WordNet

secure with a cramp; "cramp the wood"
affect with or as if with a cramp
suffer from sudden painful contraction of a muscle
a strip of metal with ends bent at right angles; used to hold masonry together (同)cramp iron
a clamp for holding pieces of wood together while they are glued
make ones way by force; "He muscled his way into the office"
animal tissue consisting predominantly of contractile cells (同)muscular_tissue
one of the contractile organs of the body (同)musculus
authority or power or force (especially when used in a coercive way); "the senators used their muscle to get the party leader to resign"

PrepTutorEJDIC

〈U〉〈C〉(筋肉の)けいれん,こむらがえり / 《複数形で》急激な腹痛 / …‘に'けいれんを起こさせる
(また『cramp iron』)かすがい / 締め具,締め金 / …'を'かすがい(締め具)で締めつける / …'を'拘束する
〈U〉(動物体の組織としての)『筋肉』,筋(きん);〈C〉(体の各部を動かす)筋肉 / 〈U〉力,(特に)筋力,腕力 / 《俗に》(…に)強引に割り込む《+『in on』(『into, through』)+『名』》
筋肉の,筋力のある / 力ずくの

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出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2016/12/18 11:15:14」(JST)

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A fasciculation /fəˌsɪkjᵿˈleɪʃən/, or muscle twitch, is a small, local, involuntary muscle contraction and relaxation which may be visible under the skin. Deeper areas can be detected by electromyography (EMG) testing, though they can happen in any skeletal muscle in the body. Fasciculations arise as a result of spontaneous depolarization of a lower motor neuron leading to the synchronous contraction of all the skeletal muscle fibers within a single motor unit. An example of normal spontaneous depolarization is the constant contractions of cardiac muscle, causing the heart to beat. Usually, intentional movement of the involved muscle causes fasciculations to cease immediately, but they may return once the muscle is at rest again.

Fasciculations have a variety of causes, the majority of which are benign, but can also be due to disease of the motor neurons. They are encountered by virtually all healthy people, though for most, it is quite infrequent. In some cases, the presence of fasciculations can be annoying and interfere with quality of life. If a neurological examination is otherwise normal and EMG testing does not indicate any additional pathology, a diagnosis of benign fasciculation syndrome is usually made.^[1]

Risk factors

Pathological conditions

Neuromyotonia, also known as Isaacs' syndrome
Diseases of the lower motor neuron, such as:
- Poliomyelitis
- Amyotrophic lateral sclerosis (ALS)
- Spinal muscular atrophies – including spinal muscular atrophy (SMA), spinal and bulbar muscular atrophy (SBMA), and others
Acetylcholinesterase inhibitors:
- Some medications to treat myasthenia gravis contain acetylcholinesterase inhibitors
- Organophosphate poisoning (e.g. insecticides)
Benzodiazepine withdrawal (a class of psychoactive drugs; the most well-known example is Valium)
Magnesium deficiency (a dietary mineral)
Rabies

The most effective way to detect fasciculations may be surface electromyography (EMG). Surface EMG is more sensitive than needle electromyography and clinical observation in the detection of fasciculation in people with amyotrophic lateral sclerosis.^[2]

Other medications

Risk factors for benign fasciculations may include the use of anticholinergic drugs over long periods. In particular, these include ethanolamines such as diphenhydramine (brand names Benadryl, Dimedrol, Daedalon and Nytol), used as an antihistamine and sedative, and dimenhydrinate (brand names Dramamine, Driminate, Gravol, Gravamin, Vomex, and Vertirosan) for nausea and motion sickness. Persons with benign fasciculation syndrome (BFS) may experience paraesthesia (especially numbness) shortly after taking such medication; fasciculation episodes begin as the medication wears off.

Stimulants can cause fasciculations directly. These include caffeine, pseudoephedrine (Sudafed), amphetamines, and the asthma bronchodilators salbutamol (brand names Proventil, Combivent, Ventolin). Medications used to treat attention deficit disorder (ADHD) often contain stimulants as well, and are common causes of benign fasciculations. Since asthma and ADHD are much more serious than the fasciculations themselves, this side effect may have to be tolerated by the patient after consulting a physician or pharmacist.

The depolarizing neuromuscular blocker succinylcholine causes fasciculations. It is a normal side effect of the drug's administration, and can be prevented with a small dose of a nondepolarizing neuromuscular blocker prior to the administration of succinylcholine, often 10% of a nondepolarizing NMB's induction dose.

Even if a drug such as caffeine causes fasciculations, that does not necessarily mean it is the only cause. For example, a very slight magnesium deficiency by itself (see below) might not be enough for fasciculations to occur, but when combined with caffeine, the two factors together could be enough.

Treatment

Inadequate magnesium intake can cause fasciculations, especially after a magnesium loss due to severe diarrhea. Over-exertion and heavy alcohol consumption^[3] are also risk factors for magnesium loss. As 70–80% of the adult population does not consume the recommended daily amount of magnesium,^[4] inadequate intake may also be a common cause. Treatment consists of increased intake of magnesium from dietary sources such as nuts (especially almonds), bananas, and spinach. Magnesium supplements or pharmaceutical magnesium preparations may also be taken. However, too much magnesium may cause diarrhea, resulting in dehydration and nutrient loss (including magnesium itself, leading to a net loss, rather than a gain). It is well known as a laxative (e.g. Milk of Magnesia), though chelated magnesium can help reduce this effect. Supplements generally recommend that they be taken only with meals, and not on an empty stomach.

