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Q. Does benign fasciculation syndrome cause muscle weakness?

Answered by
Dr. Muhammad Zubayer Alam
and medically reviewed by iCliniq medical review team.
This is a premium question & answer published on Mar 16, 2021

Hello doctor,

I am 25 years old, and my height is 172 centimeters and weight is 68 kilograms. For over a year, I dealt with unexplained symptoms. My condition is constantly fluctuating and sometimes improving. It all started a year ago with bad back pain. After two weeks, I had leg fasciculations that spread all over my body. I was very scared of ALS. At the same time, paresthesia developed in both legs but now mainly in the left leg. They start from the buttock to the foot. I am starting to have a lot of pain in my hips, knees, and ankles. When I move around, I have to strain on heavy legs. I currently have pain in the buttocks, back of the knees, ankles, feet, paresthesias, and some muscle fasciculations. My legs are heavy, and my knees are compressed. These strange sensations are present in the morning. After stretching, things get a little better. The legs are more painful in the evening, and I also have some stomach aches after meals. I took an MRI of the entire spine, and it does not reveal any abnormalities. MRI of the spinal cord reveals an intramedullary cleft and, according to the neurosurgeon consulted, represents only an anatomical variant of the normal and not syringomyelia. EMG of both legs showed no abnormalities, strictly normal examination, and no visible fasciculations. Ultrasound Doppler is normal, with no venous problems. Brain MRI has no abnormalities, no MS. X-ray of the spine showed very slight scoliosis, with no other abnormalities. The blood test showed negative to lupus, polyarthritis, spondylitis, Lyme disease and, Gougerot and, increased CPK (250 units/Litre). The rest is normal, and it is the only anomaly visible during my blood tests.

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Hi,

Welcome to icliniq.com.

I can understand your concern. According to your statement, you have been suffering from pain in the buttocks, back of the knees, ankles, and feet, along with paresthesia and some muscle fasciculations. According to your investigation, only raised CPK (creatine phosphokinase) is found, and the rest of the tests are normal. CPK (creatine phosphokinase) normal range may vary from laboratories to laboratories, so it is important to know the normal range of CPK. In some laboratories normal range of CPK is 20-200 U/L. Again it may be 39-308 U/L in the case of a male. CPK enzymes are found in the brain, heart, and skeletal muscles. So raised level of CPK indicates the diseased condition of those systems like heart attacks, muscle damage or brain injury, etc. It can also be raised from any infection, inflammation, stress, strenuous activities, alcohol consumption, medications, etc. ALS (amyotrophic lateral sclerosis) or motor neuron disorder is the least likely cause for your present sufferings, and you may suffer from Benign fasciculation syndrome (BFS). Though it is rare, it matches your present clinical features, and it will not harm the near future. Treatment is nothing but lifestyle modification.


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