those twitches are called muscle fasciculations. I get them in the muscles in my legs, mostly the calf and often without feeling them.

And twitching--
 

--is unlikely to come from pure small-fiber neuropathy, as twitches happen in muscles and small-fiber neuropathy by definition involves the unmyelinated sensory nerves that control the sensations of pain and temperature.

On the other hand, it is not unusual for those who have small-fiber syndromes to have some large fiber involvement of nerves that control muscle, though it may not be global enough to show up on nerve conduction studies, and that may result in twitching or fasiculations.

I would think, though, that such twitching is more likely due to electrolyte imbalance, which may not even be related to the rest of your condition. Such imbalance is very, very common--Mrs. D has talked about how many of us are probably deficient in magnesium--and supplementing with that, and possibly potassium, is definitely worth a trial.

So say they are from the larger fibers, even though they didn't show up now, I assume it'll show up later as I keep getting worse? The EMG was negative for large fiber, but the doc testing me was bothered that he didn't get the results he expected. *Still* waiting for the referral to UCSF for the biopsy.

Going to hope it's just the magnesium. As Mrs D pointed out, the Trilptal I'm taking does mention the salt thing. Did the soak last night and will keep doing it. How long would it take to notice a difference?

You should notice in a day or two. Longer soaks are better than short ones.

When I was having my lupus reaction to lisinopril, I was having huge muscle contractions in the night...enough to make the bed shake and my covers move. These were not twitches and they didn't hurt either. At first I thought it was our cats playing on the bed, but I never saw or heard them. They were large muscles moving, like in the back and thighs.

I did have a spot in my lower left calf that usually twitched in the mornings, or during fasts for doctor tests. My doctor told me that was a low blood sugar twitch (she observed it one time). But it has gone away as well, since I stopped the evil lisinopril 2 months ago.

Hypoglycemia can cause twitching of muscles.

It was the magnesium. The Epson salt bath totally worked! Thank you :D