Muscle Twitching (Fasciculations): Examination

A comprehensive clinical examination is the basis for selecting further diagnostic steps:

  • General physical examination – including blood pressure, pulse, body weight, height; further:
    • Inspection (viewing).
      • Skin, mucous membranes, extremities [due topossible cause of muscle twitching (fasciculations)]
  • Neurological examination – including strength testing, triggering reflexes, etc. [due todifferential diagnoses:
    • Amyotrophic lateral sclerosis (ALS) – progressive, irreversible degeneration of the motor nervous system; in this case, fasciculations as a symptom of the demise of α-motoneurons (fasciculations of the muscles and defibrillation in the tongue).
    • Creutzfeldt-Jakob disease – disease of the central nervous system leading to progressive (progressive) dementia.
    • Encephalitis (inflammation of the brain)
    • Myasthenia gravis – rare disorder of neuromuscular transmission of stimuli, which manifests itself in severe load-dependent muscle weakness and rapid onset of fatigability; fasciculations are expressed here in the cholinergic crisis.
    • Neuropathy (collective term for many diseases of the peripheral nervous system), new onset: e.g., fasciculations in association with statin-induced neuropathy
    • Polyneuropathy, unspecified – generic term for diseases of the peripheral nervous system associated with chronic disorders of peripheral nerves or parts of nerves.
    • Post-polio syndrome – muscle weakness or atypical muscle fatigue in damaged muscles; onset no earlier than 15 years after paralytic poliomyelitis (polio).
    • Spinal muscular atrophy (SMA) – muscle atrophy caused by progressive loss of motor neurons in the anterior horn of the spinal cord; usually results in thoracic scoliosisNote: Fasciculations are less common in childhood than in adults with anterior horn disease].
  • Orthopedic examination [due todifferential diagnoses:
    • Cervical spine syndrome (synonym: cervical syndrome) – unpleasant pain and sometimes dysfunction in the neck and neck area.
    • Orthopedic diseases with nerve irritation]
  • Health check

Square brackets [ ] indicate possible pathological (pathological) physical findings.