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Neurology (Expert Forum)
Questions about Benign Fasciculation Syndrome
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Questions about Benign Fasciculation Syndrome
by bowie86, Mar 19, 2007 12:00AM
I am looking for information on Benign Fasciculation Syndrome. I have had random twitches throughout my body for the last 6 months or so, with it getting worse over the past month. I am NOT concerned that I have ALS or MS or anything progressive; I feel quite confident these are benign twitches that are not going to progress. Nevertheless, I would like to get some more information about what is going on and how to deal with it.
I know BFS is a defined syndrome, but how does the medical community view it? Is the supposed auto-immune theory seen as valid or is BFS seen as a psycho-somatic complaint from a bunch of hypochondriacs who are focusing too much on their bodies? What is known and accepted by neurologists about BFS?
Does BFS always include cramps and stiffness? I’m having multiple, random twitches throughout the day, but not the rest. Would this still be considered BFS?
Does BFS ever go away?
Also, are there links between BFS and hypothyroidism?
I appreciate any and all input. I plan to discuss this with my primary care doctor at my upcoming physical next month, but I’d like to have as much information as possible before I go in.
I know BFS is a defined syndrome, but how does the medical community view it? Is the supposed auto-immune theory seen as valid or is BFS seen as a psycho-somatic complaint from a bunch of hypochondriacs who are focusing too much on their bodies? What is known and accepted by neurologists about BFS?
Does BFS always include cramps and stiffness? I’m having multiple, random twitches throughout the day, but not the rest. Would this still be considered BFS?
Does BFS ever go away?
Also, are there links between BFS and hypothyroidism?
I appreciate any and all input. I plan to discuss this with my primary care doctor at my upcoming physical next month, but I’d like to have as much information as possible before I go in.
Doctor's Answer
by Forum-M.D.-SH, Apr 09, 2007 12:00AM
First of all, keep in mind that I am unable to diagnose you because I am unable to examine you, this forum is for educational purposes.
Benign Fasiculation Syndrome (BFS) is a diagnosis of exclusion, thus it represents a patient with fasiculations when they do not have some other medical cause (this is most people with fasiculations). The cause of BFS is not known, but some possible causes are low intake of magnesium, autoimmune reaction to a viral infection, stress/anxiety, and reaction to chemicals such as oorganophospahtes. The diagnosis of BFS involves ruling out worrisome diseases that are also associated with fasiculations including ALS and other neuro-muscular diseases. I would recommend that you obtain an EMG (nerve muscle test) and blood work to evaluate your electrolytes (sodium, potasium, choride, BUN, Cr, bicarbonate, calcium, phosphorus, magnesium). This condition is not thought of in the neurologic community as a pycho-sommatic complaint, but it is recognized that this condition (although real) is associated with a high level of anxiety (mostly that the patient has ALS or some other terrible disease). Since the cause of BFS is not known (except for the theories I mentioned) I cannot state a specific link between BFS and hypothyroidism, but that association has been made based on clinical observations. BFS is often self limited and resolves or improves over time (sometimes weeks, sometimes years). Treatments have been tried, none with complete sucess, which include: beta-blockers (propanolol, nadolol) and neurontin.
I hope this has been helpful.
Benign Fasiculation Syndrome (BFS) is a diagnosis of exclusion, thus it represents a patient with fasiculations when they do not have some other medical cause (this is most people with fasiculations). The cause of BFS is not known, but some possible causes are low intake of magnesium, autoimmune reaction to a viral infection, stress/anxiety, and reaction to chemicals such as oorganophospahtes. The diagnosis of BFS involves ruling out worrisome diseases that are also associated with fasiculations including ALS and other neuro-muscular diseases. I would recommend that you obtain an EMG (nerve muscle test) and blood work to evaluate your electrolytes (sodium, potasium, choride, BUN, Cr, bicarbonate, calcium, phosphorus, magnesium). This condition is not thought of in the neurologic community as a pycho-sommatic complaint, but it is recognized that this condition (although real) is associated with a high level of anxiety (mostly that the patient has ALS or some other terrible disease). Since the cause of BFS is not known (except for the theories I mentioned) I cannot state a specific link between BFS and hypothyroidism, but that association has been made based on clinical observations. BFS is often self limited and resolves or improves over time (sometimes weeks, sometimes years). Treatments have been tried, none with complete sucess, which include: beta-blockers (propanolol, nadolol) and neurontin.
