Benign fasciculations and Corticosteroid use: possible association? An update

Marco Orsini,Júlio Guilherme Silva,Antonio Marcos Da Silva Catharino,Marco Antonio Araújo Leite,Osvaldo J.M Nascimento,Sara Lúcia Silveira De Menezes,Fabrício Bino,Alessandra Cardoso Pereira,Flavio R Sztajnbok,Peter Salem Júnior,Fernando Silva Guimarães,Marzia Puccioni Sholer,Acary Bulle Oliveira,Marcos R.G De Freitas

doi:10.4081/ni.2011.e11

Abstract

Fasciculations are characterized by visible subtle and fast contractions of muscle, even wormlike in movement, by the contraction of a fascicle of muscle fibers. The authors present the case study of a 28-year-old patient with the appearance of migratory and diffuse fasciculations with an onset after partial tapering off of oral corticosteroides (60 mg total dose) indicated for treatment of Minimal change Glomerulopathy. Clinical Neurological physical exam allied with an ENMG, besides other complementary laboratory exams were used for screening the above-mentioned patient. Afterwards, current research relating to the topic at hand was made in order to update the data available in the Bireme, Scielo and PubMed Data Banks using the following key words: Fasciculation's, motor neuron disease, and benign fasciculations in the Portuguese, English as well as Spanish language. Although fasciculation's are most commonly associated with Motor neuron disease as well as with certain metabolic disorders, they may also be present in individuals with absolutely no underlying pathological disorders. In our case, fasciculation potentials that have been present for six months, with no other signs of a neurogenic disorder as well as absence of laboratory findings, the patient received a diagnosis of Benign Fasciculation Syndrome (BFS).We believe that the use of corticosteroides in high doses with subsequent tapering contributed to the fasciculation's, especially due to the changes that this causes on the ionic channels. Fasciculation's are symptoms seen in a large range of conditions, and also being the main symptom of the so-called Benign Fasciculation Syndrome. We have presented an example of this clinical syndrome in a patient whose complaint was fasciculation's, with complete clinical remission of symptoms following complete tapering off of corticosteroid six months previously.

Highlights

Minimal Change Disease, formerly known as Lipoid Nephrosis, is responsible for approximately 70-90% of childhood Nephrotic syndrome and for 10-15% of adult nephroses.[1,2] Generally speaking, it presents itself clinically as a primary renal disease, eventually secondary to several other conditions such as: Hodgkin’s disease, certain allergic states, as well as Naiads
Physiological parameters and standards. as well as exercise on the genesis of fascicula- We considered the possibility of our Fasciculation potentials were recorded in 63 tion’s
Our patient admitted to the use of caffeine on a daily basis as well as to practicing regular aerobic exercise, three times a week for about 50 minutes. Such data were considered for the present case at hand, since the majority of patients in this age range made use of caffeine regularly as well as practice physical exercise, this pattern and distribution of fasciculation’s such as those found in our patient is not commonly seen under these conditions, which can provoke, in rare instances, fasciculation potentials, mainly in the eyelids, thumb and halux.[5,6]

Summary

Introduction

Minimal Change Disease, formerly known as Lipoid Nephrosis, is responsible for approximately 70-90% of childhood Nephrotic syndrome and for 10-15% of adult nephroses.[1,2] Generally speaking, it presents itself clinically as a primary renal disease, eventually secondary to several other conditions such as: Hodgkin’s disease, certain allergic states, as well as Naiads Amplitude and duration action potentials, pos- effects of corticosteroids upon the hydro- In the case of ALS, a progressive and chronitive sharp waves, and fibrillation potentials eletrolitic balance, through changes in the cal- ic degenerative neurologic disease which were found upon testing.

Results

Conclusion