What are the recommended diagnostic evaluations and long-term treatment strategies for persistent, intermittent generalized muscle twitching (fasciculations) that has not responded to clonazepam, vitamin B12, calcium supplementation, and the complete elimination of caffeine, alcohol, and tobacco?
It can be very frustrating to experience persistent muscle twitching, especially after making so many healthy lifestyle changes. Since clonazepam and supplements haven't helped, the next best step is to consult a neurologist. They may recommend an electromyogram (EMG) and nerve conduction studies to evaluate your nerves and muscles, alongside blood tests to check thyroid function and electrolytes. Often, this twitching is due to benign fasciculation syndrome, which is harmless. Long-term management focuses on stress reduction, quality sleep, and hydration. Sometimes, daily stretching or alternative prescription options like gabapentin are discussed. Please be reassured that this is common, and a specialist can help find the best way forward for you.