Fasciculation also often occurs during a rest period after sustained stress, such as that brought on by unconsciously tense muscles. Reducing stress and anxiety is therefore another useful treatment.^{[citation needed]}

There is no proven treatment for fasciculations in people with ALS. Among patients with ALS, fasciculation frequency is not associated with the duration of ALS and is independent of the degree of limb weakness and limb atrophy. No prediction of ALS disease duration can be made based on fasciculation frequency alone.^[2]

References

^ Blexrud MD, Windebank AJ, Daube JR (1993). "Long-term follow-up of 121 patients with benign fasciculations". Ann. Neurol. 34 (4): 622–5. doi:10.1002/ana.410340419. PMID 8215252.
^ ^a ^b Mateen FJ, Sorenson EJ, Daube JR (2008). "Strength, physical activity, and fasciculations in patients with ALS". Amyotrophic Lateral Sclerosis. 9 (2): 120–1. doi:10.1080/17482960701855864. PMID 18428004.
^ Rivlin RS (1994). "Magnesium deficiency and alcohol intake: mechanisms, clinical significance and possible relation to cancer development (a review)". Journal of the American College of Nutrition. 13 (5): 416–23. doi:10.1080/07315724.1994.10718430. PMID 7836619.
^ Galan P, Preziosi P, Durlach V, Valeix P, Ribas L, Bouzid D, Favier A, Hercberg S (1997). "Dietary magnesium intake in a French adult population". Magnesium Research. 10 (4): 321–8. PMID 9513928.

External links

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UpToDate Contents

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1. 筋萎縮性側索硬化症およびその他の運動ニューロン疾患の診断 diagnosis of amyotrophic lateral sclerosis and other forms of motor neuron disease
2. 末梢神経疾患および筋疾患の鑑別診断 differential diagnosis of peripheral nerve and muscle disease
3. 筋電図検査の概要 overview of electromyography
4. 筋力低下の評価における筋力検査 muscle examination in the evaluation of weakness
5. 筋萎縮性側索硬化症およびその他の運動ニューロン疾患の臨床的特徴 clinical features of amyotrophic lateral sclerosis and other forms of motor neuron disease

English Journal

Morphological changes of skeletal muscle in spinal and bulbar muscular atrophy (SBMA), Kennedy's disease: a case report.

Acewicz A, Wierzba-Bobrowicz T, Lewandowska E, Sienkiewicz-Jarosz H, Sulek A, Antczak J, Rakowicz M, Ryglewicz D.
Clinical neuropathology.Clin Neuropathol.2015 Apr 1. [Epub ahead of print]
Spinal and bulbar muscular atrophy (SBMA, Kennedy's disease) is an X-linked recessive disease affecting lower motor neurons. In the present case report, we describe morphological changes in a muscle biopsy obtained from a 62-year-old patient with gynecomastia and with the following neurological symp
PMID 25828775

An autopsied case of adult-onset bulbospinalform Alexander disease with a novel S393R mutation in the GFAP gene.

Iwasaki Y, Saito Y, Mori K, Ito M, Mimuro M, Aiba I, Saito K, Mizuta I, Yoshida T, Nakagawa M, Yoshida M.
Clinical neuropathology.Clin Neuropathol.2015 Apr 1. [Epub ahead of print]
A 50-year-old Japanese man with no apparent family history noticed diplopia. He gradually showed gait disturbance and dysuria. Abducens disorder of eye movement with nystagmus, tongue atrophy with fasciculation, spastic tetraparesis, and sensory disturbance were also observed. MRI showed severe atro
PMID 25828773

Neural Cell Adhesion Molecule NrCAM Is Expressed in the Mammalian Inner Ear and Modulates Spiral Ganglion Neurite Outgrowth in an In Vitro Alternate Choice Assay.

Brand Y1, Sung M, Pak K, Chavez E, Wei E, Radojevic V, Bodmer D, Ryan AF.
Journal of molecular neuroscience : MN.J Mol Neurosci.2015 Apr;55(4):836-44. doi: 10.1007/s12031-014-0436-y. Epub 2014 Nov 20.
Neuron-glial-related cell adhesion molecule (NrCAM) is a neuronal cell adhesion molecule involved in neuron-neuron and neuron-glial adhesion as well as directional signaling during axonal cone growth. NrCAM has been shown to be involved in several cellular processes in the central and peripheral ner
PMID 25407819

Japanese Journal

2P1-G08 ピクピク運動計測による筋電気刺激の最適な電極配置の選択手法の検討(感覚・運動・計測(3))

ロボティクス・メカトロニクス講演会講演概要集 2013, "2P1-G08(1)"-"2P1-G08(3)", 2013-05-22
NAID 110009963440

Efficient and Reproducible Myogenic Differentiation from Human iPS Cells: Prospects for Modeling Miyoshi Myopathy In Vitro

PLoS ONE 8(4), 2013-04-23
NAID 120005244565

緩和ケア病棟における眼瞼けいれんの特徴と苦悶様顔貌との関連性について

Palliative Care Research 8(1), 168-176, 2013
NAID 130003367225

Related Pictures

★リンクテーブル★

リンク元	「cramp」「筋攣縮」「myospasm」「muscular cramp」「筋れん縮」
関連記事	「twitching」「muscle」

「cramp」

Fasciculation
Classification and external resources
Specialty	Neurology
ICD-10	R25.3
ICD-9-CM	781.0
DiseasesDB	18832
MedlinePlus	003296
MeSH	D005207
	[edit on Wikidata]