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Fasciculation (Fasciculations)

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Involuntary contraction of the muscle fibers innervated by a motor unit. Fasciculations can often by visualized and take the form of a muscle twitch or dimpling under the skin, but usually do not generate sufficient force to move a limb. They may represent a benign condition or occur as a manifestation of MOTOR NEURON DISEASE or PERIPHERAL NERVOUS SYSTEM DISEASES. (Adams et al., Principles of Neurology, 6th ed, p1294)

Also Known As:

Fasciculations; Benign Fasciculation; Fasciculation, Benign; Fasciculation, Muscular; Fasciculation, Neural; Fasciculation, Skeletal Muscle; Fasciculation, Tongue; Benign Fasciculations; Fasciculations, Benign; Fasciculations, Muscular; Fasciculations, Neural; Fasciculations, Skeletal Muscle; Fasciculations, Tongue; Muscle Fasciculation, Skeletal; Muscle Fasciculations, Skeletal; Muscular Fasciculation; Muscular Fasciculations; Neural Fasciculation; Neural Fasciculations; Skeletal Muscle Fasciculation; Skeletal Muscle Fasciculations; Tongue Fasciculation; Tongue Fasciculations

Networked: 812 relevant articles (28 outcomes, 56 trials/studies)

Relationship Network

Disease Context: Research Results

Related Diseases

1.	Tachycardia (Tachyarrhythmias)
2.	Contracture
3.	Fever (Fevers)
4.	Myoglobinuria
5.	Hypotension (Low Blood Pressure)

Experts

1.	Schachner, Melitta: 7 articles (01/2015 - 10/2002)
2.	Kuwabara, Satoshi: 7 articles (02/2012 - 07/2006)
3.	de Carvalho, Mamede: 6 articles (01/2014 - 12/2005)
4.	Swash, Michael: 6 articles (01/2014 - 03/2008)
5.	Kanai, Kazuaki: 6 articles (02/2012 - 07/2006)
6.	Mitsumoto, Hiroshi: 4 articles (12/2015 - 03/2006)
7.	Misawa, Sonoko: 4 articles (02/2012 - 07/2006)
8.	Kiernan, Matthew C: 3 articles (01/2015 - 07/2013)
9.	Isose, Sagiri: 3 articles (02/2012 - 04/2008)
10.	Shibuya, Kazumoto: 3 articles (02/2012 - 11/2011)

Drugs and Biologics

Drugs and Important Biological Agents (IBA) related to Fasciculation:

1.	Succinylcholine (Suxamethonium Chloride)FDA LinkGeneric 02/01/1995 - "The drug is effective in eliminating fasciculations produced by succinylcholine and does not affect intubation conditions." 03/01/1986 - "Self-taming with succinylcholine decreased the incidence of fasciculations (p = 0.001) but did not decrease the succinylcholine-induced myoglobinaemia (p = 0.224). " 10/01/2005 - "Prevention of succinylcholine-induced fasciculation and myalgia: a meta-analysis of randomized trials." 03/01/1994 - "The purpose of the study was to determine the effect of nondepolarizing muscle relaxants and waiting time on muscle fasciculations after succinylcholine in anaesthetized patients. " 05/01/1992 - "The present study was undertaken to determine the time courses of succinylcholine-induced fasciculations and adductor pollicis single-twitch responses at two stimulating frequencies. "
2.	rocuronium (rocuronium bromide)FDA LinkGeneric 06/01/2014 - "Precurarization with 0.04 mg/kg rocuronium was the optimal dose considering the reduction in the incidence and severity of fasciculation and myalgia with acceptable onset time, and the safe and effective precurarization." 06/01/2014 - "The incidence and severity of visible muscle fasciculation was significantly less with increasing the amount of precurarizing dose of rocuronium (P < 0.001). " 12/01/2009 - "It is concluded that pretreatment with Rocuronium reduced the incidence of myalgias, fasciculations and produced rapid precurarization in one minute thereby saving time on busy operating lists. " 06/01/1998 - "Muscle fasciculations were observed in 19 of the 20 patients in the control group and in 3 of the 20 patients in the rocuronium group, the best of the pretreatments in that aspect. " 12/01/1999 - "Rocuronium pretreatment was more effective in reducing fasciculations than was vecuronium pretreatment, but both were equally effective in preventing myalgia on postoperative day 1. This difference may reflect the differential activities of rocuronium and vecuronium at the neuromuscular junction. "
3.	Tubocurarine (Tubocurarine Chloride)FDA Link 08/01/1992 - "Tubocurarine pretreatment (3 mg) resulted in a significant decrease in fasciculations, but myalgia, which occurred in five patients, remained the same. " 01/01/1992 - "Pretreatment combining d-tubocurarine (d-TC, 0.075 mg/kg, sc) and ATS (16 mg/kg, sc) prevented the myonecrosis and fasciculation without protecting AChE against inhibition by these nerve agents. " 03/01/1985 - "Tubocurarine virtually abolished visible fasciculation and, in the dose used, reduced the intensity and duration of the neuromuscular block. " 05/08/1967 - "[Effect of small doses of d-tubocurarine on the prevention of muscle fasciculations and pains after scoline injection]." 10/01/1972 - "A clinical study using D-tubocurarine to prevent post fasciculation muscle pain."
4.	Diazepam (Valium)FDA LinkGeneric 02/01/1996 - "Present study was undertaken to show whether any correlation of the degree of fasciculation and postsuxamethonium myalgia is present or not and whether diazepam has any role in reducing muscle injury and in turn reducing the levels of serum K+ and CPK." 09/01/2002 - "6. Continuous electromyographic activity even at rest (with absence of fasciculations) improves after intravenous diazepam." 10/01/1984 - "Diazepam pretreatment was ineffective for the prevention of fasciculations and myalgia." 10/01/1984 - "Fasciculations were seen in 90% of patients in the control group and 15% in the dTc pretreatment group, while diazepam was ineffective in altering the frequency or intensity of fasciculations. " 11/01/1983 - "The diazepam and control groups did not differ significantly in extent of fasciculations or ease of intubation. "
5.	Propofol (Diprivan)FDA LinkGeneric 02/01/2003 - "Administration of propofol 3.5 mg kg-1 is effective in reducing fasciculations and myalgia after succinylcholine." 02/01/2003 - "Effects of high-dose propofol on succinylcholine-induced fasciculations and myalgia." 05/01/1996 - "Propofol did not affect the incidence or severity of fasciculations following succinylcholine, or the incidence of myalgias. " 01/01/2012 - "Magnesium sulfate and propofol have been found to be effective against succinylcholine-induced fasciculations and myalgia, respectively, in separate studies. " 07/01/2010 - "After i.v. pretreatment with either remifentanil 1.5 microg/kg (remifentanil group, n = 20) or an equivalent volume of i.v. saline (saline group, n = 20), patients were anaesthetized with a 2.0 mg/kg of i.v. propofol followed by i.v. succinylcholine 1.0 mg/kg. Intensity and duration of muscle fasciculation following i.v. succinylcholine administration were recorded. "
6.	cisatracurium (Nimbex)FDA Link 12/01/1999 - "Although fasciculations occurred less frequently in the cisatracurium group than in the placebo group (59% vs. 85%, respectively), this difference did not reach statistical significance. " 09/01/2002 - "Cisatracurium is only effective in preventing succinylcholine-induced fasciculations when a longer pretreatment interval, i.e. " 09/01/2002 - "3 and 6 min, on the efficacy of 0.01 mg/kg cisatracurium in preventing succinylcholine-induced fasciculations and myalgia. " 02/01/2003 - "A Kruskal-Wallis analysis of variance, used to analyze data collected from the fasciculation scale, demonstrated there was no statistically significant difference in efficacy between tubocurarine and rocuronium for defasciculation or between cisatracurium and saline for defasciculation. " 12/01/1999 - "Fasciculations were observed less frequently (p < 0.05) in the d-tubocurarine and rocuronium groups compared with the placebo and cisatracurium groups. "
7.	Atropine (Hyoscyamine)FDA LinkGeneric 12/01/2002 - "The rats receiving atropine pre-treatment exhibited similar fasciculations (nicotinic effects) without subsequent respiratory arrest, resulting in a significant improvement in survival (88%, p < 0.001). " 01/01/1989 - "However, atropine does not affect either AChE inhibition or muscle fasciculations and is also ineffective in counteracting the lesions in spite of its potency as an effective general antidote. " 08/01/2002 - "No fasciculations, seizures or convulsions were noted in animals receiving 16 mg/kg atropine. " 12/01/2011 - "In acute organophosphate poisoning the issue of special concern is the appearance of muscle fasciculations and convulsions that cannot be adequately antagonised by the use of atropine and oxime therapy. " 04/01/1997 - "Atropine sulfate and pralidoxime chloride were administered intermittently, but the patient continued to be extremely agitated and have muscle fasciculations. "
8.	PotassiumIBA 12/01/2011 - "Previous nerve excitability studies have shown reduced axonal potassium currents in ALS patients that may contribute to the hyperexcitability and thereby generation of fasciculations. " 12/01/1997 - "In ALS, impairment of potassium conductance was shown and was speculated to have the possible rrelation with fasciculation. " 12/01/1995 - "The disrupted blood-nerve barrier and lack of Schwann cell-mediated extracellular potassium regulation may predispose the membrane depolarization, thereby accounting for the conduction block and fasciculations. " 11/01/1995 - "The changes in the serum potassium concentration, the degree of muscle fasciculations and the presence of postoperative myalgia were recorded. " 09/01/1991 - "We suggest that post-ischaemic motor fasciculations in man also involve transitions between two equilibrium states, occurring in axons with high extracellular potassium and high electrogenic pump activity."
9.	Atracurium (Tracrium)FDA Link 08/01/1996 - "The incidence of fasciculations was less in the atracurium pretreatment group (group B) than in the group treated with normal saline (group A). " 12/01/1994 - "The use of atracurium reduced the incidence of myalgia by 60% (P < 0.001) and the severity of fasciculations (P < 0.001). " 11/01/1990 - "Fasciculations occurred in all patients who received saline and in 44% of those treated with atracurium. " 07/01/1990 - "Atracurium reduced the incidence of fasciculations from 100% observed in the control to between 0 and 40% in the atracurium groups. " 11/01/1990 - "These findings show that atracurium 5 mg i.v. is effective in preventing succinylcholine-induced fasciculations and postoperative myalgias, and suggest atracurium as the drug of choice for this purpose, particularly in muscular subjects."
10.	Phenytoin (Dilantin)FDA LinkGeneric 11/28/1989 - "Pretreatment with phenytoin, 20 mg/kg, reduced the number of fasciculations to 32% of control without altering contractile strength. " 01/01/1977 - "A report on a patient who developed profuse fasciculations following diphenylhydantoin therapy for 30 months with subsequent complete recovery on cessation of therapy is presented. " 08/01/1992 - "A prospective, randomised trial was undertaken in 60 healthy adults to determine the efficacy of intravenously administered phenytoin in doses of 5 mg.kg-1 for the prevention of suxamethonium-induced fasciculations, a rise in serum K+ and myalgia. " 08/01/1992 - "Phenytoin treatment abolished the clinical signs of muscle fasciculations following oral potassium challenge and decreased or abolished repetitive firing and myotonic discharges found on electromyographic examination. " 10/01/1986 - "Administration of d-tubocurarine (dTC) or diphenylhydantoin (DPH) was evaluated as a pretreatment to prevent succinylcholine (Sch) evoked fasciculations. "

