Fasciculations - Overview of pathophysiology, clinical significance and detection

Fasciculations are random, fine, rapid, flickering twitchings of a group of muscle fibres innervated by a single motor unit. Although they are almost obligatory in patients with degenerative motor neuron disease, fasciculatio ns also occur in many other conditions such as syringomyelia, radiculopathi es, polyneuropathies, and even in healthy subjects. Different techniques ha ve been used for detecting fasciculations: inspection, palpation, auscultat ion, acoustic myography, needle and surface electromyography, and myosonogr aphy, but none of them guarantees a reliable differentation between fascicu lations in patients with neuromuscular disease and in healthy subjects. Myo sonography proved to be the most sensitive and suitable method. Up to now, origin and pathophysiology of fasciculations could not be sufficiently clar ified, but most of the fasciculations seem to originate from the periphery of the motor nerve. This review presents a survey of the update knowledge a bout diagnosis, etiology and treatment of fasciculations.