STUDY - Technical - New Dacian's Medicine
Fasciculations
(Classical / Allopathic Medicine)
Fasciculations are
local muscle contractions representing the spontaneous
discharge of a muscle fiber bundle innervated by a single
motor nerve filament. These contractions cause visible
dimpling or wavelike twitching of the skin, but they aren't
strong enough to produce joint movement. They occur
irregularly at frequencies ranging from once every several
seconds to two or three times per second; infrequently,
myokymia - continuous, rapid fasciculations that cause a
rippling effect - may occur. Because fasciculations are brief
and painless, they may go undetected or be ignored.
Benign,
nonpathologic fasciculations are common and normal. They may
occur in tense, anxious, or overtired people and commonly
affect the eyelid, thumb, or calf. However, fasciculations may
also indicate a severe neurologic disorder, most notably a
diffuse motor neuron disorder that causes loss of control over
muscle fiber discharge. They're also early signs of pesticide
poisoning.
ALERT:
If onset of fasciculations is sudden:
- ask the patient about the nature, onset, and duration of the fasciculations
- find out if the patient was exposed to pesticides
- institute emergency measures, if necessary.
If the patient isn't in severe distress, perform a focused assessment.
If onset of fasciculations is sudden:
- ask the patient about the nature, onset, and duration of the fasciculations
- find out if the patient was exposed to pesticides
- institute emergency measures, if necessary.
If the patient isn't in severe distress, perform a focused assessment.
HISTORY:
Ask the patient if he has experienced sensory changes, such as paresthesia, or difficulty speaking, swallowing, breathing, or controlling bowel or bladder function.
Ask the patient if he's experiencing pain.
Review the patient's medical history for neurologic disorders, cancer, and recent infections.
Ask the patient about his lifestyle, especially stress at home, on the job, or at school.
Ask the patient if he has experienced sensory changes, such as paresthesia, or difficulty speaking, swallowing, breathing, or controlling bowel or bladder function.
Ask the patient if he's experiencing pain.
Review the patient's medical history for neurologic disorders, cancer, and recent infections.
Ask the patient about his lifestyle, especially stress at home, on the job, or at school.
PHYSICAL
ASSESSMENT:
Observe the patient for fasciculations while the affected muscle is at rest.
Test for motor and sensory abnormalities, particularly muscle atrophy and weakness, and decreased deep tendon reflexes.
Perform a comprehensive neurologic examination.
Observe the patient for fasciculations while the affected muscle is at rest.
Test for motor and sensory abnormalities, particularly muscle atrophy and weakness, and decreased deep tendon reflexes.
Perform a comprehensive neurologic examination.
SPECIAL
CONSIDERATIONS:
Fasciculations may progress, depending on the specific cause. Be sure to monitor the patient for progressive muscle weakness adjacent to where the fasciculations are occurring.
Pediatric pointers
Fasciculations, particularly of the tongue, are an important early sign of Werdnig-Hoffmann disease.
Fasciculations may progress, depending on the specific cause. Be sure to monitor the patient for progressive muscle weakness adjacent to where the fasciculations are occurring.
Pediatric pointers
Fasciculations, particularly of the tongue, are an important early sign of Werdnig-Hoffmann disease.
PATIENT
COUNSELING:
Help the patient with progressive neuromuscular degeneration to cope with activities of daily living, and provide appropriate assistive devices. Teach effective stress-management techniques to the patient with stress-induced fasciculations.
Help the patient with progressive neuromuscular degeneration to cope with activities of daily living, and provide appropriate assistive devices. Teach effective stress-management techniques to the patient with stress-induced fasciculations.
Bibliography:
1. Rapid Assessment, A
Flowchart Guide to Evaluating Signs & Symptoms, Lippincott
Williams & Wilkins, 2004.
2. Professional Guide to
Signs and symptoms, Edition V, Lippincott
Williams & Wilkins, 2007.
3. Guide to common
symptoms, Edition V, McGraw - Hill, 2002.
Dorin,
Merticaru (2010)