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{{Infobox_Disease |
  Name          = {{PAGENAME}} |
  Image          = |
  Caption        = |
  DiseasesDB    = 18832 |
  ICD10          =  {{ICD10|R|25|3|r|25}}  |
  ICD9          = {{ICD9|781.0}} |
  ICDO          = |
  OMIM          = |
  MedlinePlus    = 003296 |
  eMedicineSubj  = |
  eMedicineTopic = |
  MeshID        = D005207 |
}}
{{SI}}
{{SI}}
{{CMG}}
{{CMG}} {{AE}} {{LRO}}


==Overview==
==Overview==
A '''fasciculation''' (or "muscle [[twitch]]") is a small, local, involuntary [[muscle contraction]] (twitching) visible under the skin arising from the spontaneous discharge of a bundle of [[skeletal muscle]] fibers. Fasciculations have a variety of causes, the majority of which are [[benign]], but can also be due to disease of the motor neurons.
A '''fasciculation''' (or "muscle [[twitch]]") is a small, local, involuntary [[muscle contraction]] (twitching) visible under the skin arising from the spontaneous discharge of a bundle of [[skeletal muscle]] fibers. Fasciculations have a variety of causes, the majority of which are [[benign]], but can also be due to disease of the motor neurons.


==Causes and risk factors==
==Causes<ref name="pmid8215252 ">{{cite journal |author=Blexrud MD, Windebank AJ, Daube JR |title=Long-term follow-up of 121 patients with benign fasciculations |journal=Ann. Neurol. |volume=34 |issue=4 |pages=622-5 |year=1993 |pmid=8215252 |doi=10.1002/ana.410340419}}</ref>==
===Conditions===
<div style="-webkit-user-select: none;">
* The origin of most cases is at present unknown and has therefore been given the title [[benign fasciculation syndrome]]<ref name="pmid8215252 ">{{cite journal |author=Blexrud MD, Windebank AJ, Daube JR |title=Long-term follow-up of 121 patients with benign fasciculations |journal=Ann. Neurol. |volume=34 |issue=4 |pages=622-5 |year=1993 |pmid=8215252 |doi=10.1002/ana.410340419}}</ref>.
===Life Threatening Causes===
* [[Werdnig-Hoffman disease]]
*[[Benzodiazepine withdrawal]]
* [[Amyotrophic lateral sclerosis]] (rare)
*[[Dehydration]]
* [[Kennedy disease]]
*[[Donepezil|Donepezil toxicity]]
* [[Organophosphate poisoning]]
*[[Multiple sclerosis]]
* [[Benzodiazepine withdrawal]]
*[[Organophosphate poisoning]]
* [[Magnesium_deficiency_%28medicine%29|Magnesium deficiency]] (which can be caused by stress)
*[[Quaternary syphilis]]
* [[Dehydration]]
*[[Renal disease]]
* [[Fatigue (medical)|Fatigue]]
*[[Tacrine|Tacrine toxicity]]


===Medications===
===Common Causes===
Other risk factors may include the use of [[anticholinergic]] drugs over long periods, in particular [[ethanolamine]]s such as [[diphenhydramine|Benadryl]], used as an antihistamine and sleep aid, and [[dimenhydrinate|Dramamine]] for nausea and motion sickness. Persons with [[Benign fasciculation syndrome]] (BFS) may experience [[paraesthesia]] shortly after taking such medication; hours later as it wears off (especially upon awaking), fasciculation episodes begin. 
*[[Amyotrophic lateral sclerosis ]]
*[[Bell palsy]]  
*Brown-vialetto-van laere syndrome,  
*[[Central pontine myelinosis]]
*[[Fatigue]]  
*[[Friedreich ataxia]]
*[[Guillain-Barré syndrome|Guillain-barre syndrome]]
*[[Neuropathy|Hereditary sensorimotor neuropathy type 1]]
*[[Infantile neuroaxonal dystrophy]]  
*[[Isaac's syndrome|Isaac syndrome,]]
*[[Kennedy disease]]
*[[Motor neuron disease]]
*[[Multifocal motor neuropathy]]
*[[Multiple sclerosis]]
*[[Myasthenia gravis]]
*[[Neuromyotonia]]
*[[Neuropathy]]
*[[Peripheral neuropathy]]
*[[Poliomyelitis]]
*[[Posterior inferior cerebellar artery syndrome]]
*[[Post-polio syndrome|Postpoliomyelitis syndrome]]  
*[[Progressive bulbar palsy]]  
*[[Progressive muscular atrophy]],  
*[[Spinal muscular atrophy]]
*[[Spinocerebellar ataxia]]
*[[Subacute combined degeneration of the cord]]
*[[Transverse myelitis]]
*Welander distal myopathy
*[[Werdnig-Hoffman disease|Werdnig-hoffman disease]]


