Fasciculation anxiety syndrome in clinicians 2013 study

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Fasciculation anxiety syndrome in clinicians 2013 study

Postby Little Lost on February 28th, 2014, 5:57 pm

Hi

Just something to read if anyone interested. Here is a passage from the introduction to a recent article in the J of Neurology. I am putting it in because although it is something we all know, this journal (next to Nature) is the journal for publishing all things neurological. Peer reviewed before publication so respected info not any old internet article. I know some of the old timers will yawn, but remember a lot of you have walked the path we are now walking, and what is repetition to you, is the foundations that we have to build for ourselves. I am 3 years into this and just beginning to get on the rungs of the ladder that so many of you sit quite high up on. I can see you up there but I can’t reach you. What can I say I am a slow learner. So I still need info like this.


J Neurol. 2013 Jul;260(7):1743-7. doi: 10.1007/s00415-013-6856-8. Epub 2013 Feb 12.
Fasciculation anxiety syndrome in clinicians.
Simon NG1, Kiernan MC.

In the intro it says

“90% of normal subjects will have FP detected by surface electromyography (less with needle as less area examined). FP symptomatic only in 50% of people. However only occasionally patients with frequent fasciculations will present for formal assessment possibly having already researched their symptoms on the internet where online search engines may fuel concerns about ALS and other serious neurological disorders, given that such a diagnosis often features prominently in the search results.

The article was 2013 it was a small survey about a syndrome known as FASICS which stands for Fasciculation anxiety syndrome in clinicians. It was almost a tester survey to see if it is worth expanding, but here’s what they found anyway. Here’s a summary.

So they took 14 healthy clinicians that had this FASICS. They needle emg (it was extensive: with wide sampling of affected and unaffected muscles from all limbs). To fit the criteria of FASICS their neurophysiological studies had to have normal nerve conduction studies and they had to have the presence of simple FP, but no acute denervation or neurogenic motor unit changes. (they also tested negative for antibodies to voltage-gated potassium channels). All presented with symptomatic frequent fasciculations.

So 11/14 were male, average age of 46, ALL admitted they were anxious that their fasciculations were ALS, 3 had generalised fasciculations everywhere ( jumped about), 10 had them mostly in the lower legs, 3 had upper and lower limbs, and 1 had arms only. All admitted to having high levels of anxiety about ALS. 50% were neurologists, 1 was in gastro, 1 respiratory and 3 were GPs. 8/14 had recent contact with an ALS patient. In line with several other small study reports about FASICS there were no surgical or psychiatric clinicians represented. Exacerbating factors for intensifying fasciculations were identified, the most common was exercise, followed by stress, then fatigue, and lastly caffeine consumption. Alcohol had no influence on fasciculations.

Anyway just thought I would post this. Know there are other articles on the subject.

Poor poor clinicians perhaps they should come to this forum....or perhaps they are already here.

HX
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Re: Fasciculation anxiety syndrome in clinicians 2013 study

Postby MarioMangler on February 28th, 2014, 7:27 pm

This is something somebody wise once told me in my early days of BFS. He said that back in the old days, neurologists and doctors and other people in the medical field were the only people who ever got BFS. Since they had actually seen people with these horrible neurological conditions, they actually knew about this stuff and their anxiety about it was off the charts. So they would inevitably wind up with BFS or some other anxiety overload condition. And for years, it was understood that this sort of thing was pretty much only relegated to the medical world.

Then, of course, around 1996 the internet came around. And now suddenly EVERYONE had access to medical journals and medical literature and studies about terrible neurological conditions. So suddenly the general public had access to the same type of knowledge that previously only doctors and neurologists knew about. And this was a horrible combination because laypeople simply do not have the education or the knowledge of science to be able to filter what they are reading into a logical conclusion. So your average layperson will tend to read "twitches=ALS" and once that pathway is established in your brain, it is going to be very very difficult to get rid of it. And hence what you have now, thanks to the internet, is thousands upon thousands of everyday people who have nerve conditions that previously only neurologists were getting.

