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Cramp-fasciculation syndrome


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Overview

What is cramp-fasciculation syndrome?

How might cramp-fasciculation syndrome be treated?

What are the differential diagnoses for cramp-fasciculation syndrome?

What is cramp-fasciculation syndrome?

Cramp-fasciculation syndrome is a rare condition of the muscles. People with this condition have persistent muscle twitching (fasciculations) and cramping, which can lead to muscle discomfort, pain, or tiredness. These symptoms are thought to be due to overactivity of the associated nerves. Muscles in the leg are most commonly affected, though this condition may involve several parts of the body. Exercise often worsens symptoms.[1][2] Cramp-fasciculation syndrome is believed to remain stable over time, meaning that it does not develop into a more serious disease.[2]
Last updated: 6/12/2013

How might cramp-fasciculation syndrome be treated?

There is limited information in the medical literature about the treatment of cramp-fasciculation syndrome (CFS). Much of what is available describes individual cases. Decisions regarding treatment should be carefully considered and discussed with a knowledgeable healthcare provider.

Some people with cramp-fasciculation syndrome improve without treatment. Treatment with carbamazepine, gabapentin, or pregabalin (medications that reduce the hyper-excitability of nerves) was described as helpful in improving symptoms in individual cases.[3] Immunosuppressive therapy (e.g., prednisone) has been used to treat cases of CFS that did not respond to other treatments.[3] For severe cases, additional treatment options may be considered.
Last updated: 5/8/2014

What are the differential diagnoses for cramp-fasciculation syndrome?

Diagnosis of cramp-fasciculation syndrome is based upon the signs and symptoms of the patient. Namely, a history of frequent muscle cramps, twitching, and pain (often worsened by exercise) without muscle weakness or wasting. An electromyograph (EMG) may be done to assesses the health of muscles and the nerves that control them.

Diagnosis also involves ruling out other causes of muscle cramps and twitches. Muscle cramps and twitches (fasciculations) are common symptoms that often occur in otherwise healthy people.[4][5][6] In these cases the symptoms may be triggered by muscle overuse, dehydration, lack of nutrients in the diet, lack of blood flow to the muscles, side effect of medications or therapies, sleep apnea, or stress.[4][5][7] These symptoms come and go and rarely last for more than a few days.[5]

In addition to cramp-fasciculation syndrome, muscle cramps and twitching can also be due to an underlying nervous system disorder, such as amyotrophic lateral sclerosis, nerve injury, pinched nerve, muscular dystrophy, and spinal muscular atrophy.[4][5][6][8] Unlike cramp-fasciculation syndrome, nervous system disorders can also cause a loss or change in sensation, muscle wasting, and muscle weakness.[5] Autoimmune conditions, such as Isaac syndrome can also cause muscle twitching.[5]

Cramp-fasciculation syndrome by definition is a non-progressing, benign disease. If a person with cramp fasciculation syndrome experiences a worsening of symptoms, a careful evaluation to rule out other diagnoses is recommended.[6]
Last updated: 6/12/2013

References
  1. Jansen PH, van Dijck JA, Verbeek AL, Durian FW, Joosten EM. Estimation of the frequency of the muscular pain-fasciculation syndrome and the muscular cramp-fasciculation syndrome in the adult population. European archives of psychiatry and clinical neuroscience. 1991; 241:102-104. http://www.ncbi.nlm.nih.gov/pubmed/1834178. Accessed 1/22/2013.
  2. de Carvalho M, Swash M. Cramps, muscle pain, and fasciculations: not always benign?. Neurology. 2004; 63:721-723. http://www.ncbi.nlm.nih.gov/pubmed/15326252. Accessed 1/22/2013.
  3. Liewluck T, Klein CJ, Jones LK Jr. Cramp-fasciculation syndrome in patients with and without neural autoantibodies. March, 2014; 49(3):351-356. Accessed 5/12/2014.
  4. Muscle cramps. MedlinePlus.gov. http://www.nlm.nih.gov/medlineplus/musclecramps.html. Accessed 6/12/2013.
  5. Muscle twitching. MedlinePlus.gov. http://www.nlm.nih.gov/medlineplus/ency/article/003296.htm. Accessed 6/12/2013.
  6. Singh V et al.,. Fasciculations and cramps: how benign? Report of four cases progressing to ALS. J Neurol. 2011 Apr;258(4):573-8; http://www.ncbi.nlm.nih.gov/pubmed/20967550. Accessed 6/12/2013.
  7. Reddy PL, Grewal RP . Resolution of muscle cramps and fasciculations with treatment of sleep apnea. J Clin Neuromuscul Dis. 2009 Sep;11(1):66-7; http://www.ncbi.nlm.nih.gov/pubmed/19730026. Accessed 6/12/2013.
  8. Elman LB, McCluskey L. Diagnosis of amyotrophic lateral sclerosis and other forms of motor neuron disease. In: Basow, DS (Ed). UpToDate. Waltham, MA: UpToDate; 2013;


See Disclaimer regarding information on this site. Some links on this page may take you to organizations outside of the National Institutes of Health.