Fasciculation

Classification according to ICD-10
R25.3	Fasciculation
ICD-10 online (WHO version 2019)

Fasciculations are involuntary, fine twitching of small muscle fiber bundles , which become visible as movements under the skin with no significant effect. They are not painful, occur spontaneously and intermittently, and can occasionally be provoked by pressure on the muscle.

diagnosis

Fasciculations are generally not a specific sign of the presence of a fundamental disease and are therefore classified a priori as benign or benign fasciculation syndrome. The fasciculations are only examined in more detail when other symptoms are present that are specific to the respective illness and thus indicate an illness (e.g. in combination with muscle atrophy or muscle weakness) or in connection with specific triggers (e.g. certain drugs). Pathological fasciculations are much rarer than benign fasciculations and occur as a symptom above all in diseases with a loss of α-motor neurons (e.g. amyotrophic lateral sclerosis ). If peripheral nerves are damaged, fasciculations can occur in the paralyzed muscle.

The diagnostic proof of fasciculation is done by electromyography in the form of fasciculation potentials . These are derived as typical potentials at rest ("pathological spontaneous activity"). In the electromyogram, fasciculations are typically expressed as biphasic potentials with high amplitude. Non-pathological fasciculation potentials typically occur at a lower frequency (less than 3 in 10 seconds) than pathological ones, which occur at a higher frequency. In addition, EMG potentials that are typical for certain diseases / symptoms (such as fibrillation potentials) that can give an indication of the more precise cause of the disease are visible.

Benign fasciculation

→ Main article : Benign fasciculation

These benign ( benign ) Fasciculations often occur on the face or the limbs on. It comes z. B. a short twitch of the eyelid or hand, which can be repeated several times. The feeling here can range from vibrations in muscle fibers to motor-driven muscle twitching (such as when falling asleep). This has no disease value, even if it can be annoying in individual cases. Mental imbalance, stress and the consumption of stimulants can trigger or intensify fasciculations.

Pathological fasciculations

There are a variety of diseases and causes that can trigger fasciculations. Here is a list of the most common causes:

Neuromuscular Diseases

• Amyotrophic Lateral Sclerosis
• poliomyelitis
• Polyneuropathy (such as diabetes mellitus )
• Myopathy
• Spinal muscular atrophy

Medicinal causes

• Acetylcholinesterase (cholinesterase inhibitors)
• lithium
• Benzodiazepine withdrawal
• Myasthenia gravis medication
• Pseudoephedrine
• Salbutamol
• Methylphenidate

Electrolyte imbalances

• Hyponatremia
• Hypomagnesaemia
• Hypocalcemia or hypokalaemia (may trigger convulsions and tetany )

Pathogens

• rabies

Other

• Cervical spine degeneration
• Toxic causes such as B. Organophosphatic poisoning
• Caffeine
• Convulsive fasciculation syndrome
• Cholinergic crisis (e.g. overdose of cholinesterase inhibitors )

Demarcation

The following must be distinguished from fasciculation as the visible fine contractions of muscle fiber bundles (fascicles):

• Fibrillation - twitching of individual muscle fibers, most of which - with the exception of the tongue - are not visible
• Myoclonia - muscle twitching with or without the effect of movement
• Tremor - regular reciprocating motion (tremors)
• Dystonia - prolonged muscle spasms
• Myokymia - superficial, localized, wave-like muscle contraction
• Spasm - unwanted and painful muscle tension

See also

• Eyelid twitch
• twitch

Individual evidence

1. ↑ Marco Antonio Araujo Leite, Marco Orsini, Marcos RG de Freitas, João Santos Pereira, Fábio Henrique Porto Gobbi: Another Perspective on Fasciculations: When is it not Caused by the Classic form of Amyotrophic Lateral Sclerosis or Progressive Spinal Atrophy? In: Neurology International . tape 6 , no. 3 , August 5, 2014, ISSN  2035-8385 , p. 5208 , doi : 10.4081 / ni.2014.5208 , PMID 25309711 , PMC 4192433 (free full text).
2. ↑ Entry on fasciculation in Flexikon , a wiki from DocCheck , accessed on November 26, 2015.
3. ↑ Fasciculation in the General Practice Notebook
4. ^ Electromyography in the Engelhardt Lexikon
5. ↑ Archive link ( Memento of the original dated December 11, 2015 in the Internet Archive ) Info: The archive link was inserted automatically and has not yet been checked. Please check the original and archive link according to the instructions and then remove this notice. The EMG; by Albert C. Clarimont, MD, Ohio University 
6. ^ DocCheck Medical Services GmbH: Cholinergic crisis. Retrieved May 13, 2019 . 
7. ↑ weakness; Myopathy, Anterior Horn Cell Disease, Neuropathies and Neuromuscular Transmission Defects. (PDF) Retrieved February 26, 2018 . 

This article is about a health issue. It is not used for self-diagnosis and does not replace a diagnosis by a doctor. Please note the information on health issues !