Maybe the Unabomber was right. Maybe technology really -is- a terrible thing. I can guarantee you that if there was no internet, most of us wouldn't be here. Maybe we should all start living in a dirty wooden shack out in the middle of Montana.
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1. No, that's not bulbar
2. No, the location doesn't matter
3. Yes, we have all had that symptom
4. No, you're not the exception
5. No, that's not ominous
6. No, you don't need an EMG
7. Yes, you will be fine
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Re: Fasciculation anxiety syndrome in clinicians 2013 study

Postby Little Lost on February 28th, 2014, 8:41 pm

I would probably go and live in said dirty shack, and on my first night get bitten by some weird spider. Would not have internet to confirm it's identity, but probably by the very fact it is red and black striped and the cat it also bit is now foaming at mouth beside me, deduce it is not the best of spiders to be bitten by. I would then rush to a neighbour asking for antidote and be given some weird green liquid to drink, on way home I would likely meet a kind lady who informs me to stay away from green liquid bearing nutter neighbour,as she uses arsnic in some of her remedies. This kindly neighbour would then cough all over me saying please excuse her she has a touch of haemorragic fever......I would go home not knowing if I had been bitten, poisoned, or infected, sit up all night in a state......no not into dirty shack idea, as they say one often meets their fate on the path they take to avoid it.

I do get what you mean though and you do have good point. .

Hx
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Re: Fasciculation anxiety syndrome in clinicians 2013 study

Postby christo on March 1st, 2014, 3:28 am

I am an IT guy, software engineer, geek, I love and live for new tech and I say mario is right.
Internet is 100% part of BFS. Not sure if it is causing it for some of us (including me) or just fueling it, bit it definetly plays a role. Now BFS or not, don't unplug me the internet :D
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Re: Fasciculation anxiety syndrome in clinicians 2013 study

Postby J4son on March 1st, 2014, 6:07 am

Helen great post and article thanks a lot for posting.

Mario except on Unabomber who in my opinion was nothing more than a coward and a criminal, I agree with everything you said.
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Re: Fasciculation anxiety syndrome in clinicians 2013 study

Postby SecretAgentMan on March 1st, 2014, 9:50 am

Technology is a tool. It is how you use it that makes it positive or negative. Just like money. You can use tools like technology or money to help people or to hurt people. You can use them to help yourself or hurt yourself. You can do positive things with them or negative things. It is all in the hands of the user.
If your mind is your own worst enemy, why not make friends with it and turn it into your greatest ally? Mental discipline is achievable and there is help available. Learn what works for you, practice, and change your life for the better.
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Re: Fasciculation anxiety syndrome in clinicians 2013 study

Postby RobJ on March 1st, 2014, 11:08 am

twiches = als isnt true. nowhere on internet does it say that. even if ur emg was off the charts and u were twitching and cramping...u wont get diagnosed w als need weakness. if u tested pos for sma or sbma without weakness no diagnosis.
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Re: Fasciculation anxiety syndrome in clinicians 2013 study

Postby MarioMangler on March 1st, 2014, 4:02 pm

Of course it isn't true. But that is the misconception that drives most people to freak out. And then at that point it basically becomes a self fulfilling prophecy. Any symptom you read about other people having, you will start to have too. It is the nature of how BFS likes to mess with you.

One of my favorite descriptions I have ever heard of BFS is that it should stand for Bull Fu*king Sh*t. I love that definition because that is pretty much what I also think of BFS these days. I don't even take it seriously anymore. I have had it long enough to realize that nobody here has anything deadly or particularly serious.
BFS FAQ:
1. No, that's not bulbar
2. No, the location doesn't matter
3. Yes, we have all had that symptom
4. No, you're not the exception
5. No, that's not ominous
6. No, you don't need an EMG
7. Yes, you will be fine
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Re: Fasciculation anxiety syndrome in clinicians 2013 study

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