Prevalence of Cramp Fasiculation Syndrome

[APMIL]

How common is cramp fasiculation syndrome?
I have been twitching and fasiculating(Mostly twitching)for year a now and only recently began having cramps.I don't think that I have any clear signs of atrophy but am gathering photos from the past to attempt to make an objective assessment.As for weakness, it seems as though my right quadricep fatigues a bit while I depress the break in my car as I sit and wait in traffic. This is new. It seems as though my shoulders fatigue a bit when I shave. Both seem preety focal. Within 7 months of the onset of symptoms I had 3 emgs. 2 performed by physical medicine and rehabilitation and 1 by a neuromuscular specialist. The first 2 were read as normal and the third read as abnormal with follow commentary:The most prominent finding was increased insertional activity in all muscles tested, The activity was rather dramatic. There was some evidence in some muscles of myokimia and fasiculations. There was also an occasional CRD and positive wave. The units,occassionally and most prominently in the deltoid were small and with short duration Conclusion: The findings may be consistent with a mynecrotic myopathy due to the realtively small motor units and occassional muscle membrane instability. As the predominant abnormality was increased insertional actvity, cannot entirely rule out a syndrome of continuous motor activity.
Baseline CKs 530(Range 530-700) I am African American and weight train regular w/ above avergae muscle hypertrophy(large calves noted in siblings(?).TG=500. What is a reasonable differntial dx in your opinion?  
Thank you

[kimi1313]

A related discussion, help us please was started.

[Ish2]

I'd love to see some prevalance data on BFS -- don't doctors file their diagnoses for aggregation?  I guess not.

Anyway, google up aboutbfs.com for an active web board with lots of BFSers, as well as probably others as well.

Or alterntively see the Neuromuscular forum at http://brain.hastypastry.net/forums

Take everything there with a grain of salt though, lots of neurotics (I'm one) and very few contributiong medical professionals.  But in sum, if not individually, quite a bit of sound interesting advice, along with an great deal of coping support.

Couldn't help but notice your mention of weight lifting.  Many of us have observed (we think) an apparent, possible, association between BFS and a fitness oriented lifestyle, and conjectured that something associated with that lifestyle, like resistance training, weight loss, low carb diets, or protein supplements (that last is my bet) was the trigger.  Why don't you log in to aboutbfs.com and add your story to the mix?

My story: twitching 24/7 (2/sec in legs 1/10secs elsewhere) for c. 1.5 years.  Also very substantial soreness, stiffness, as well as some "buzzing" and other strange sensations.  Neuro exam by senior neuro at major teaching hosptial (after 1 year): normal.  EMG: "normal except for fasciculations".  Diagnosis: BFS.  Best guess as to something that might have caused it: at the time of onset I was, at 52, engaged in a very intense diet, workout, resistance training and protein powder supplementation regimen.  

Or then again maybe it was the new mouthwash...;)

Do look in at aboutbfs.com.

[CCF-Neuro-M.D.-CS]

I could not find a specific number as to how common cramp fasciculation syndrome is. It is seen in most major neuromuscular practices, and is a well described entity. Your examination and detailed story would help to narrow the possible diagnoses. However it is possible that you have some form of myotonia or increased excitability of the nerves and muscles (such as a condition called Isaac's syndrome). There are other conditions which have abnormalities in the various electrolyte receptors (such as potasium, calcium, or sodium). This could also represent a form of cramp fasciculation syndrome. It would be reasonable to have a second opinion at a large academic medical center with another neuromuscular specialist. They may need to repeat the EMG, since this is a subjective test, to confirm the findings. Then the proper testing can be completed. Good luck.