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Twitching After Brain Injury: Is It a Bad Sign? (Not Always!)

Young woman at doctors office being treated for twitching after brain injury

Twitching after brain injury could be a sign of spasticity. But there are also other reasons your muscles could be twitching. In some cases, muscle twitching can actually be a positive indicator of recovery.

This article will explain the most common causes of twitching after a head injury plus some of the best treatments for it.

Causes of Twitching After Head Injury

There are many possible causes of twitching after brain injury, not all of which are negative.

The following are a few reasons that your muscles may start twitching during TBI recovery:

1. Spasticity

man holding hand and wincing because he has spasticity

Spasticity symptoms typically include tight or stiff muscles and sudden, severe muscle twitching. This condition is caused by damage to the spinal cord or neural pathways in the brain that control voluntary movement.

Normally, your muscles rely on signals from the brain which tell them when to contract and when to relax. After a brain injury, however, these signals can no longer get through. As a result, the muscles will stay in a permanent state of contraction, also known as spasticity.

Spasticity may not be present immediately after a brain injury but will usually appear within the first six months. If left untreated, it can cause problems such as pressure sores, joint deformity, and contractures.

Twitching after brain injury is sometimes the first sign that spasticity is setting in. If you can treat it early though, you can minimize the effects of spasticity.

2. Tremors

Muscles that twitch in a rhythmic pattern after brain injury could be a sign of tremor.

The most common type of tremor that occurs after brain injury are cerebellar tremors.

A typical feature of cerebellar tremors is a slow, but visible, shaking movement in the arms and legs. They also tend to happen at the end of certain movements, such as reaching for an object.

As the name suggests, these tremors are caused by damage to the cerebellum or its pathways. The cerebellum plays a critical role in coordinating muscle movements, which explains why damage to it can result in twitching or tremors.

3. Movement Disorders

therapist helping man with muscle twitching after brain injury sit up on table

There are also several other movement disorders that can cause twitching after brain injury.

For example, a condition known as myoclonus causes sudden, brief muscle spasms throughout the body.

Most healthy people experience myoclonus at some point in their life. For example, hiccups are spasms in the intercostal muscles, and jerking awake after you just fell asleep is another example.

However, after a head injury, these twitches happen much more frequently.

4. Dystonia

Another possible cause of twitching after brain injury is dystonia. This refers to sustained, involuntary muscle contractions that force people into abnormal positions.

There are two main types of dystonia that a person can experience: focal dystonia and segmental dystonia.

Focal dystonia only affects one part of the body, such as:

  • Eyes
  • Jaw
  • Mouth
  • Neck
  • Arms/legs

Segmental dystonia, on the other hand, strikes at two or more adjacent muscle groups at once. So, instead of just your neck spasming, both your neck and jaw would start twitching simultaneously.

With both segmental and focal dystonia, the twitching appears on the side of your body opposite from where the brain damage occurred.

5. Muscle Reactivation

man doing his arm exercises with physical therapist

Finally, twitching after head injury could be a sign of increasing communication between your brain and your muscles.

Many TBI patients with brain injury paralysis report twitching in their muscles right before they regain movement in their affected side.

This occurs because, as your brain rewires itself through neuroplasticity, it rebuilds the neural pathways connecting it to your muscles. This lets you regain control of your movement.

When the pathways are just beginning to reform, however, only a few signals can get through, which can cause twitching. Therefore, twitching may indicate a new stage in your recovery. To keep the momentum going, you will need to continue with therapy.

These are just a few of the most common causes of twitching after brain injury. But how do you treat them?

Treatments for Twitching After Brain Injury

Treatment for muscle twitches will depend on the context. If your twitching is a sign of recovery, your approach will look different than if it is a sign of spasticity or movement disorders.

Pain is a good way to determine whether your twitching is a positive or negative development. Generally, pain, stiffness, and discomfort are all symptoms of spasticity. If the pain is especially severe, your doctor might administer a Botox injection. This can relax your muscles and temporarily relieve spasticity.     

In the end, however, the only way to fully eliminate twitching after brain injury is to re-establish the neural connections to your muscles. You can accomplish this through neuroplasticity.

Using Neuroplasticity to Eliminate Muscle Twitching

3-D image of human brain in space to illustrate neuroplasticity

Neuroplasticity refers to the brain’s ability to create new neural pathways. This allows the brain to actually rearrange itself so that undamaged areas take over functions from injured ones.

Neural pathways form in response to high repetition, i.e. massed practice exercises. Therefore, to eliminate twitching after brain injury you must move your affected muscles.

With enough repetition, you will reinforce the fresh neural pathways, and the connection to your muscles will return. When the full connection returns, the twitching should subside.

However, it will take a high number of repetitions to achieve this. For example, animal studies have shown that it takes about 400 to 600 repetitions per day of challenging functional tasks to cause changes in the brain.

The average person finishes 40-60 reps in a single PT session. This means you will need to continue with your exercises at home in addition to your traditional PT sessions.

That’s why home therapy devices such as FitMi or MusicGlove are so helpful. They motivate patients to finish hundreds of exercises at home, all in a fun and engaging way. In fact, the average patient performs about 23 times more repetitions with FitMi than with traditional therapy.

The more exercises you can complete, the faster you can recover muscle function and reduce twitching.

Understanding Muscle Spasms After Brain Injury

Twitching after brain injury is not always a bad sign. Although it can be a symptom of spasticity and other muscular problems, it can also signal improvement.

If your muscle spasms cause you pain and discomfort, talk to your doctor. They can prescribe treatments to help relieve the pain.

But whether or not your twitching is a sign of recovery, the best way to treat it is to exercise your muscles.

By activating neuroplasticity, you can re-establish your brain’s connection to your muscles until your twitching ceases for good.

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