Family history should include any neuromuscular disease, family history of cataracts and the age of onset, and history of heart disease or arrhythmias. Ophthalmologic history should include cataracts, especially any developing before age 50. [now.aapmr.org]

Clinical myokymia refers to the presence of focal or generalized continuous muscle twitching, often exhibiting a rippling, “bag of worms” appearance under the skin. [medlink.com]

The major manifestations are cramps, muscle twitching or stiffness, pseudomyotonia, paraesthesias, numbness and hyperhydrosis [ 2 ]. [casesjournal.biomedcentral.com]

It is caused by rapid bursts of nerve impulses, resulting in muscle twitching, cramping, increase sweating and delayed muscle relaxation. In very few cases speech and breathing may be affected if pharyngeal or laryngeal muscles are involved. [drthindhomeopathy.com]

Marcelo ***@**** I've had muscle twitching for more than 2 years with joint pain, not much muscle cramping, mornings suck. My biggest concern are the tongue fasiculations. [medhelp.org]

A 17-yr-old Hispanic female presented for evaluation of bilateral lower-extremity hypertrophy and muscle twitching. The patient’s symptoms began approximately 5 yrs before presentation, with muscle twitching and cramps. [journals.lww.com]

[…] cases with methylphenidate, as recommended by the American Academy of Sleep Medicine for patients with DM1. 20 DM1: Special precautions are needed during anesthesia given the prevalence of cardiopulmonary involvement especially the increased risk for atelectasis [now.aapmr.org]

There have been case reports of neuromyotonia following Staphylococcus aureus spinal epidural abscess with septicaemia [ 3, 4 ], and there is also a report of ocular neuromyotonia following cavernous sinus thrombosis due to mucormycosis [ 5 ]. [casesjournal.biomedcentral.com]

Muscle biopsy abnormalities are more common in dystrophic myopathies compared to more variable findings in nondystrophic myotonia, including normal, myopathic or hypertrophied muscles. [now.aapmr.org]