Can frequent fasciculations indicate benign fasciculation syndrome?

Hi doctor,

I am a 42-year-old right-handed internist and hospital administrator. Around seven months ago, I developed fasciculations. I underwent an MRI (magnetic resonance imaging) brain, cervical spine examination, and EMG (electromyography) twice, and all were negative except for some spondylosis at C7 (cervical vertebrae 7) with cervical and neuroforaminal stenosis, both of which were insignificant. The physical exam was completely normal. Fasciculations have been intermittent, and I have been satisfied that these were benign twitches. As an administrator, I spend excessive time in front of my computer and using my phone. I have recently noticed that when I use a mouse and, to a much lesser extent, a keyboard, I can see fasciculations in the first dorsal interosseous muscles and the hypothenar muscles on the most lateral aspect of my hand. Fasculation stops when I lift my hand off the mouse or keyboard. Occasionally, they will continue, but when I completely relax my hand, they stop. Symptoms are much more pronounced in my right hand. The fasciculations are almost vermiform at times. There is no weakness at all, though sometimes my right-hand feels uncoordinated. Objectively, however, it is not, and I can type 100 words per minute. I wake up frequently with numbness or tingling along the lateral aspects of my arm, from the elbow down. I feel pain in my forearm with wrist dorsiflexion or typing and using my phone. It can occasionally occur at rest as well. The pain is mostly burning type. Do I have the beginning of a compressive ulnar neuropathy? I do not practice any outpatient medicine, so this sort of thing is not something that I have any experience in. Symptoms seem consistent, but I cannot find much about these fasciculations occurring as they do. As I said, they almost exclusively occur while using a mouse or keyboard. I continue to have twitches in my hands, forearms, and shoulders, which are much less pronounced than when they started six or seven months ago. The BFS (benign fasciculation syndrome) feels different from the fasciculations I am describing using a mouse. I am currently taking Trazodone, Famotidine, and Myrbetriq. I underwent laboratory tests conducted by a neuromuscular physician for fasciculations, and the reports were normal.

I hope this will help you.

Thank you.

Hello doctor,

Thanks for the reply.

I should have said medial. It is on the ulnar aspect of my right forearm, which includes the fourth and fifth digits, and occurs at night. The burning pain in the forearm does appear to follow the C7 (cervical vertebrae 7) dermatome distribution. The sensory problems are not distressing to me. It is the fasciculations that occur in the hands that bother me. Again, it only appears when using the muscle, such as pushing on a mouse or holding my phone. When I feel a strange sensation and look down, the first interosseus is twitching. Or I will be carrying my phone, and the phone will twitch. Please help.

Thank you.