[[Stimulant]]s can cause fasciculations directly. These include [[caffeine]], [[pseudoephedrine]] (Sudafed®), and the [[asthma]] [[bronchodilator]]s [[albuterol]]/salbutamol (e.g. Proventil®, Combivent®, Ventolin®). Medications used to treat [[ADHD|attention deficit disorder]] often contain stimulants as well, and are common causes of benign fasciculations.
===Causes by Organ System===
{|style="width:80%; height:100px" border="1"
|style="height:100px"; style="width:25%" border="1" bgcolor="LightSteelBlue" |'''Cardiovascular'''
|style="height:100px"; style="width:75%" border="1" bgcolor="Beige" | [[Dural arteriovenous fistula]],  [[Posterior inferior cerebellar artery syndrome]]
|-
|bgcolor="LightSteelBlue"| '''Chemical/Poisoning'''
|bgcolor="Beige"| [[Organophosphate poisoning]]
|-
|-bgcolor="LightSteelBlue"
| '''Dental'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Dermatologic'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Drug Side Effect'''
|bgcolor="Beige"| [[Albuterol]],  [[Ambenonium]],  [[Anticholinergic drugs]],  [[Benadryl]],  [[Caffeine]],  [[Corticosteroids]],  [[Diuretics]],  [[Dramamine]],  [[Pellagra]],  [[Pseudoephedrine]],  [[Salbutamol ]],  [[Succinylcholine ]]
|-
|-bgcolor="LightSteelBlue"
| '''Ear Nose Throat'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Endocrine'''
|bgcolor="Beige"| [[Acute intermittent porphyria]],  [[Adult polyglucosan body disease]],  [[Hypocalcaemia]]
|-
|-bgcolor="LightSteelBlue"
| '''Environmental'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Gastroenterologic'''
|bgcolor="Beige"| [[Adult polyglucosan body disease]]
|-
|-bgcolor="LightSteelBlue"
| '''Genetic'''
|bgcolor="Beige"| [[Brown-vialetto-van laere syndrome]],  [[Gangliosidosis gm2, type 1]],  [[Infantile neuroaxonal dystrophy]],  [[Kennedy disease]],  [[Spastic paraplegia 11]],  [[Werdnig-hoffman disease]]
|-
|-bgcolor="LightSteelBlue"
| '''Hematologic'''
|bgcolor="Beige"| [[Hypocalcaemia]],  [[Magnesium deficiency ]]
|-
|-bgcolor="LightSteelBlue"
| '''Iatrogenic'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Infectious Disease'''
|bgcolor="Beige"| [[Botulism]],  [[Guillain-barre syndrome]],  [[Poliomyelitis]],  [[Postpoliomyelitis syndrome]],  [[Quaternary syphilis]],  [[Rabies]], [[Syringomyelia]]
|-
|-bgcolor="LightSteelBlue"
| '''Musculoskeletal/Orthopedic'''
|bgcolor="Beige"| [[Cervical spondylosis]], [[Intervertebral disc herniation]], [[Jokela type spinal muscular atrophy]],  [[Neuromyotonia]],  [[Spinal muscular atrophy]],  [[Spinocerebellar ataxia]],  [[Subacute combined degeneration of the cord]],  [[Welander distal myopathy]]
|-
|-bgcolor="LightSteelBlue"
| '''Neurologic'''
|bgcolor="Beige"| [[Amyotrophic lateral sclerosis ]],  [[Bell palsy]],  [[Brown-vialetto-van laere syndrome]],  [[Central pontine myelinosis]],  [[Fatigue]],  [[Friedreich ataxia]],  [[Guillain-barre syndrome]],  [[Hereditary sensorimotor neuropathy type 1]],  [[Infantile neuroaxonal dystrophy]],  [[Isaac syndrome]],  [[Kennedy disease]],  [[Motor neuron disease]],  [[Multifocal motor neuropathy]],  [[Multiple sclerosis]],  [[Myasthenia gravis]],  [[Neuromyotonia]],  [[Neuropathy]],  [[Peripheral neuropathy]],  [[Poliomyelitis]],  [[Posterior inferior cerebellar artery syndrome]],  [[Postpoliomyelitis syndrome]],  [[Progressive bulbar palsy]],  [[Progressive muscular atrophy]],  [[Spinal muscular atrophy]],  [[Spinocerebellar ataxia]],  [[Subacute combined degeneration of the cord]],  [[Transverse myelitis]],  [[Welander distal myopathy]],  [[Werdnig-hoffman disease]]
|-
|-bgcolor="LightSteelBlue"
| '''Nutritional/Metabolic'''
|bgcolor="Beige"| [[Dehydration]],  [[Finnish type amyloidosis]],  [[Magnesium deficiency ]],  [[Nutritional deficiency]]
|-
|-bgcolor="LightSteelBlue"
| '''Obstetric/Gynecologic'''
|bgcolor="Beige"| [[Cervical myelopathy]]
|-
|-bgcolor="LightSteelBlue"
| '''Oncologic'''
|bgcolor="Beige"| [[Syringobulbia]]
|-
|-bgcolor="LightSteelBlue"
| '''Ophthalmologic'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Overdose/Toxicity'''
|bgcolor="Beige"| [[Benzodiazepine withdrawal]],  [[Caffeine]], [[Donepezil toxicity]],  [[Ethanolamines]], [[Tacrine toxicity]]
|-
|-bgcolor="LightSteelBlue"
| '''Psychiatric'''
|bgcolor="Beige"| [[Anxiety]], [[Stress]]
|-
|-bgcolor="LightSteelBlue"
| '''Pulmonary'''
|bgcolor="Beige"| [[Asthma]]
|-
|-bgcolor="LightSteelBlue"
| '''Renal/Electrolyte'''
|bgcolor="Beige"| [[Dehydration]],  [[Diuretics]],  [[Renal disease]]
|-
|-bgcolor="LightSteelBlue"
| '''Rheumatology/Immunology/Allergy'''
|bgcolor="Beige"| [[Myopathy]]
|-
|-bgcolor="LightSteelBlue"
| '''Sexual'''
|bgcolor="Beige"| [[Quaternary syphilis]]
|-
|-bgcolor="LightSteelBlue"
| '''Trauma'''
|bgcolor="Beige"| [[Intervertebral disc herniation]],  [[Strenuous exercise]]
|-
|-bgcolor="LightSteelBlue"
| '''Urologic'''
|bgcolor="Beige"| [[Uremia]]
|-
|-bgcolor="LightSteelBlue"
| '''Miscellaneous'''
|bgcolor="Beige"| No underlying causes
|-
|}
 
