressed out and worried. I have mild random and sporadic twitching all over body, they come and go. For most of the day they are absent but show up during the night or when I am super stressed. It could appear on my arm, elbow, eyelid, butt, calves, feet, back, hip, stomach, chin. I also have had numbness in my left wrist and right feet. All these issues started after I hurt my back while exercising like 4 weeks ago, the symptoms all come and go. I also have tired feeling in my leg and feels like they are heavy. It feels like its shaking if I am standing for some time. I have never had such symptoms ever in my life. I am really afraid that this could be due to MS or ALS. I have attached a video of me trying to test out my reflex at home, I know i should not be doing this but I tried to substitute a hammer with my phone and I am not sure if my reflexes are normal or as the doctor said hyper. Does hyper reflex mean some MND disease or it could also be due to stress/anxiety as I have a lot of stress going on or due to spine issues? But my spine is not hurting now. I also have vitamin D3 deficiency and borderline magnesium. All other chemicals are good, have not tested for Potassium.