Therapies and Procedures

1.	General Anesthesia 01/01/2002 - "Shivering, an irregular muscular fasciculation lasting longer than 15 s, is a common complication secondary to general anesthesia. " 02/01/1995 - "General anesthesia was then induced; after administration of succinylcholine, the presence or not of fasciculations was noted and intubation conditions were evaluated. " 02/01/2010 - "The purpose of this study was to evaluate the efficacy of remifentanil in preventing succinylcholine-induced fasciculation in patients undergoing general anesthesia. " 05/01/1980 - "The increases in these enzymes have been explained on the basis of muscle damage resulting from succinylcholine chloride induced muscle fasciculations and by hypoperfusion of tissues due to depression of the cardiovascular system caused by general anesthesia. "
2.	Nephrectomy 06/01/1990 - "Four months after nephrectomy, his strength had improved and he had no fasciculations. " 01/01/2009 - "After nephrectomy, the muscle weakness and fasciculations disappeared spontaneously within 2 months. "
3.	Ambulatory Surgical Procedures (Outpatient Surgery) 12/01/1999 - "To evaluate the efficacy of cisatracurium, rocuronium, and d-tubocurarine in preventing succinylcholine-induced fasciculations and postoperative myalgia in patients undergoing ambulatory surgery. "
4.	Denervation 01/01/2014 - "Fasciculations were recorded in 72% in TA and increased jitter in 33% at study entry, but without EMG features of denervation. " 07/01/2013 - "Neurophysiological studies confirmed normal nerve conduction studies and the presence of simple fasciculations, without acute denervation or neurogenic motor unit changes. " 02/01/2011 - "The aim of the study was to determine the relative importance of ongoing (active) denervation, fasciculations, chronic partial denervation with reinnervation at weak effort and loss of motor units at maximal voluntary contraction (MVC) in ALS. " 03/01/2008 - "Electrophysiologic studies showed significant spontaneous motor activity in the form of denervation potentials, fasciculations, and complex repetitive discharges. " 10/01/1994 - "Laboratory testing is frequently normal or nonspecific except for electrophysiologic studies which typically demonstrate reduced compound muscle action potential amplitudes, fasciculations, and features consistent with acute and chronic denervation in distal upper extremity muscles. "
5.	Anesthesia 02/01/2003 - "Many anesthesia care providers prefer to prevent them due to a possible association between fasciculations and increased intracranial and intraocular pressures. " 04/01/2013 - "Fasciculation and myalgia at the postoperative thirtieth minute, and creatine kinase levels before the induction of anesthesia and at the postoperative 24th hour, and adequacy of relaxation for intubation were recorded. " 09/01/2008 - "Short-duration anesthesia (less than 30 min) was obtained, and in many frogs, muscular fasciculation was seen during the acetic acid test. " 06/01/2006 - "Succinylcholine is used during induction of anesthesia, and it may induce fasciculations. " 08/01/1981 - "Succinylcholine-induce fasciculations and intragastric pressure during induction of anesthesia."