Fasciculation

# Overview
A fasciculation (or "muscle twitch") is a small, local, involuntary muscle contraction (twitching) visible under the skin arising from the spontaneous discharge of a bundle of skeletal muscle fibers. Fasciculations have a variety of causes, the majority of which are benign, but can also be due to disease of the motor neurons.

# Causes

## Life Threatening Causes
- Benzodiazepine withdrawal
- Dehydration
- Donepezil toxicity
- Multiple sclerosis
- Organophosphate poisoning
- Quaternary syphilis
- Renal disease
- Tacrine toxicity

## Common Causes
- Amyotrophic lateral sclerosis
- Bell palsy
- Brown-vialetto-van laere syndrome,
- Central pontine myelinosis
- Fatigue
- Friedreich ataxia
- Guillain-barre syndrome
- Hereditary sensorimotor neuropathy type 1
- Infantile neuroaxonal dystrophy
- Isaac syndrome,
- Kennedy disease
- Motor neuron disease
- Multifocal motor neuropathy
- Multiple sclerosis
- Myasthenia gravis
- Neuromyotonia
- Neuropathy
- Peripheral neuropathy
- Poliomyelitis
- Posterior inferior cerebellar artery syndrome
- Postpoliomyelitis syndrome
- Progressive bulbar palsy
- Progressive muscular atrophy,
- Spinal muscular atrophy
- Spinocerebellar ataxia
- Subacute combined degeneration of the cord
- Transverse myelitis
- Welander distal myopathy
- Werdnig-hoffman disease

## Causes by Organ System

## Causes in Alphabetical Order
- Acute intermittent porphyria
- Adult polyglucosan body disease
- Adult sma
- Albuterol
- Ambenonium
- Amyotrophic lateral sclerosis
- Anticholinergic drugs
- Anxiety
- Asthma
- Bell palsy
- Benadryl
- Benzodiazepine withdrawal
- Botulism
- Brown-vialetto-van laere syndrome
- Caffeine
- Central pontine myelinosis
- Cervical myelopathy
- Cervical spondylosis
- Corticosteroids
- Dehydration
- Diuretics
- Donepezil toxicity
- Dramamine
- Dural arteriovenous fistula
- Ethanolamines
- Fatigue
- Finnish type amyloidosis
- Friedreich ataxia
- Gangliosidosis gm2, type 1
- Guillain-barre syndrome
- Hereditary sensorimotor neuropathy type 1
- Hypocalcaemia
- Infantile neuroaxonal dystrophy
- Intervertebral disc herniation
- Isaac syndrome
- Jokela type spinal muscular atrophy
- Kennedy disease
- Magnesium deficiency
- Motor neuron disease
- Multifocal motor neuropathy
- Multiple sclerosis
- Myasthenia gravis
- Myopathy
- Neuromyotonia
- Neuropathy
- Nutritional deficiency
- Organophosphate poisoning
- Organophosphates
- Pellagra
- Peripheral neuropathy
- Poliomyelitis
- Posterior inferior cerebellar artery syndrome
- Postpoliomyelitis syndrome
- Progressive bulbar palsy
- Progressive muscular atrophy
- Pseudoephedrine
- Quaternary syphilis
- Rabies
- Renal disease
- Salbutamol
- Spastic paraplegia 11
- Spinal muscular atrophy
- Spinocerebellar ataxia
- Strenuous exercise
- Stress
- Subacute combined degeneration of the cord
- Succinylcholine
- Syringobulbia
- Syringomyelia
- Tacrine toxicity
- Transverse myelitis
- Uremia
- Welander distal myopathy
- Werdnig-hoffman disease

# Treatment
Inadequate magnesium intake can cause fasciculations, especially after a magnesium loss due to severe diarrhea. Over-exertion is another risk factor for magnesium loss. As much as 80% of the population does not get the recommended daily amount of magnesium; this may be a common cause. Treatment is with supplements or increased intake of foods rich in magnesium, especially almonds & other nuts, and bananas. Ironically, magnesium supplements may result in diarrhea and more magnesium loss, so dosage and timing (i.e. with meals) are important.
Fasciculation also often occurs during a rest period after sustained stress, such as that brought on by unconsciously tense muscles. Reducing stress and anxiety is therefore another useful treatment.