title: Another Perspective on Fasciculations: When is it not Caused by the Classic form of Amyotrophic Lateral Sclerosis or Progressive Spinal Atrophy?
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.
authors.affiliation: Neurology Service, Movement Disorders Unit, Fluminense Federal University , Niterói, Rio de Janeiro, Brazil.
authors.forename: Marco Antonio Araujo
authors.initials: MA
authors.lastname: Leite
authors.affiliation: Neurology Service, Movement Disorders Unit, Fluminense Federal University , Niterói, Rio de Janeiro, Brazil.
authors.forename: Marco
authors.initials: M
authors.lastname: Orsini
authors.affiliation: Neurology Service, Movement Disorders Unit, Fluminense Federal University , Niterói, Rio de Janeiro, Brazil.
authors.forename: Marcos R G
authors.initials: MR
authors.lastname: de Freitas
authors.affiliation: Neurology Service, Movement Disorders Unit, Fluminense Federal University , Niterói, Rio de Janeiro, Brazil ; Neurology Service, Rio de Janeiro University , Brazil.
authors.forename: João Santos
authors.initials: JS
authors.lastname: Pereira
authors.affiliation: Neurology Department, São Paulo University , Brazil.
authors.forename: Fábio Henrique Porto
authors.initials: FH
authors.lastname: Gobbi
authors.affiliation: Departament of Physiotherapy, Piaui Federal University , Parnaíba, Brazil.
authors.forename: Victor Hugo
authors.initials: VH
authors.lastname: Bastos
authors.affiliation: Departament of Physiotherapy, Piaui Federal University , Parnaíba, Brazil.
authors.forename: Dionis
authors.initials: D
authors.lastname: de Castro Machado
authors.affiliation: Physical Activity Neuroscience, Physical Activity Sciences Postgraduate Program, Salgado de Oliveira University , Niterói, Brazil.
authors.forename: Sergio
authors.initials: S
authors.lastname: Machado
authors.affiliation: Movement Disorders and Sleep Unit, General Hospital Dr. Manuel Gea González, Secretaria de México D.F. , México.
authors.forename: Oscar
authors.initials: O
authors.lastname: Arrias-Carrion
authors.affiliation: Neurology Service, Movement Disorders Unit, Fluminense Federal University , Niterói, Rio de Janeiro, Brazil.
authors.forename: Jano Alves
authors.initials: JA
authors.lastname: de Souza
authors.affiliation: Neurology Service, São Paulo Federal University , São Paulo, Brazil.
authors.forename: Acary Bulle
authors.initials: AB
authors.lastname: Oliveira
keywords: electromyography treatment; fasciculations; neurological diseases