Fasciculation

Introduction Fasciculation: A muscle that is spontaneously discharged by one or more motor units at the resting state, causing muscle fibrillation, a brief single contraction, found in various lower motor neuron damage diseases and certain normal people.

Cause

Muscular causes and pathogenesis are unclear. 5% to 10% of patients have a family history called familial motor neuron disease. In recent years, genetic abnormalities of superoxide dismutase have been found in this group of patients with family history of motor neuron disease, and it is believed that this may be the cause of the disease. With the application of experimental motor neuron disease model in the active immunization of animals with spinal cord anterior horn cells, autoantibodies have been detected in patients with serum and cerebrospinal fluid anti-GM1 antibodies, increased anti-calcium channel antibody detection rate and immunosuppressive therapy. The theory of the mechanism has received much attention.

an examination

Related inspection

Electromyography muscle tension test

1. Cerebrospinal fluid examination is basically normal.

2. Electromyography can be seen in the self-generated position, and the nerve conduction velocity is normal.

3. Muscle biopsy shows neurogenic muscle atrophy.

4. Head and neck MRI can be normal.

Muscle tremor is actually caused by the contraction of a group of muscle cells, which is medically called fasciculation. This fasciculation can have different areas and amplitudes, and some small tremors can be felt but not seen, and the obvious tremor can be seen with the naked eye. This muscle beating is usually benign if the muscles are not accompanied by muscle weakness and atrophy. Most of the benign muscle beating can't find the exact cause. It may appear when fatigue or stress is high. Drinking tea or coffee may also aggravate this beating. Most of this beating is intermittent, but a few people may be physically and easily appear. Many people have had the experience of eyelid beating. In fact, eyelid beating is also a benign fasciculation.

However, muscle beating may also be a warning for some neuromuscular diseases. Muscle beating, if accompanied by muscle weakness and atrophy, should be quick to find a neurologist. These diseases include lesions of motor neurons in the spinal cord, peripheral neuropathy and a few muscle diseases. These diseases can cause problems in the transmission of signals between motor nerve cells and muscles. The result of nerve instability will release some extra signals, which will cause the muscles to jump. Neurologists must examine the extent of muscle weakness, assess the extent of muscle atrophy, and supplement with nerve conduction and electromyography to find out the cause. Certain diseases can also be used to reduce muscle beating.

Differential diagnosis

1. Cervical spondylosis: upper limb or shoulder pain, and segmental sensory disturbance, no medullary paralysis, imaging examination and sternocleidomastoid EMG are not affected.

2. Syringomyelia: The disease is characterized by segmental, isolated pain and temperature sensation; cavities can be seen according to segmental dissociative sensory disturbance and cervical spinal magnetic resonance (MRI).

3. Spinal cord tumors and brainstem tumors: different degrees of conduction beam-type sensory disturbances. Lumbar puncture showed spinal canal obstruction, spinal canal angiography, CT or magnetic resonance imaging (MRI) showed intra-osseous space-occupying lesions.

4. Myasthenia gravis: The same myasthenia gravis easily affects the medulla and limb muscles, but the myasthenia gravis has volatility and other fatigue phenomena, and it is generally not difficult to identify.

5. Multifocal motor neuropathy: clinically similar to motor neuron disease, the main identification is the electromyography showing the influence of nerve conduction velocity, especially the multifocal punctate myelinopathy found. In addition, the positive rate of anti-GMI antibody increase in cerebrospinal fluid of this group of patients was higher. Sometimes it takes a long time to follow up to make an identification.

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