Fasiculations and Cramps

[ScottM]

I am a 43 year old male. 12 years ago after having 2 EMG's and Nerve Conduction studies I was diagnosed with benign fasiculations and cramps. Over the 12 year period, the fasiculations have stayed about the same....24/7 primarily in the calf area with an occasional twich in other muscles. I have been for the most part cramp free, but experience a tightness is the calf area from time to time.

But over the last two months the fasiculations have increased in both feet and i am now cramping in the feet to the point that I am having trouble walking.
About a month ago I went to see a neurologist, and he told me to try Coenzyme and Quinine Sulfate, but neither of those did any good, in fact, the cramping has become worse. They Did another EMG and Conduction study, both of which came back normal. They did order some lab test, the only thing that was abnormal was my Aldolase level, I believe it was 10.
I went back to the Doctor yesterday and he said that I had them all "Baffled". They have no idea why I am having these problems.
He now wants to do a test called "Ischemic Lactate Test" (which they cant do for another month) and told me to take Baclofen to see if that helped the cramping. I will start on that today.

I guess my question to you is, Since my Doctor has no idea what is going on, do have any suggestions on what might be causing these problems, and are they doing the right test? and is Baclofen the right medication..I am at the point now that if I cannot get this under control, I'm worried that i won't be able to continue to work.
Thank You for your time.

[Cimmy]

A related discussion, Cramps was started.

[Lad]

Same symptoms: fasiculations and cramps in the legs (especially at night)with the addition of cramps in the ribs. Nerve conduction tests showed nothing abnormal.

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

Without examining you and reviewing your tests and history I cannot provide a clinical diagnosis. There is a condition called cramp fasciculation syndrome which is characterized by onset in adulthood and presenting with fasciculations (typically in the legs) and painful cramps. This condition can prgoress over time and lead to disability secondary to the cramps. There are various electrolyte abnormalities, endocrine disorders, and medications which can cause cramps. What would be important to note for the doctors is if the cramps occur at rest or with activity. If they occur with activity then the excercise lactate test may be helpful.

Baclofen is used to treat spasticity and occasionally cramps. Other medications which can be considered include carbamazepine, phenytoin, and verapamil to name a few. These medications act to stabilize the muscle and hopefully prevent the cramp from occurring.

It would be reasonable to have a second opinion at a large academic medical center with a neuromuscular specialist. They can review your findings and tests and determine if other testing is necessary. They can also make specific recommendations regarding medication. Good luck.