Questions posted in the
Neurology and Neurosurgery Forum have been answered by doctors from The Cleveland Clinic Foundation.
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Subject: Re: Fasciculations Have had fasciculations for a year now, primarly in calves of legs and feet. These began about the same time as strange anxiety attack that lasted over 3 weeks. Have seen many doctors and had x-rays of spine, MRI of spine, EMG, CAT scan of head, CAT scan of abdominal area, EEG because I was losing so much weight. Finally began on paxil which eventually eased the rapid pulse, hyperventilation, nausea, etc., but the fascics have continued. Have seen two neurologists - second one I cotinue to see. She tries to convince me these are benign fasciculations (myokymia) and we have tried several different drugs. I continue on the Paxil, take klonopin only at night, tried Baclofen and am now trying tegretol. The fascics are most prominent and visible in calves of legs which also go into spasms including feet with toes moving in different directions by themselves. The fascics also occur in ALL other areas of body, back, arms, buttocks, abdomen - everywhere. These are move severely felt or perhaps I am just used to the ones in legs. All blood and urine tests were normal. I have entered menopause and take Prempro which basically does nothing for me - periods are heavy and last for weeks. I am no in pain except for the occasional muscle spasms, work everyday and manage a household. Even saw psychiatrist who dismissed me after two meetings - I am so totally normal. Stress related ???? both my parents died last year, the year before that we lost of dog of 13 years, my son went away to college. I thought of myself as the rock - has the rock fallen apart? Any insight or suggestions would be most appreciated. = The anxiety attacks and related symptoms are likely to be stress related, probably no surprise to you. It is possible that the fasciculations have nothing to do with the other symptoms. Benign fasciculations happen in normal people and in fact do not require treatment. If these are painful or uncomfortable, then they are likely to be something other than fasciculations. If you just are worried about having them, but they are not truly uncomfortable, then I wouldn't use medications to try to amke them better. Paxil helps the anxiety-related symptoms and is pretty good. But unless there is some other rationale for baclofen, Tegretol, etc, I would be hesitant to take them just because that is a setup for side effects and the risks and benefits don't match up. (Tegretol can be used as a mood stabilizer as well, so don't just discontinue medications without appropriate discussion with your doctor). Fasciculations can be normal (benign fasciculations) or can signal damage to nerves. I expect your neurologist has performed a thorough neurologic exam designed to reveal evidence of neuropathy, and perhaps other tests (such as EMG as well). If these have been normal, then you can breathe easier. If anything changes: new symptom, discomfort, weakness, etc, then that may be a clue to something going on. It doesn't hurt to be re-evaluated once or twice at 6-12 month intervals by the neurologist. If nothingn develops in that time, you're probably OK. This information is for your medical education. Specific comments regarding diagnosis, prognosis, and treatment options must come from your doctor after appropriate evaluation. I hope this helps. CCF MD mdf.
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