Benign Fasciculation Syndrome is a neurological disorder characterized by fasciculation (twitching) of various voluntary muscles in the body. These voluntary muscle groups are muscle used on an everyday basis. These groups include all of the extremities like the arms, hands, legs, and feet as well as the abdominal muscles and facial muscles. Yet it is most common in the eyelids, arms, legs, and feet. Some extreme cases have even shown the tongue also being one of the muscles affected by the syndrome [1]. The twitching associated with BFS can be occasional or nearly continuous depending on the individual, muscle group, and severity of the condition. This type of muscle twitching is also seen in association with other serious disorders like spinal injury multiple sclerosis or any atrophic lateral sclerosis. Since the twitching in BFS patients can be associated with other, some more severe, disorders or injuries it is also a cause of mental disorders like anxiety and social phobia. Patients have a tendency for anxiety because of them being self-conscience of their disorder. [2]
Benign Fasciculation Syndrome & its symptoms
Muscle twitching: resembling the muscle twitches from a healthy individual, a patient with BFS will go on twitching for a longer duration of time. Some spanning from days to months and other spanning from months to years. At times, the twitching can be brought on or worsen by stress, exertion, infection, and sometimes at night when the muscles are more relaxed. the twitching isn’t any more severe than that of a normal person but can be a bit more agitating based on the concept that a patient has to deal with this for a longer period of time.
Anxiety: Having BFS can come along with anxiety. Social anxiety, or social phobia, can come because the patient isn’t exactly comfortable in his/her surroundings with this condition. Many patients with cases of BFS are at an impasse of their own accord. Depending on the muscle group affected, the patient will not be very inclined to work in certain jobs relating to the public and customer service. Such positions put the patient in front of the customer which can make him/her self-aware of the syndrome causing the twitch to become more severe or last for a longer period of time. The twitching can cause others to take notice of the individual and can cause them to feel uncomfortable making the twitch more severe. Not only will the symptom be more severe but it will also last for a longer duration of time. [3]
Pain: BFS patients can experience pain due to cramping from repeated contractions. The cramping is caused by the over use of the muscle fiber or muscle which shall last from a matter of seconds to minutes. The muscle cramp is a strong, painful contraction of a muscle that comes on suddenly. [4]
Fatigue: physical activity can be reduced due to BFS. Benign fasciculation syndrome reduces the exercise tolerance of the individual, often times this is mistaken for weakness associated with other neurological disorders like ALS. There is a difference between the loss of exercise tolerance and weakness. Weakness associated with disorders like ALS is just that a weakness the inability to live above a certain amount of weight or do a certain amount of physical activity. With BFS a low exercise tolerance is all that shows there is no loss of muscle strength, just a loss of exercise tolerance. [5]
Other symptoms: Some patients experience a numbing or tingling sensation in the affected muscle due to lack of movement. The numbing and tingling sensation is caused by a number of things like lack of movement or the lack of the blood flow to the affected muscle or group. The muscle or groups affected by the syndrome are acclimated to the over stimulation and blood flow to the group.
References:
[1] Nusrat K, Mahmood S, Marsia S, Mahmood K. Elaborate tongue fasciculations going down to the neck: A rare case of sporadic, young-onset amyotrophic lateral sclerosis with bulbar symptoms, from pakistan. Cureus. 2019;11(5):e4600.
[2] Meca-Lallana JE, Hernández-Clares R, Carreón-Guarnizo E. Spasticity in multiple sclerosis and role of glatiramer acetate treatment. Brain and Behavior. 2015;5(9):e00367.
[3] Blackman G, Cherfi Y, Morrin H, et al. The association between benign fasciculations and health anxiety: A report of two cases and a systematic review of the literature. Psychosomatics. 2019;60(5):499-507.
[4] Ehde DM, Dillworth TM, Turner JA. Cognitive-behavioral therapy for individuals with chronic pain: Efficacy, innovations, and directions for research. American Psychologist. 2014;69(2):153-66.
[5] Mollayeva T, Kendzerska T, Mollayeva S, et al. A systematic review of fatigue in patients with traumatic brain injury: The course, predictors and consequences. Neuroscience & Biobehavioral Reviews. 2014;47:684-716.