===Causes in Alphabetical Order===
{{columns-list|
*[[Acute intermittent porphyria]]
*[[Adult polyglucosan body disease]]
*[[Adult sma]]
*[[Albuterol]]
*[[Ambenonium]]
*[[Amyotrophic lateral sclerosis ]]
*[[Anticholinergic drugs]]
*[[Anxiety]]
*[[Asthma]]
*[[Bell palsy]]
*[[Benadryl]]
*[[Benzodiazepine withdrawal]]
*[[Botulism]]
*[[Brown-vialetto-van laere syndrome]]
*[[Caffeine]]
*[[Central pontine myelinosis]]
*[[Cervical myelopathy]]
*[[Cervical spondylosis]]
*[[Corticosteroids]]
*[[Dehydration]]
*[[Diuretics]]
*[[Donepezil toxicity]]
*[[Dramamine]]
*[[Dural arteriovenous fistula]]
*[[Ethanolamines]]
*[[Fatigue]]
*[[Finnish type amyloidosis]]
*[[Friedreich ataxia]]
*[[Gangliosidosis gm2, type 1]]
*[[Guillain-barre syndrome]]
*[[Hereditary sensorimotor neuropathy type 1]]
*[[Hypocalcaemia]]
*[[Infantile neuroaxonal dystrophy]]
*[[Intervertebral disc herniation]]
*[[Isaac syndrome]]
*[[Jokela type spinal muscular atrophy]]
*[[Kennedy disease]]
*[[Magnesium deficiency ]]
*[[Motor neuron disease]]
*[[Multifocal motor neuropathy]]
*[[Multiple sclerosis]]
*[[Myasthenia gravis]]
*[[Myopathy]]
*[[Neuromyotonia]]
*[[Neuropathy]]
*[[Nutritional deficiency]]
*[[Organophosphate poisoning]]
*[[Organophosphates]]
*[[Pellagra]]
*[[Peripheral neuropathy]]
*[[Poliomyelitis]]
*[[Posterior inferior cerebellar artery syndrome]]
*[[Postpoliomyelitis syndrome]]
*[[Progressive bulbar palsy]]
*[[Progressive muscular atrophy]]
*[[Pseudoephedrine]]
*[[Quaternary syphilis]]
*[[Rabies]]
*[[Renal disease]]
*[[Salbutamol ]]
*[[Spastic paraplegia 11]]
*[[Spinal muscular atrophy]]
*[[Spinocerebellar ataxia]]
*[[Strenuous exercise]]
*[[Stress]]
*[[Subacute combined degeneration of the cord]]
*[[Succinylcholine ]]
*[[Syringobulbia]]
*[[Syringomyelia]]
*[[Tacrine toxicity]]
*[[Transverse myelitis]]
*[[Uremia]]
*[[Welander distal myopathy]]
*[[Werdnig-hoffman disease]]
}}
</div>


