The benign fasciculation syndrome ( BFS ) is a neurological disorder characterized by fasciculation (twitching) of various voluntary muscles in the body. Twitches can occur in any voluntary muscle group but most commonly occur in the eyelids, arms, legs, and legs. Even the tongue can be affected. Twitch may be occasional or can be continuous. Usually the deliberate movement of the muscles involved causes the fasciculation to stop immediately, but they can return once the muscle rests again.
Video Benign fasciculation syndrome
Signs and symptoms
The main symptom of benign fasciculation syndrome is focal or broad involuntary muscle activity (twitching), which can occur randomly or at a specific time (or place). Presenting symptoms of benign fascic syndrome may include:
- Fasciculation (main symptoms)
- Blepharospasms (spasm of the eye)
- General fatigue
- Muscle aches
- Anxiety (which can also be the cause)
- Workout intolerance
- Globus Sensation
- Paraesthesias
- Muscle cramps or seizures
Other symptoms include:
- Hyperreflexia
- Stiffness
- Tremor
- itchy
- Myoclonic jolted
Symptoms BFS is usually present when the muscles are rested and not accompanied by severe muscle weakness. In some cases of BFS, fasciculations can jump from one part of the body to another. For example, it can start with the leg muscles, then within seconds jump to the forehead, then the stomach, etc. Since fasciculation can occur in the head, it strongly indicates the brain as a generator due to its exclusiveness in the spinal cord. (Together, the brain and spinal cord consist of the central nervous system.)
Maps Benign fasciculation syndrome
Cause
The exact cause of BFS is unknown, and it is not known whether it is a motor neurological disease, muscle, or neuromuscular junction. Although twitching is sometimes a symptom of serious illnesses such as spinal cord injuries, muscular dystrophy, Lyme disease, Creutzfeldt-Jakob disease (CJD), neurofibromatosis or amyotrophic lateral sclerosis (ALS), leading to such over-mastery more common. Mitsikostas et al. found that fasciculation "slightly correlates with weight and height and to anxiety levels" in normal subjects.
BFS may also be associated with long-term anticholinergic use such as diphenhydramine and opiates such as morphine, but the latter case is usually when withdrawal symptoms are present.
Magnesium deficiency can cause fasciculation and anxiety. Vitamin D deficiency can also cause fasciculation, which results from the reduction of ionized calcium in the blood (hypocalcemia).
Recent studies have found an association between fasciculation and/or widespread paresthesias with small fiber neuropathy in up to 82% of cases with an EMG study and normal nerve conduction.
Diagnosis
Benign fasciculation syndrome is a diagnosis of exclusion; that is, other potential causes for twitching (most forms of neuropathy or motor neurone disease such as ALS) should be ruled out before the BFS can be assumed. The important diagnostic tool here is electromyography (EMG). Because BFS does not appear to cause actual nerve damage (at least as seen in EMG), patients may show completely normal EMG (or one where the only visible disorder is fasciculation).
Another important step in diagnosing BFS is to check patients for clinical weakness. Clinical weakness is often determined through a series of strength tests, such as observing the patient's ability to walk on heels and toes. Barrier strength tests can include lifting each leg, pushing forward and backward with legs and/or toes, pressing with your fingers, stretching your fingers, and pushing with or extending arms and/or hands. In each of these tests, the test provider will apply rejects and monitor significant differences in limb strength or opponent's strength ability. If the difference is noted or the patient is unable to apply a fighting force, clinical weakness may be noted.
Lack of clinical weakness along with normal EMG results (or those just fasciculated) largely eliminates more serious disorders of potential diagnosis.
Especially for younger people who have only femoral LMN signs, "In the absence of weakness or abnormalities of thyroid or electrolyte function, individuals under 40 years of age can be convinced without using electromyography (EMG) to avoid the small but very damaging possibility of positive-error". "Equally, however, most subspecialists will remember a small number of cases, usually men in their 50s or 60s, whose latency of presentation with benign fasciculations seems weak (and then obviously MND) is a few years. the indication may be that MND fasciculation is often abrupt and widespread at the onset of individuals previously unaffected by fasciculation in younger times. The place of fasciculation, for example, in the calf versus abdomen, has not been shown to be discriminatory for benign disorders.There is conflicting evidence as to whether fasciculated characters differ neurophysiologically on MND ".
Another common disorder found in clinical examination is the rapid reflex action known as hyperreflexia. Normal standard laboratory tests. According to neurologist John C. Kincaid:
In the absence of clinical findings and electromyography of neurogenic diseases, a diagnosis of benign fasciculation is made. I suggest that such patients be followed for a year or more with clinical and electromyographic examination at 6-month intervals before a person becomes safe in the diagnosis that fasciculations are completely benign. My approach to treating a seemingly docile fasciculation is to first convince the patient that no unpleasant diseases are present.
Treatment
Some levels of fasciculation control can be achieved with the same drug used to treat essential tremors (beta-blockers and anti-seizure medications). However, often the most effective approach to treatment is treating the accompanying anxiety. No drugs, supplements, or other treatments were found that completely controlled the symptoms. In cases where fasciculation is caused by magnesium deficiency, magnesium supplementation can be effective in relieving symptoms.
In many cases, the severity of BFS symptoms can be significantly reduced through a proactive approach to reducing overall daily stress. Common ways to reduce stress include: exercising more, sleeping more, working less, meditation, and eliminating all forms of dietary caffeine (eg coffee, chocolate, cola, and certain drugs outside the counter).
If muscle pain or pain is present with fasciculation, patients may be advised to take over-the-counter pain medications such as ibuprofen or acetaminophen during the period of increased pain. Another form of pain management can also be used. Before taking over-the-counter medications, individuals should start discussions with their healthcare provider to avoid adverse effects associated with long-term use or pre-existing conditions.
Prognosis
The prognosis for those suffering from diagnosed benign fascial syndrome is generally considered good to excellent. This syndrome does not cause long-term physical damage that is known. Patients may experience high anxiety even after being diagnosed with a benign condition. Such patients are often directed to professionals who can help reduce and understand stress/anxiety, or those who can prescribe medication to help control anxiety.
Spontaneous remission has been known to occur, and in cases where anxiety is considered a major contributor, symptoms usually decrease after the underlying anxiety is treated. In a 1993 study by Mayo Clinic, 121 people diagnosed with benign fasciculation syndrome were assessed for 2-32 years (~ 7 years on average) after diagnosis. Of these patients there was no BFS case that developed into a more serious disease, and 50% of patients reported significant improvements in their symptoms at the time of follow-up. Only 4% of patients reported symptoms that were worse than those at the time of their diagnosis.
See also
- Fasciculation Syndrome Cramp
- Neuromiotonia
References
Source of the article : Wikipedia
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