Benign Fasciculation Syndrome (BFS) Reminder ...

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Benign Fasciculation Syndrome (BFS) Reminder ...

Postby misterjuanperalta on August 7th, 2015, 3:23 pm

Benign Fasciculation Syndrome (BFS) Reminder ... (which may include cramps):

In the absence of weakness or abnormalities of thyroid function or electrolytes, individuals aged less than 40 years can be reassured without resorting to electromyography (EMG) to avoid the small but highly damaging possibility of false-positives. Equally, however, most subspecialists will recall a small number of cases, typically men in their 50s or 60s, in whom the latency from presentation with apparently benign fasciculations to weakness (and then clear MND) was several years.

(Source: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3664389/)

Further, only about 6% (to 14%) of subjects aged 45 years and older with fasciculations as their only complaint go on to develop MND.

(Source: https://books.google.com/books?id=mBGB7 ... e&q&f=true - page 107)

We studied 11 patients with benign fasciculations, aged 38 to 70 years (mean [SD], 58.5 [11.7] years). These patients had normal strength and their EMG showed normal motor unit potential (MUP) analysis. There was no progression to other disorders in the following 2 years. Some had associated muscle cramps. No metabolic or medication-related cause was identified. The TA muscle was studied in each patient. - Mamede de Carvalho, MD; Michael Swash, MD

(Source: http://archneur.jamanetwork.com/article ... ID=1788580)

Using the case records of Mayo Clinic patients, 121 patients with a diagnosis of benign fasciculations were identified. All had a normal neurological examination and normal electrophysiological studies, except for fasciculation potentials. Interviews by telephone were conducted 2 to 32 years after diagnosis. None of the patients developed symptomatic motor neuron disease. Forty individuals were in health care careers. A subset of 19 patients described acute onset of fasciculations following a viral infection. Benign fasciculations are not a preclude to progressive motor neuron disease.

(Source: http://www.ncbi.nlm.nih.gov/pubmed/?term=8215252)
(Supplemental: http://www.bfsrecovery.com/forum/viewto ... t=163#p564)

Patients diagnosed with BFS through our clinic were identified by searching computerized billing records from 2003 through 2007 for this diagnostic code. This yielded a total of 13 patients who had presented with fasciculations and whose neurological examination, blood workup (including serum electrolytes and thyroid function tests), as well as nerve conduction studies/electromyography were normal. Only these patients were included in the BFS group. In the BFS group, the youngest patient was 20 and the oldest was 59; the mean age was 41.7 ± 10.7 (SD) years. Eleven out of 13 (85%) patients in the BFS group were male. In the BFS group, long-term follow-up of over 2 years was available in six patients. These patients had been treated with selective serotonin reuptake inhibiting agents and had received reassurance that they did not have MND. All these patients were documented to have done well, with the fasciculations subsiding over time. None of the other seven patients in the BFS group returned for follow-up visits despite having been asked to do so. Since it is very likely that if they had progressed to MND they would have been referred back for treatment to our MND clinic, we believe that there was no progression of their symptoms.

(Source: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2812734/)

Twenty consecutive clinicians presenting with fasciculations were prospectively assessed with serial clinical and neurophysiological evaluations.... In FASICS, fasciculations most often involved the lower limbs, without evidence of muscle weakness on clinical examination.... Exercise, stress, fatigue and caffeine consumption were identified as common exacerbating factors.... One of twenty or 5% developed or were diagnosed with MND.

(Source: http://www.ncbi.nlm.nih.gov/pubmed/23400500)

Some causes of fasciculations (twitching) are listed here: viewtopic.php?f=3&t=21999&p=164345#p164345
Last edited by misterjuanperalta on July 28th, 2017, 3:00 am, edited 11 times in total.
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Re: Benign Fasciculation Syndrome (BFS) Reminder ...

Postby Xina535 on August 14th, 2015, 7:27 am

Hi Misterjuan - I got your PM and I have seen this post, but I have not yet been able to read the links. I tried writing you back in PM but it said I couldn't since you have the option disabled.

But yes, lots of evidence here that BFS does not progress to ALS. Thank you for finding these and please keep posting all of your helpful links and facts!
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Re: Benign Fasciculation Syndrome (BFS) Reminder ...

Postby leroyb on August 14th, 2015, 8:13 am

In a lot of cases I've seen or PALS I've spoken to weakness and atrophy only came after fasciculations.

This makes sense as the giant Motor Units formed when neurons fail are unstable and produce the muscle twitches that 'look' like BFS twitches.
These muscle fibers are still being innervated by the GMU's so you will not have muscle loss at this point.
When these GMU's fail and consequently fasciculations slow down you will have muscle atrophy.

This all happens withing a reasonably short time of course and normally less than a year.

Of course some PALS never notice any fasciculations. It's my personal opinion that the situation I outlined above
happens mostly to young men who had large muscle mass to begin with.
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Re: Benign Fasciculation Syndrome (BFS) Reminder ...

Postby leroyb on August 14th, 2015, 8:29 am

To clarify above afaik if you have an EMG done on the symptomatic area it will show abnormalties so
if you had a normal study you are healthy.

Can someone explain to me about these studies: We know Benign Twitches don't progress to MND but they have to be ruled Benign first so I have no idea what those studies are trying to show? :roll:
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Re: Benign Fasciculation Syndrome (BFS) Reminder ...

Postby misterjuanperalta on August 14th, 2015, 11:15 am

A benign determination is always "at the time" of the test(s). The studies above are trying to show how unlikely it is for twitching to turn to ALS.
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Re: Benign Fasciculation Syndrome (BFS) Reminder ...

Postby leroyb on August 14th, 2015, 3:12 pm

Still don't really get it. They are either als twitches or they aren't and as some cases on these forums show they cannot be ruled completely benign without emg os symptomatic area.
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Re: Benign Fasciculation Syndrome (BFS) Reminder ...

Postby misterjuanperalta on August 14th, 2015, 5:14 pm

The studies are to reduce the anxiety without speculations. If you don't understand, don't worry about it. Just know that they serve as reassurance from the medical community. Further, good neurologists always test suspect or symptomatic areas.
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Re: Benign Fasciculation Syndrome (BFS) Reminder ...

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