I hope this has been helpful.
BFS, is a diagnosis of exclusion. we usually start by asking the age of the patient (crucial), family history, taking any kind of meds, the exact destribution over the body, the exacerbating factores(Caffeine, stress, ..ext), and what exactly meant by progressing?
It could be associated by cramps, but should not be associated with weakness or atrophy (loss of muscle bulk).
I'm not aware of a somatization presenting as case BFS, and the relation is to hyperthyroidism (includes the over replacement of a hypothyroid patient) which also cause cramps, hyperparathyroidism, and hypomagnesemia.. Hypothyroidism could cause cramps instead, as dehydration and low sodium.
It could go away spontanously as any benign phenomena, but the secondary causes should be excluded.
Bob
And yes, facs can be caused by somat disorders. Anyone in medicine knows this. It is neuropsych 101.
Neurology. 2004 Aug 24;63(4):721-3
J of Neurol Sci. 1997 Sep 10;150(2):129-31
Neurology. 1986 Jul;36(7):997-8.
I have few more but they are very old ,so I dont think you could find them
Bob
Bob
Sorry to hear about your twitches, I've got 'em too, for about 3 months now. Mostly arms, but all over other times. I've been checking these forums and i have noticed that a lot of the people who have them are self proclaimed Hypochodriacs, of which I believe myself to be a tad myself. I'm wondering too if this could be brought on and/or exaserbated by stress and worry about your own symptoms. Although the twitches are easilly seen and real. What I would like to hear an answer on is are there any tests one can do on themselves to see if they have weakness or not? I can still run fine, can squeeze the hand grip exerciser as good or better than ever, etc.etc. Yet I'm twitching all the time, everywhere. Started in my right mid arm, then left pinky, then back, occasional legs, etc.
I'd also like a clear answer from a Doc if twitching ALL OVER is much less indicative of something serious? Or more likely BFS? I've read all different articles that go in all directions, but I'm getting the sense that ALS twitching is more often confined to the muslce that is affected at that time, not the whole body at once? Is that true?
How are you doing now? Has anything helped? The only thing that seems to help me is not thinking about it. However I think lots of water has helped a bit when I remember to drink it, and getting some sun believe it or not, and sleep. Exercise always makes me feel better, but I think it's because my mind relaxes because I'm thinking "hey, if I can still do all this I must be o.k. ".
Anyway, good luck
For the last year I have had the very same symptoms you all have been expressing- muscle spasms everywhere- from arms to leg to face to lower and upper back...even butt cheeks! They vary in size, duration, and type. I have seen a neurologist regarding my symptoms and have gotten an EEG, EMG and MRI- all showing nothing. Like all of you, I feel frustrated at the idea of not knowing what these spasms/twitches are the result of. Additonally, I too am considered by friends, family and myself as a hypochondriac, which further complicates matters since I know that my symptoms are very real. When you can see your spasms you know that your mind is not the cause! Anyways, I am looking for anwers to my questions: Do I have a serious neurological condition? Will I have these symptoms for the rest of my life? Are my symptoms related to a greater problem? And finally, have I created permanent nerve damage as a result of years of consistently worrying about and dwelling on illness?
I think this exchange of ideas, healthy dialogue and education is essential to our peace of mind. I am glad that there are other people who share these symptoms and frustration over them. If any doctors or patients have any advice for me I would be very grateful.
Thanks :)
well I too have these symtoms and I am a hypochondriac aswell, atleast thats what my friends and family say. I have twitching in my left thumb real bad and then all over.....Im scared out of my mind that its parkinsons!!!! but the neuro said it wasnt but im just not convinced. I had a baby nov 4th the a uterine infection that was wrongly diagnosd as the flu for 2 weeks!!! and then I had a staph infection after I had the d and c then I had severe gastritis which was wrongly diagnoised for weeks and then chronic bv after the d and c and on top of that horrific hot flashed since I had my baby where I cant even think straight. Then I have a new baby and a 3 year old that need me allllllll day long. I had 13 antibiotics pumped through me and who knows what that did! So am I stressed out OH YEAH! I have been through alot and everyone *husband and family