==Treatment==
==Treatment==
Line 46: Line 251:


{{Symptoms and signs}}
{{Symptoms and signs}}
{{SIB}}


[[Category:Neurology]]
[[Category:Neurology]]
[[Category:Medical signs]]
[[Category:Signs and symptoms]]
[[Category:Signs and symptoms]]
[[Category:Overview complete]]
[[Category:Overview complete]]
[[Category:Symptoms]]




[[de:Faszikulation]]
 
 
[[es:Fasciculación]]
[[es:Fasciculación]]
[[fr:Fasciculation]]
[[fr:Fasciculation]]
[[nl:Fasciculatie]]
[[no:Fascikulasjon]]
[[fi:Elohiiri]]
[[pt:Fasciculação]]
[[pt:Fasciculação]]


{{WH}}
{{WH}}
{{WikiDoc Sources}}
{{WikiDoc Sources}}

Latest revision as of 20:56, 10 January 2020

WikiDoc Resources for Fasciculation

Articles

Most recent articles on Fasciculation

Most cited articles on Fasciculation

Review articles on Fasciculation

Articles on Fasciculation in N Eng J Med, Lancet, BMJ

Media

Powerpoint slides on Fasciculation

Images of Fasciculation

Photos of Fasciculation

Podcasts & MP3s on Fasciculation

Videos on Fasciculation

Evidence Based Medicine

Cochrane Collaboration on Fasciculation

Bandolier on Fasciculation

TRIP on Fasciculation

Clinical Trials

Ongoing Trials on Fasciculation at Clinical Trials.gov

Trial results on Fasciculation

Clinical Trials on Fasciculation at Google

Guidelines / Policies / Govt

US National Guidelines Clearinghouse on Fasciculation

NICE Guidance on Fasciculation

NHS PRODIGY Guidance

FDA on Fasciculation

CDC on Fasciculation

Books

Books on Fasciculation

News

Fasciculation in the news

Be alerted to news on Fasciculation

News trends on Fasciculation

Commentary

Blogs on Fasciculation

Definitions

Definitions of Fasciculation

Patient Resources / Community

Patient resources on Fasciculation

Discussion groups on Fasciculation

Patient Handouts on Fasciculation

Directions to Hospitals Treating Fasciculation

Risk calculators and risk factors for Fasciculation

Healthcare Provider Resources

Symptoms of Fasciculation

Causes & Risk Factors for Fasciculation

Diagnostic studies for Fasciculation

Treatment of Fasciculation

Continuing Medical Education (CME)

CME Programs on Fasciculation

International

Fasciculation en Espanol

Fasciculation en Francais

Business

Fasciculation in the Marketplace

Patents on Fasciculation

Experimental / Informatics

List of terms related to Fasciculation

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Luke Rusowicz-Orazem, B.S.

Overview

A fasciculation (or "muscle twitch") is a small, local, involuntary muscle contraction (twitching) visible under the skin arising from the spontaneous discharge of a bundle of skeletal muscle fibers. Fasciculations have a variety of causes, the majority of which are benign, but can also be due to disease of the motor neurons.

