Fasciculation
| Fasciculation | |
|---|---|
| Specialty | Neurology  |
A fasciculation (fah SIK yoo lay shun) (or "muscle twitch") is a small, local, involuntary muscle contraction (twitching) visible under the skin arising from the spontaneous discharge of a bundle of skeletal muscle fibers. Fasciculations have a variety of causes, the majority of which are benign, but can also be due to disease of the motor neurons.
Causes and risk factors
Conditions
- The origin of most cases is at present unknown and usually inconclusive, has therefore been given the title benign fasciculation syndrome.[1]
- Lower motor neuron lesion
- Werdnig-Hoffman disease
- Amyotrophic lateral sclerosis (Very Rare)
- Kennedy disease
- Organophosphate poisoning
- Benzodiazepine withdrawal
- Magnesium deficiency (which can be caused by stress)
- Myalgic Encephalomyelitis
- Dehydration
- Fatigue
- Lyme Disease
- Myasthenia Gravis
- Rabies
- Multiple Sclerosis
Medications
Other risk factors may include the use of anticholinergic drugs over long periods, in particular ethanolamines such as Benadryl, used as an antihistamine and sleep aid, and Dramamine for nausea and motion sickness. Persons with benign fasciculation syndrome (BFS) may experience paraesthesia shortly after taking such medication; fasciculation episodes begin as the medication wears off.
Stimulants can cause fasciculations directly. These include caffeine, pseudoephedrine (Sudafed), amphetamines, and the asthma bronchodilators albuterol/salbutamol (e.g. Proventil, Combivent, Ventolin). Medications used to treat attention deficit disorder often contain stimulants as well, and are common causes of benign fasciculations.
Treatment
Inadequate magnesium intake can cause fasciculations, especially after a magnesium loss due to severe diarrhea. Over-exertion is another risk factor for magnesium loss. As 70-80% of the adult population does not consume the recommended daily amount of magnesium,[2] inadequate intake may also be a common cause. Treatment consists of magnesium supplements or increased intake of foods rich in magnesium, such as nuts (especially almonds) and bananas. Ironically, magnesium supplements may cause diarrhea which may cause magnesium loss. This can be managed by adjusting dosage and taking the supplements with meals.
Fasciculation also often occurs during a rest period after sustained stress, such as that brought on by unconsciously tense muscles. Reducing stress and anxiety is therefore another useful treatment.
Atropine sulfate can be used with Suxamethonium chloride to decrease fasciculations during Rapid Sequence Intubation (RSI).
References
- ^ Blexrud MD, Windebank AJ, Daube JR (1993). "Long-term follow-up of 121 patients with benign fasciculations". Ann. Neurol. 34 (4): 622–5. doi:10.1002/ana.410340419. PMID 8215252.
{{cite journal}}: CS1 maint: multiple names: authors list (link) - ^ Galan P, Preziosi P, Durlach V, Valeix P, Ribas L, Bouzid D, Favier A, Hercberg S (1997). "Dietary magnesium intake in a French adult population." Magnesium Research 10(4):321-8. PMID: 9513928.
External links
- Fasciculations - additional details and underlying conditions
- . GPnotebook https://www.gpnotebook.co.uk/simplepage.cfm?ID=-946208762.
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