Hi I’m Dr Simon Freilich Consultant in Clinical
Neurophysiology and in this video I will talk about Benign Fasciculation Syndrome or BFS
for short. Fasciculation’s are involuntary muscle twitches
that can occur in both healthy people, and those with a wide variety of diseases. It’s difficult to say just how common this
condition is, but it is not rare, and it is well described amongst health professionals. It is important to state that BFS is a diagnosis of exclusion i.e. one needs to investigate other potential causes before making this
diagnosis. However, there are a number of clinical pointers
towards BFS rather than being as a result of an underlying pathological condition. BFS tends to affect the muscles in the lower
legs, hands and eyelids. It can even cause twitching in the tongue
and in the ear muscles causing a beating sound to be felt. The twitches tend to occur periodically, with
some periods where the condition is more active than others and also tends to flit between
muscle regions. In this video clip you can see a patient’s
muscle twitching autonomously. It is quite irregular and arrhythmic and is
occurring in one of the typical muscles to be affected in the hand. They can also be associated with cramps, myalgia,
tingling, fatigue, anxiety and a sensation of something being stuck in the throat called
‘Globus Pharyngis’. The twitches may be exacerbated by tiredness
and stress and can be partially interrupted by actively moving the muscles involved. The most important features that needs to be
checked is that there should be no muscle weakness or wasting. If there is, it would argue against BFS and
the fasciculation’s would likely be secondary to another condition. It is generally accepted that Fasciculation’s
are due to an over excitability of the nerves innervating the muscles. However, because the nervous system is both
highly complex and involves long distances, it has proven difficult to provide categorical
answers as to where exactly in the nervous system they originate. There is evidence of both spinal cord and
peripheral nerve origins to the fasciculations in BFS. More recently, thanks to pioneers such as
Prof Hugh Bostock, we have been better able to study nerve excitability. Individual ion channel dysfunctions such as
HCN which may play a role in inducing over excitability of the nerves. Other conditions that can be associated with
fasciculations include: Radiculpathies and Neuropathies which can
lead to nerve damage and dysfunction. Neuromuscular Junction Disturbances can also
increase the probabilities of spontaneous contractions,
Metabolic causes such as Hyperthyroidism and Hyperparathyroidism can have primary or secondary
effects. Electrolyte disturbances such as having raised
Potassium or low Magnesium and Calcium levels Vitamin D Deficiency can have secondary impact
on calcium levels. Stimulants such as drinking too much Caffeine
can cause this. Medications that enhance the sympathetic nervous
system with Adrenalin like substances such as Epinephrine nasal sprays or Amphetamines. Anti-cholinergic agents such as Ipratroprium
and Tiotropium that are used in Asthma, or Trihexyphenydate that may be used in Parkinson’s
Disease, Diuretics used in Heart failure and ACE-Inhibitors
in Hypertension can alter potassium levels. Statins for raised cholesterol, Isoniazid
in TB, Opiates and Opiate withdrawal and Corticosteriods are all well described. Auto-immune conditions such as Isaacs Syndrome
and certain Spinocerbellar Atrophy syndromes are very rare causes of fasciculation’s. Of course, what commonly worries most patients
and their physicians is potential Motor Neurone Disease. Motor neurone disease is progressive and is
associated with clinical weakness and wasting of the muscles. In addition, fasciculation’s in MND tend
to be persistent, spread and are found in adjacent areas rather than flitting between
disparate areas. What is very important in these situations
is Neurophysiology studies using EMG to look for evidence of underlying denervation which
may be sub-clinical. You can see examples of fibrillations and
fasciculation’s in the I-Cards above. The nature of the fasciculation’s can also
be helpful such as double fasciculation’s though complex wave forms do not appear to
be as diagnostic as previously thought. Ultimately, time is the greatest discriminator
and once past the 4 or 5 year mark without additional signs, BFS is a secure diagnosis. So in terms of diagnosis – a good clinical
history looking for the features listed above, going through all relevant medications and
a thorough clinical examination are required to exclude alternative and more serious causes. Blood tests will be necessary to check electrolyte
and metabolic disturbances and where necessary for auto-immune conditions. And of course Neurophysiology studies with
NCS Tests and EMG are important screening tools. In time Nerve excitability studies may become
more mainstream as we continue to learn more about this condition. Treatment Is symptomatic and should be holisitic. So if sleep deprivation and stress are contributory
causes these will need evaluation and will need to be addressed. Stress and anxiety are potent activators of
the Sympathetic Nervous System which drives the flight and fright response and nerve hyperexcitability. Stress management techniques can be helpful
to ameliorate this. Caffeine and other stimulants should be avoided. Some patients can have this as a result of
sleep apnoea which may need specific treatment. Any electrolyte disturbances or vitamin deficiencies
will need screening and correction and any exacerbating medications should be discontinued,
where possible. There are certain medications such as Carbamazepine,
Propanolol and Verapamil which can help, though the benefits are often less than satisfactory
and this condition tends to wax and wane anyway. There doesn’t appear to be any long-term
health consequences of having this condition. I hope that you have found this video useful
and if so please support this channel by subscribing and giving a thumbs up.
