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Found this!

Postby Airmade on April 13th, 2004, 6:14 pm

Hi my friends!
I've just found this article on a website for docs (Medscape).


Possible Cause of Fasciculations in a Married Couple?

Question
I am seeing a husband, 46 years old, and wife, 37 years old, as patients. The husband developed fasciculations in his upper and lower extremities 1 year ago. Because of associated neck and back pain, he underwent an MRI that excluded any cord or ganglion compression. Laboratory examinations including CPK were all within normal limits. I diagnosed benign fasciculations. Two months after his presentation, his wife presented with generalized fasciculations, although hers seemed to be predominately lingular and fascial. MRI of her head and spine was normal. All laboratory investigations, including HIV antibody testing, were negative on both patients.

Are there any infectious etiologies or environmental toxins that should be explored in this couple who continue to experience fasciculations but no muscle weakness?


Response from Joel M. Rothfeld, MD, PhD
Neurology Division Chair, Department of Medicine, Enloe Medical Center, Chico, California.






The presence of muscle fasciculations can be categorized as benign, or secondary to disease. The generation of benign fasciculations is caused by the spread of activation (in some cases secondary to irritation of muscle due to multiple etiologies, as mentioned below) of adjacent muscle fibers (via ephaptic transmission). By contrast, disruption of the motounit and resulting muscle denervation is thought to be the underlying cause of fasciculations in disease states. Many different factors can give rise to such acute denervation. From an infectious perspective, poliomyositis can cause motor neuron death and denervation, giving rise to fasciculations (although in this setting there is elevated CK and noticeable development of muscle weakness). In general, any etiology that disrupts the motounit integrity can give rise to fasciculations occurring in disease states (eg, numerous types of neuropathies including motor neuron disease)

Other causes of fasciculations (within the realm of the benign category) include: fatigue, smoking, caffeine intake, certain drugs (anticholinesterases, lithium), electrolyte (hypomagnesemia, hyponatremia), and metabolic disturbances (thyrotoxicosis).

There is no one group of infectious agents that would be associated with benign fasciculations. Rather, one should assess for any process (or potential toxin exposure) that could conceivably bring about the irritability of muscle fibers leading to the development of benign fasciculations.
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