article of interest.

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article of interest.

Postby Little Lost on October 20th, 2014, 5:31 pm

A study which aimed to disprove that the presence of fasciculation in the neurological examination is indicative of amyotrophic lateral sclerosis.

Basically it lists and examples a whole array of causes of fasciculation, with the aim of destroying the myth that fasciculation means ALS.

There was a bit about BFS which I copied, and about treatment. Anyway please if you do not read anything else......please please please pleae pleeeeeeeeaaaaaaassssseeeeee...............read the sentences I put in bold.


Neurol Int. 2014 Aug 8
Another Perspective on Fasciculations: When is it not Caused by the Classic form of Amyotrophic Lateral Sclerosis or Progressive Spinal Atrophy?

Abstract
Fasciculations are visible, fine and fast, sometimes vermicular contractions of fine muscle fibers that occur spontaneously and intermittently. The aim of this article is to discuss the main causes for fasciculations and their pathophysiology in different sites of the central/peripheral injury and in particular to disprove that the presence of this finding in the neurological examination is indicative of amyotrophic lateral sclerosis. Undoubtedly, most fasciculations have a distal origin in the motor nerve both in normal subjects and in patients with motor neuron disease. The clinical and neurophysiological diagnosis must be thorough. It may often take long examination to record fasciculations with electroneuromyography. In other cases, temporal monitoring is necessary before the diagnosis. The treatment, which may be adequate in some cases, is not always necessary.

So article lists all the causes of fasciculation. This is what it says about benign.


Quote: Fasciculations can also often be found in individuals with no neurological disease. In 1963, Reed and Kurland first warned that the presence of fasciculation s was not necessarily associated with a progressive and lethal disease, due to the involvement of the lower motor neuron. Since then, several authors have explored this topic, defining a benign fasciculation syndrome (BFS), that most frequently affects young healthcare professionals, who, in some cases, have already developed dyspnea. An interesting Australian prospective study published recently examined the cases of 20 physicians (20 consecutive cases) complaining of fasciculations. Fourteen of them were very concerned about being diagnosed with ALS. The fasciculations were mainly ( but not confined) in the limbs, which had normal muscle strength. In the electrophysiological study, fasciculations potentials were of the simple type, motor conduction was normal and no signs of denervation or neurogenic changes of motor units were apparent.

These authors, in agreement with others, concluded that physical exercise, stress, fatigue and caffeine abuse can precipitate or aggravate this picture. Among the other six individuals in the sample, five patients manifested a cramp-fasciculation syndrome (Denny-Brown syndrome) and only one suffered from ALS.

Work by Fermont et al. reported the prevalence and distribution of fasciculations in healthy adults. The potentials were studied in 58 individuals from different age groups. The subjects were also interviewed using questionnaires about the exacerbation of caffeine consumption and physical activity. Of the total sample, 43% had fasciculations, especially in the hallucis longus abductor muscle. Older individuals showed more fasciculations than young adults. The authors have noted that certain physical activities, when very intense, may exacerbate symptoms in the lower limbs.

It is noteworthy that there is no specific treatment for fasciculations, as it is symptomatic. The use of antiepileptic drugs such as carbamazepine and phenytoin has shown a partial therapeutic response. Gabapentin can also be used generally at low doses from 300 to 600 mg. However, due to their benign and transitional nature, it is not always necessary to treat fasciculations. A recent study proposed a new approach to treat the Cramps Syndrome and Benign Fasciculations through the identification and correction of sleep apnea, which in most cases can be one of the triggers.

Lastly there is another new study out this month that claims. "Early intrinsic hyperexcitability does not contribute to motoneuron degeneration in amyotrophic lateral sclerosis "........as fasciculation can be one symptom of hyperexcitability this study is reassuring. lfvyou want links PM me, as we decided a while ago not to post links.

In fact I dont usually cite or review science articles on this site anymore, but thought I would just mention the above articles.

Hx
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Re: article of interest.

Postby trustme78 on October 20th, 2014, 10:38 pm

Interesting read indeed. Thanks for posting this.

I have read that on here before but it always strikes me that in the good old times only young people in health care connected twitches with ALS and freaked out over it. Thanks to the internet we all can panic about it now.
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Re: article of interest.

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