Is it normal to feel this everywhere in the body but most in legs and feet ? I have like 24/7 in the legs but can appear everywhere in my body as well . And also it feels like burning and cramping ?
I’ve been having this since I was 10 I’m twelve now and as I’m typing this I’m having a twitch in my head, it’s driving for crazy it happens in almost every single part of my body I just wanna die at this point I’d rather just die you have not idea how annoying this is it’s drivin me fucking crazy
My bfs is above my knee and in my shoulder
This video calmed me down a bit. I'm 24 and have this condition. It's really stress inducing when it happens which is ironic since stress can cause it in the first place. I feel like I'm stressed even on holidays, dont know how to solve that. Anyone also like me?
I've been dealing with my BFS for over 10 yrs. Have come to the conclusion after a couple years of reading online of all the other people living with it and getting no relief let alone answers from the medical field that many are not aware of the only thing I've come to find as a cure. It is not a secret yet was invented I believe for blepharospasm many many years ago before it became a beauty regimen for rich people. BOTOX (un-expired botox!) I will never understand why this condition is not studied more and given the attention as many other disabilities. If anyone out there really wants to try a cure, I mean medicine, that works if done by a legit doctor who will charge you a freaking arm and a leg to pay for out of pocket unless you find a way to get it covered under insurance, then get BOTOX IN THE AREA OF TRAUMA! It is the ONLY way I can live my life now without daily all over body BFS! Can ya tell I'm mad about this entire ordeal? Yes I am. Sick and tired. Note – my BFS in my entire body stops when I treat the area of my worst twitching in my eyelids, so figure that one out….no idea why or how but I am 100% sure of my experiences being legit and it's a miracle for me. So many who need to try too since I swear it has changed my life not living with BFS every single day and as soon as the medicine starts to wear off and my twitches begin….BAM….back to get needles in my face…no more twitch. Sorry…had to vent.
This sums it up…BFS Sucks1
I started twitching in both legs and right eye after mononucleosis. Should i worry so much? I am 35. Emg normal
I am victim of this since you year please give me solution
I drink caffine alot
And i have this contraction and throbbing on my knee . I AM AFRAID OF MY KNEE BEING TWISTED
I am watching from yemen .I cant go to hospital because doctors here are not that knowledgable
Wow I really thought I was the only one, when I told my dad about it he always says it's just in my head and nothing is wrong with me, he also tells me all I need is exercise. I'm 18 and I have extreme anxiety and depression so idk if they may be the cause, I also have hormonal imbalance for about 2 years now, which results in a lot of late periods.. I just hope I'm ok 😔
hHi I have cfs I get cramp in my arms hands chest calfs feet neck.ive had this for about 7years very painful I also get very fatigued .
I had this for a day
I have muscle cramps and fasciulation for a very long time. Im 31 years old male with total hip replacement done last year. I get real bad thigh and calf cramps and biceps chest wrist and even finger muscle fasculation. I had to end up in emergency once coz of having inner thigh cramps which lasted for 7- 10 min which was real bad. After that they checked my electrolyte level which was normal. Blood test was done twice regarding to the different level of magnasium and potassium losses they turned out to be normal as well. Now even dr says this is normal. It used to happen all over my body before surgery like thigh, calf, stomach, chin muscle, knees,biceps but these days basically on my operated i get most of the cramps. I did ultra sound as well if there is any problem in nerve or ligament after total hip which turned ot to be normal again. But cramps and fascitulation is happening all the time. I have no idea what should do rather than waiting for dr to find out something which is causing problem. Any way i have seen bit of muscle loss on my thigh after surgery. Cramps are like normal things for me in the night time. I just let it go without feeling much pressure. I was suggested one that i should do some sort of nuro test but i havent done yet. Im not too much worried but what if these regualr cramps and fascitulation are some symptoms of unknown disease that i dont know.
Excellent video. I developed this condition (only occurs after exercise) approx 5 years ago – lower legs writhe up and down (almost worm like motion) and twitch VERY noticeably from the top of the calf muscle to the ankles. Now 60 years old I think this is a combination of age and having suffered for the first time, extreme anxiety with low moods. More than worrying, the movements fascinate me.
