Benign Fasciculation Syndrome


Fasciculation is involuntary twitching of the muscles that do not do any harm. Most people have experienced twitching in their eyelids at least once in a lifetime, and this medical condition has various names.

  • Eyelid spasm
  • Myokymia
  • Blepharospasm
    eye muscle spasm

    Image Source: en.wikipedia.org

What does Benign Fasciculation Syndrome indicate?

Fasciculation can often be a potential pointer for numerous conditions. About seven in every ten healthy individuals experience them. They are most unlikely to occur from a complex neuromuscular disease. Nevertheless, as the symptoms resemble with those of a number of degenerative disorders like motor neuron disease, one should seek medical advice after experiencing any such instances of fasciculation.

Benign fasciculation syndrome, or BFS, in short, is a rare condition and such patients may have felt twitches in the following parts of their bodies.

  • Arms
  • Tongue
  • Feet
  • Thumb
  • Thighs
  • Eye
  • Calves

Note: Twitching in the calves is pretty typical

Some people also experience fasciculation with muscle cramps. However, such people are considered otherwise healthy. No neurological reason or underlying disorder can be diagnosed for these twitches and cramps. Nonetheless, the symptoms can become taxing both psychologically and physically in no time. Severe cramps can interfere with one’s daily routine.muscle twitching in legs

Fasciculation Causes

Researchers are yet to discover the precise cause of BFS. However, the following reasons are often suggested:

  • Overexertion
  • Magnesium deficiency
  • Gluten neuropathy
  • Administration of particular drugs like opiates (morphine) or anticholinergics (diphenhydramine)
  • Chronic Organophosphate Poisoning (COP)

Note: Further research is due to substantiate this cause

Benign Fasciculation Syndrome Symptoms

It is crucial to remember that the BFS symptoms, especially the fasciculation part, become evident at the time of rest. The fasciculation can shift from one particular group of muscles to another, being experienced in one’s leg, and finally at the tongue or in the arm. These signs are mistaken for those of amyotrophic lateral sclerosis most of the time and trigger anxiety in the patient.

  • Fasciculation of voluntary muscles
  • Twitching is typically occurring at the body areas mentioned before, and that differs from one person to another
  • The patient is likely to experience overall pain and exhaustion in the corresponding muscles
  • An individual may become anxious, given the fact that twitching is a potential indicator of more complicated neurological disorders like motor neuron disease
  • Intolerance to physical activity may also appear
  • Perception of having something stuck in one’s throat due to anxiety response
  • Numbness or tingling in the affected muscles
  • Rigidity or cramp in the corresponding muscles
  • Exaggerated tendon reflexes
  • Itchiness or tremors
  • Myoclonic jerks, i.e., sudden muscle contractions

Benign Fasciculation Syndrome Diagnosis

Electromyography (EMG)

Note: EMG is always recorded normal for BFS patients

Clinical examination

  • Muscular weakness test (MWT)
  • Clinical weakness test (CWT)

Note: The patient would be asked to move on the toes or heels

  • Tendon reflexes examination (TRE)
  • Resistance strength test (RST)

Differential Diagnosis

The differential diagnosis should be accomplished with sound judgment, as it involves other entities that could present with fasciculation only in the very beginning. However, it can grow to more ominous signs and symptoms later. The distinguishing characteristic between malign and benign fasciculation should be achieved by examining and analyzing how the motor potential of the subject diagnosed with BFS is configured in the EMG. It includes morphology, amplitude, and phases, or MAP, in short and also the absence or presence of other types of spontaneous activity, such as, positive sharp wave (PSW) and fibrillation.

  • Neuropathy
  • Amyotrophic Lateral Sclerosis (ALS)

Note: It is also known as the motor neuron disease (MND)

  • Lyme disease

Benign Fasciculation Syndrome Treatment

  • Beta-blockers and anti-seizure medication are typically administered to manage tremors
  • Use of psychotherapy and psychiatric drugs if the symptoms are found to be stemming from anxiety
  • Prescribing a customized diet plan or magnesium supplements for patients who are deficient in the said mineral
  • Using anti-inflammatory medication like acetaminophen or ibuprofen in the affected individuals who also happen to suffer from inflammation or pain
  • Reducing stress
    – Physical exercise
    – Improving work-life balance
    – Ample sleep at night time
    – Yoga or meditation
    – Eliminating caffeine from one’s food intake; such as caffeinated sodas, drinks, or chocolates

Benign Fasciculation Syndrome Preventions

Despite the extensive volume of research activities in the field, the scientists are yet to find a cure for BFS. Some doctors believe that consuming a diet, which is rich in iodized salt and magnesium, does help to prevent this disease. Also, living a stress-free life is greatly beneficial for the said purpose. When someone gets anxious due to BFS, the pessimism makes that person even more anxious, which results in the further development of pessimistic thoughts. Thus, the negative feelings of a BFS patient eventually create a negative feedback loop, and hence; successful anxiety management holds immense significance for the prevention of this disorder.

Prognosis

Considering the fact that BFS is a non-severe condition, the prognosis is much good, though not excellent. It is vital to understand that it does not initiate physical changes, in spite of the continuous twitching happening in any of the muscle group. The greatest level of discomfort arises from the accompanying anxiety and makes the affected person continually worrying about the manifestation of a more complicated neurological disorder.

Psychotherapy plays an instrumental role in the treatment of this disease and helps the patient to explore all the viable coping mechanisms and reducing the amount of stress associated with this phenomenon. The patient will be adequately sensitized and made aware of the fact that the level of anxiety can be substantially reduced, and that one’s condition is not critical at all, one that is not going to pose any associated health issues or risks. Medication might be suggested to keep the stress and anxiety at bay.

Spontaneous remission has been documented in some cases of BFS, and the most promising outcomes were delivered after successfully eliminating the signs of anxiety. To reiterate, the most effective option to avail an excellent prognosis is psychological counseling. However, a few patients did report that their condition was worsened after the talk therapy (CBT or cognitive behavioral therapy) sessions started.

When to visit a doctor?

Call nine-one-one if in the USA and consult a health care professional as soon as the symptoms start to appear.

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