From the Research
Introduction to Fasciculations
Fasciculations are a clinical phenomenon characterized by brief, spontaneous contractions of muscle fibers, resulting in a flicker of movement under the skin [ 1 ]. These contractions can be associated with various conditions, ranging from benign to severe neurological disorders.
Conditions Associated with Fasciculations
Several conditions are associated with fasciculations, including:
- Amyotrophic lateral sclerosis (ALS) [ 1 ]
- Benign fasciculation syndrome (BFS) [ 2 ]
- Cramp-fasciculation syndrome (CFS) [ 2 ]
- Neuropathy [ 2 ]
- Hereditary diseases such as familial amyotrophic lateral sclerosis (FALS), spinal muscular atrophy (SMA), and others [ 3 ]
- Peripheral nerve hyperexcitability syndromes [ 3 ]
Clinical Significance of Fasciculations
Fasciculations can be an early harbinger of dysfunction and aberrant firing of motor neurons in ALS [ 1 ]. In contrast, fasciculations without weakness, muscle atrophy, or increased tendon reflexes may suggest a benign fasciculation syndrome [ 1 ]. The clinical significance of fasciculations depends on the associated symptoms and signs, and a thorough evaluation is necessary to determine the underlying cause [ 4 ].
Treatment and Management
The treatment and management of fasciculations depend on the underlying condition. In some cases, no specific treatment may be required, while in others, medications such as those used to manage muscle cramps or spasticity may be prescribed. It is essential to note that fasciculations can persist over time, even in benign cases, but the risk of progression to motor neuron disease is low [ 5 ].
Differential Diagnosis and Caveats
A differential diagnosis should consider various conditions that can cause fasciculations, including motor neuron diseases, peripheral nerve disorders, and muscle diseases. It is crucial to evaluate the clinical presentation, medical history, and results of neurophysiological studies to determine the underlying cause of fasciculations [ 2 ]. Additionally, the presence of exacerbating factors such as exercise, stress, fatigue, and caffeine consumption should be considered [ 2 ].