The Benign fasciculation syndrome is a medical condition, in which fasciculation or twitching occurs at the level of voluntary muscles, due to a neurological dysfunction. Even though the fasciculation can appear in any muscle of the body, the most common areas in which it happens include: feet, legs, arms and eyelids. Some people might experience twitching at the level of the tongue as well. The fasciculation can appear from time to time, the frequency of appearance varying from one patient to the other. Interesting enough, the movement of the respective muscle causes the fasciculation to stop; however, the fasciculation might return, as soon as the movement has stopped.
These are the most common causes and symptoms that can appear with the benign fasciculation syndrome:
- Fasciculation at the level of the voluntary muscles
- The twitching is common at the level of the above-mentioned areas (varying from one patient to the other)
- The patient might experience overall fatigue and pain in the respective muscles
- One can become anxious, considering that the twitching is a symptom of more serious neurological disorders, such as ALS
- Intolerance to physical exercise can appear as one of the symptoms
- Sensation of having something in the throat (due to the anxiety as well)
- Numbness or tingling at the level of the affected muscles
- Cramps or rigidity in the respective muscles
- Exaggerated tendon reflexes
- Tremors or itchiness
- Sudden muscle contractions (also known as myoclonic jerks)
It is important to keep in mind that the symptoms of the benign fasciculation syndrome (especially the fasciculation) become obvious when one is resting, being stopped with active movement. The fasciculation can move from one muscle group to the other, being felt in the leg, then in the arm or at the level of the tongue. These symptoms are often mistaken for the ones of amyotrophic lateral sclerosis, causing the patient to become anxious.
The exact cause of the benign fasciculation syndrome has yet to be identified. However, these are the causes that have been suggested:
- Chronic organophosphate poisoning (further research is necessary to confirm that cause)
- Administration of certain drugs, such as: anticholinergics (diphenhydramine), opiates (morphine)
- Magnesium deficiency – patients who suffer from such problems present both the symptoms of the benign fasciculation syndrome and the ones of anxiety
- Neuropathies – gluten neuropathy.
These are the most common methods used for the diagnosis of the benign fasciculation syndrome:
- Differential diagnosis – neuropathy, Lyme disease, motor neuron disease (ALS)
- Electromyography – important diagnostic tool (if the patient suffers from the benign fasciculation syndrome, the EMG should be normal)
- Clinical examination of the patient
- Identification of muscular weakness
- Strength tests – clinical weakness (the patient might be asked to walk on his/her heels or toes)
- Resistance strength tests
- Examination of tendon reflexes
These are the most common methods used for the treatment of the benign fasciculation syndrome:
- Medication commonly administered for the essential tremor, such as anti-seizure medication and beta-blockers
- Psychological counselling and medication for the symptoms of anxiety
- Magnesium supplements or special diet in order to reduce the symptoms presented by the patients with magnesium deficiency
- Anti-inflammatory medication – this is recommended in the patients who also suffer from pain or inflammation; the indicated choices include ibuprofen and acetaminophen
These are the methods that can be used in order to reduce the daily stress, commonly associated with the benign fasciculation syndrome:
- Physical exercise
- Sleeping at least eight hours per night
- Reducing the working hours
- Practicing meditation or yoga on a regular basis
- Eliminating caffeine from the diet (caffeine-based drinks, sodas or chocolate)
Given the fact that this is a benign condition, the prognosis is quite good, if not excellent. It is important to keep in mind that the benign fasciculation syndrome does not cause physical changes, despite the constant twitching of the muscles. The highest level of discomfort comes from the associated anxiety, the patient constantly worrying about having a more serious neurological disorder.
Psychological counselling is of essential importance, as it can help the patient discover coping strategies and reduce the level of associated stress. The patient has to be taught that the anxiety can be reduced and he/she suffers from a benign condition, one that does not present any associated health risks. Medication might be prescribed in order to keep the anxiety under control.
Some patients have experienced spontaneous remission, the most successful results being related to the elimination of the anxiety symptoms. Once again, the psychological counselling is the best option available for an excellent prognosis. Few patients report a worsening of their symptoms after the psychological counseling has started.
Is there any cure for the benign fasciculation syndrome?
Despite the extensive research in the field, there is no cure for the benign fasciculation syndrome. As it was already mentioned, there are some patients who have experience a spontaneous remission. The treatment solutions can be used in order to keep the symptoms under control. A diet that is rich in magnesium and iodine salt can improve this condition. Psychological counselling is also useful for anxious patients, allowing them to make the difference between a benign and a malign condition.
Why is the management of anxiety so important? When a person is anxious because of the benign fasciculation syndrome symptoms, the anxiety and the negative emotions can lead to re-occurrences. The sooner you learn to control your anxiety, the more reduced the change of the fasciculation reappearing are going to be.
In conclusion, the benign fasciculation syndrome does not present any serious concerns but it can cause the patient a lot of discomfort. However, it is important to make the difference between this benign condition and other neurological disorders, such as ALS. Lifestyle changes, including those related to the diet, are essential in keeping this condition under control. Psychological counselling is, as it was already mentioned, also useful in reducing the anxiety related to this condition. Patients are advised with go to the doctor for regular check-ups, so as to verify the symptoms and especially the functioning of the muscles.