Causes[1]

Life Threatening Causes

Common Causes

Causes by Organ System

Cardiovascular Dural arteriovenous fistula, Posterior inferior cerebellar artery syndrome
Chemical/Poisoning Organophosphate poisoning
Dental No underlying causes
Dermatologic No underlying causes
Drug Side Effect Albuterol, Ambenonium, Anticholinergic drugs, Benadryl, Caffeine, Corticosteroids, Diuretics, Dramamine, Pellagra, Pseudoephedrine, Salbutamol , Succinylcholine 
Ear Nose Throat No underlying causes
Endocrine Acute intermittent porphyria, Adult polyglucosan body disease, Hypocalcaemia
Environmental No underlying causes
Gastroenterologic Adult polyglucosan body disease
Genetic Brown-vialetto-van laere syndrome, Gangliosidosis gm2, type 1, Infantile neuroaxonal dystrophy, Kennedy disease, Spastic paraplegia 11, Werdnig-hoffman disease
Hematologic Hypocalcaemia, Magnesium deficiency 
Iatrogenic No underlying causes
Infectious Disease Botulism, Guillain-barre syndrome, Poliomyelitis, Postpoliomyelitis syndrome, Quaternary syphilis, Rabies, Syringomyelia
Musculoskeletal/Orthopedic Cervical spondylosis, Intervertebral disc herniation, Jokela type spinal muscular atrophy, Neuromyotonia, Spinal muscular atrophy, Spinocerebellar ataxia, Subacute combined degeneration of the cord, Welander distal myopathy
Neurologic Amyotrophic lateral sclerosis , Bell palsy, Brown-vialetto-van laere syndrome, Central pontine myelinosis, Fatigue, Friedreich ataxia, Guillain-barre syndrome, Hereditary sensorimotor neuropathy type 1, Infantile neuroaxonal dystrophy, Isaac syndrome, Kennedy disease, Motor neuron disease, Multifocal motor neuropathy, Multiple sclerosis, Myasthenia gravis, Neuromyotonia, Neuropathy, Peripheral neuropathy, Poliomyelitis, Posterior inferior cerebellar artery syndrome, Postpoliomyelitis syndrome, Progressive bulbar palsy, Progressive muscular atrophy, Spinal muscular atrophy, Spinocerebellar ataxia, Subacute combined degeneration of the cord, Transverse myelitis, Welander distal myopathy, Werdnig-hoffman disease
Nutritional/Metabolic Dehydration, Finnish type amyloidosis, Magnesium deficiency , Nutritional deficiency
Obstetric/Gynecologic Cervical myelopathy
Oncologic Syringobulbia
Ophthalmologic No underlying causes
Overdose/Toxicity Benzodiazepine withdrawal, Caffeine, Donepezil toxicity, Ethanolamines, Tacrine toxicity
Psychiatric Anxiety, Stress
Pulmonary Asthma
Renal/Electrolyte Dehydration, Diuretics, Renal disease
Rheumatology/Immunology/Allergy Myopathy
Sexual Quaternary syphilis
Trauma Intervertebral disc herniation, Strenuous exercise
Urologic Uremia
Miscellaneous No underlying causes

Causes in Alphabetical Order

Treatment

Inadequate magnesium intake can cause fasciculations, especially after a magnesium loss due to severe diarrhea. Over-exertion is another risk factor for magnesium loss. As much as 80% of the population does not get the recommended daily amount of magnesium; this may be a common cause. Treatment is with supplements or increased intake of foods rich in magnesium, especially almonds & other nuts, and bananas. Ironically, magnesium supplements may result in diarrhea and more magnesium loss, so dosage and timing (i.e. with meals) are important.

Fasciculation also often occurs during a rest period after sustained stress, such as that brought on by unconsciously tense muscles. Reducing stress and anxiety is therefore another useful treatment.

References

  1. ↑ Blexrud MD, Windebank AJ, Daube JR (1993). "Long-term follow-up of 121 patients with benign fasciculations". Ann. Neurol. 34 (4): 622–5. doi:10.1002/ana.410340419. PMID 8215252.

Template:Skin and subcutaneous tissue symptoms and signs Template:Nervous and musculoskeletal system symptoms and signs Template:Urinary system symptoms and signs Template:Cognition, perception, emotional state and behaviour symptoms and signs Template:Speech and voice symptoms and signs Template:General symptoms and signs

Template:WH Template:WikiDoc Sources

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