What are the causes of finger twitching, also known as finger fasciculations?

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Last updated: April 8, 2025View editorial policy

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From the Guidelines

Finger twitching is most commonly caused by peripheral neuropathy, which can result from various factors including medication side effects, nerve damage, or underlying medical conditions. According to a study published in Haematologica in 2010 1, patients can experience trembling or twitching, particularly in the fingers, due to peripheral neuropathy associated with treatments for multiple myeloma. The study highlights that thalidomide, a medication used in the treatment of multiple myeloma, can cause a length-dependent axonal neuropathy, leading to symptoms such as numbness, stinging sensations, and trembling.

Some key points to consider regarding the causes of finger twitching include:

  • Peripheral neuropathy can cause sensory and motor impairment, leading to symptoms like finger twitching
  • Medications such as thalidomide can cause sensorimotor axonal neuropathy, resulting in twitching and other neurological symptoms
  • Nerve damage and underlying medical conditions can also contribute to finger twitching
  • Electrophysiological studies, such as nerve conduction velocity tests, can help diagnose the underlying cause of finger twitching

In terms of addressing finger twitching, it is essential to identify and manage the underlying cause. This may involve:

  • Medication adjustments or changes to minimize side effects
  • Physical therapy to address nerve-related issues
  • Lifestyle modifications, such as reducing stress and ensuring proper nutrition and hydration
  • Medical evaluation to rule out underlying conditions that may be contributing to the twitching. As noted in the study 1, motor nerve electrophysiological study changes can be seen commonly, and it is crucial to monitor and address these changes to prevent further complications.

From the Research

Causes of Finger Twitching

  • Finger twitching can be a symptom of various underlying conditions, including peripheral neuropathy, which is a dysfunction of sensory, motor, and autonomic nerves 2.
  • In patients with multiple sclerosis (MS), peripheral neuropathy has been reported, with electrophysiologic abnormalities found in 33 of 244 nerves examined (14.7%) and occurring in 10 patients (45.5%) 3.
  • Parkinson's disease (PD) has also been linked to peripheral neuropathy, with studies suggesting that prolonged L-DOPA exposure and increased levels of homocysteine and methylmalonic acid may be underlying mechanisms 2.
  • Other potential causes of finger twitching include:
    • Demielenating peripheral neuropathy, which has been reported in patients with MS and neuromyelitis optica (NMO) 4.
    • Vitamin B12 and cobalamin deficiencies, which have been implicated as drivers of peripheral neuropathy in PD patients 2.
    • Accumulation of phosphorylated α-synuclein, which is a central feature in peripheral neuropathy and requires further exploration via large cohort studies 2.
  • In some cases, finger twitching may be a symptom of a more complex condition, such as demyelination-related chronic symptomatic parkinsonism, which has been reported in patients with progressive MS phenotypes and demyelinating lesions in the basal ganglia and/or upper midbrain 5.
  • Electrophysiologic studies have shown that patients with MS may have peripheral nervous system involvement, with significantly lower median and tibial nerves conduction velocities (NCV) compared to healthy controls 6.

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Research

Peripheral neuropathy in Parkinson's disease.

Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology, 2020

Research

Parkinsonism in multiple sclerosis patients: A prospective observational study.

Multiple sclerosis and related disorders, 2022

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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