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Leite MAA, Orsini M, de Freitas MRG, Pereira JS, Gobbi FHP, Bastos VH, de Castro Machado D, Machado S, Arrias-Carrion O, de Souza JA, Oliveira AB. Another Perspective on Fasciculations: When is it not Caused by the Classic form of Amyotrophic Lateral Sclerosis or Progressive Spinal Atrophy? Neurol Int 2014; 6:5208. [PMID: 25309711 PMCID: PMC4192433 DOI: 10.4081/ni.2014.5208] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2013] [Accepted: 03/28/2014] [Indexed: 12/25/2022] Open
Abstract
Fasciculations are visible, fine and fast, sometimes vermicular contractions of fine muscle fibers that occur spontaneously and intermittently. The aim of this article is to discuss the main causes for fasciculations and their pathophysiology in different sites of the central/peripheral injury and in particular to disprove that the presence of this finding in the neurological examination is indicative of amyotrophic lateral sclerosis. Undoubtedly, most fasciculations have a distal origin in the motor nerve both in normal subjects and in patients with motor neuron disease. Most of them spread to other dendritic spines often producing an antidromic impulse in the main axon. The clinical and neurophysiological diagnosis must be thorough. It may often take long to record fasciculations with electroneuromyography. In other cases, temporal monitoring is necessary before the diagnosis. The treatment, which may be adequate in some cases, is not always necessary.
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Affiliation(s)
- Marco Antonio Araujo Leite
- Neurology Service, Movement Disorders Unit, Fluminense Federal University , Niterói, Rio de Janeiro, Brazil
| | - Marco Orsini
- Neurology Service, Movement Disorders Unit, Fluminense Federal University , Niterói, Rio de Janeiro, Brazil
| | - Marcos R G de Freitas
- Neurology Service, Movement Disorders Unit, Fluminense Federal University , Niterói, Rio de Janeiro, Brazil
| | - João Santos Pereira
- Neurology Service, Movement Disorders Unit, Fluminense Federal University , Niterói, Rio de Janeiro, Brazil ; Neurology Service, Rio de Janeiro University , Brazil
| | | | - Victor Hugo Bastos
- Departament of Physiotherapy, Piaui Federal University , Parnaíba, Brazil
| | | | - Sergio Machado
- Physical Activity Neuroscience, Physical Activity Sciences Postgraduate Program, Salgado de Oliveira University , Niterói, Brazil
| | - Oscar Arrias-Carrion
- Movement Disorders and Sleep Unit, General Hospital Dr. Manuel Gea González, Secretaria de México D.F. , México
| | - Jano Alves de Souza
- Neurology Service, Movement Disorders Unit, Fluminense Federal University , Niterói, Rio de Janeiro, Brazil
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Gilbert RMW, Fahn S, Mitsumoto H, Rowland LP. Parkinsonism and motor neuron diseases: Twenty-seven patients with diverse overlap syndromes. Mov Disord 2010; 25:1868-75. [DOI: 10.1002/mds.23200] [Citation(s) in RCA: 54] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
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