JuanitaPeralta
Well-known member
Benign Fasciculation Syndrome (BFS) Reminder ... (which may include cramps):In the absence of weakness or abnormalities of thyroid function or electrolytes, individuals aged less than 40 years can be reassured without resorting to electromyography (EMG) to avoid the small but highly damaging possibility of false-positives. Equally, however, most subspecialists will recall a small number of cases, typically men in their 50s or 60s, in whom the latency from presentation with apparently benign fasciculations to weakness (and then clear MND) was several years.(Source: )Further, only about 6% (to 14%) of subjects aged 45 years and older with fasciculations as their only complaint go on to develop MND.(Source: - page 107)We studied 11 patients with benign fasciculations, aged 38 to 70 years (mean [SD], 58.5 [11.7] years). These patients had normal strength and their EMG showed normal motor unit potential (MUP) analysis. There was no progression to other disorders in the following 2 years. Some had associated muscle cramps. No metabolic or medication-related cause was identified. The TA muscle was studied in each patient. - Mamede de Carvalho, MD; Michael Swash, MD(Source: )Using the case records of Mayo Clinic patients, 121 patients with a diagnosis of benign fasciculations were identified. All had a normal neurological examination and normal electrophysiological studies, except for fasciculation potentials. Interviews by telephone were conducted 2 to 32 years after diagnosis. None of the patients developed symptomatic motor neuron disease. Forty individuals were in health care careers. A subset of 19 patients described acute onset of fasciculations following a viral infection. Benign fasciculations are not a preclude to progressive motor neuron disease.(Source: )(Supplemental: )Patients diagnosed with BFS through our clinic were identified by searching computerized billing records from 2003 through 2007 for this diagnostic code. This yielded a total of 13 patients who had presented with fasciculations and whose neurological examination, blood workup (including serum electrolytes and thyroid function tests), as well as nerve conduction studies/electromyography were normal. Only these patients were included in the BFS group. In the BFS group, the youngest patient was 20 and the oldest was 59; the mean age was 41.7 ± 10.7 (SD) years. Eleven out of 13 (85%) patients in the BFS group were male. In the BFS group, long-term follow-up of over 2 years was available in six patients. These patients had been treated with selective serotonin reuptake inhibiting agents and had received reassurance that they did not have MND. All these patients were documented to have done well, with the fasciculations subsiding over time. None of the other seven patients in the BFS group returned for follow-up visits despite having been asked to do so. Since it is very likely that if they had progressed to MND they would have been referred back for treatment to our MND clinic, we believe that there was no progression of their symptoms.(Source: )Twenty consecutive clinicians presenting with fasciculations were prospectively assessed with serial clinical and neurophysiological evaluations.... In FASICS, fasciculations most often involved the lower limbs, without evidence of muscle weakness on clinical examination.... Exercise, stress, fatigue and caffeine consumption were identified as common exacerbating factors.... One of twenty or 5% developed or were diagnosed with MND.(Source: )Some causes of fasciculations (twitching) are listed here:
