Cramp-fasciculations syndrome

Overview

A rare condition characterized by muscle pain, cramps, twitching, spasms and other abnormal sensations that occur mainly in the limbs.

Symptoms

* Twitching muscles * Muscle cramps * Muscle spasms * Rippling muscles * Slow rhythmic muscle contractions

Causes

Though twitching is sometimes a symptom of serious diseases such as spinal injury, muscular dystrophy, Lyme Disease, or amyotrophic lateral sclerosis (ALS), it is much more often due to more benign causes (BFS, over-exertion, etc), and virtually everyone will experience some episodes of benign fasciculation during their lifetime.

Diagnosis

Diagnosis of BFS is a "diagnosis of exclusion," in other words, other likely causes for the twitching (mostly forms of neuropathy, such as borreliosis (Lyme disease) neuropathy, motor neuron diseases such as ALS, etc) must be eliminated before BFS can be assumed. An important diagnostic tool here is the electromyography (EMG). Since BFS appears to cause no actual nerve damage (at least as seen on the EMG), a completely normal EMG (or one where the only abnormality seen is fasciculations) largely eliminates more serious disorders and strongly suggests BFS.

Prognosis

BFS is not life-threatening and generally not disabling, but it may be persistent enough to create some degree of disability, especially if cramps or pain are also present. In many cases, however, the accompanying anxiety is more disabling than the disease itself. The vast majority of cases clear up spontaneously in a few days or weeks (and in fact are never presented for diagnosis), but some may continue for years.

Treatment

Some degree of control of the fasciculations may be achieved with the same medication used to treat essential tremor (beta-blockers and anti-seizure drugs). However, often the most effective approach to treatment is to treat any accompanying anxiety.[citation needed] No drugs, supplements, or other treatments have been found that completely control the symptoms. In many cases, the severity of BFS symptoms can be significantly reduced through a proactive approach to decrease the overall daily stress. Common ways to reduce stress include: exercising more, sleeping more, working less, meditation, and eliminating all forms of dietary caffeine (e.g. coffee, chocolate, cola, and certain over-the counter medications).