Cramp Fasciculation syndrome

Clinic

• CFS is a rare peripheral nerve hyperexcitability disorder. Neuromyotonia is another disease belonged to this category.
• Most cases of cramp fasciculation syndrome are idiopathic. Cramp fasciculation syndrome is diagnosed by clinical examination and electromyography (EMG).
• Fasciculation is the only abnormality (if any) seen with EMG.
• Cramp fasciculation syndrome is a chronic condition.

Signs / Symptoms

• Muscle pain / Stiffness / Cramp
• Generalized fatigue / Exercise intolerance
• Anxiety
• Globus sensations
• Paresthesia
• Hyper Reflexia

• It present with myalgia and cramps without weakness.
• Examination may show fasciculations, myokymia, or both in muscles with an otherwise normal neuromuscular examination.
• The condition is considered a benign syndrome, and the pathophysiology involves instability of the distal motor axon. The workup includes electrodiagnostic studies. Needle examination demonstrates fasciculation potentials and normal motor unit action potential morphology and recruitment. Supramaximal stimulation of motor nerves at 0.5 Hz, 1 Hz, 3Hz, and 5 Hz may show after discharges following the initial motor response.
• Voltage-gated potassium channel (VGKC) complex antibodies may be seen, suggesting an autoimmune pathogenesis, as is the case with other peripheral nerve hyperexcitability syndromes.