Ive been dealing with this for months now….muscle twitches and spasms throughout every inch of my body. Legs, arms, torso hands, eyes, cheeks everywhere….it never ever stops it just gets more or less intense….so far my doctor and also a neurologist cannot figure it out. Im told stress but uts not like im stressed every second of the day….sometimes my hands or hamstrings will cramp altogether and cause pain….its so debilitating i cannot even function and have a normal life
Dangit i have this
Hey, I just recently started getting this weird twitch in my thigh. It only just began about a month ago. But its sporadic, usually occurs when im in school. However, when im relaxing it rarely pops up. Is there any treatment for this
Dr. Simon, am I understanding correctly that BFS muscle twitches move about from location to location around the body, but that twitching from ALS would more likely occur in a more localized manner? Thank you!
very helpful
Sir what is the treatment for this syndrom
My right hand thumb shivers and feels too weak sometimes and doesnt work i mean its easy to move it but hard to use cant use any force on it, and still i ma writing this comment its still feeling the same thing, hardly typing,,,, plz tell why its happening, its hard to tell anybody else here
This Dr is a regular at Tottenham Hotspur chanting Yid Army LOL!
Hello Dr. Simon,
It's a bit difficult for me to differentiate clinically between fasiculation and Myokymia? Do you have any tips for me? thanks alot.
I have been living with this for 3 years. It has not change so i guess the more serious disease are ruled out.
Does BFS usually come with a jerky step-wise tremor when muscles are activated or released ?
I was diagnosed with bfs after a clean emg in 2015. It went away in 2016. A few months ago it all came back but widespread, stomach, lips, arms, legs, head and very frequent. Should I be worried. Is bfs known to go into remission and then come back years later? Do I need another emg?
Does this happen to anybody else?: every time I start to twitch, I would look at the area where the twitching is and it would stop, but then when I’m not looking it would start again😑
Wait there's a term for this? Whew, I thought only I had this lol.
Can i have muscle twitching in my legs due to L4, L5 and S1 lesions in my low back? Is that possible?
I think I have this I’ve had this annoying twitching in my toes since October this ain’t normal
I have had the same muscle twitch for over 2 weeks now. It’s my highest, left abdominal muscle directly under my rib cage and it primarily twitches when I go to inhale. I’ve dealt with muscle twitches before but this one is really bugging me the most and keeps me up at night. The twitching only when I inhale is really odd also. Is there any reason for this. And also can a specific muscle twitch permanently? Btw I’ve had blood tests done and they cake back normal and I’ve also seen a Neurologist who diagnosed me with BFS
Thanks Doc🙂
My upper leg buttocks is twitching since yesterday, don't know why but it feels strange.
I have this everywhere over my body. It's so annoying I can't stand it. Sometimes I get little tingly soft ones. And other times I just extremely hard and intense ones which bother me the most. However I have single twitches to. For example, my arm would twitch once then my leg would twitch once right after. Someone please tell me how to stop these!! 😭😭😭
Thank gosh I thought I was the only one.
I have a twitch in my left temple. I suffer from anxiety, drink a lot of caffeine and my sleep schedule is messed up. I still think theres something wrong with my brain
I just cried watching this I can’t controlling it and it’s affecting me everyday. I wish it wasn’t in me.
Greetings doctor. Your video was very informative. I'm experiencing fasciculations from 1 and half year. For 3 days I have had them at one point on my left bicep constantly. some of them are moderate while others are like jolt which some time make the whole bicep or hand move. many a times more than one of varying intensity can be felt. Is this Double Fasciculation?
I couldn't understand your take on double fasciculation. Please can you clear it for me. Regards.
I have had twitching (fascilations) since I was 14, I'm now 33. I was never really that bothered by it, there were only a few times were it was so bad I couldn't sleep (usually in the back since the muscles are larger and can really twitch hard). It's been getting much worse the past 5 months or so though, and because of that I've been getting even more anxious when it will pop up. Because its been so long I know its very likely not anything serious, but went to the doctors to get checked out. blood work checked out okay but being sent to a neurologist to be safe. From what I read, stress and anxiety can be a big cause I might try to go to a therapist as well. Any other advice I'm all ears I just want it to stop.
The underside of my right arm has been twitching ever since I did push-ups in the morning.
Someone please help me. I can’t take it. My left calf has been twitching for about 3 days now. I’ve never had any serious anxiety problems, but this twitching is giving me anxiety and it won’t stop. I need someone who knows what to do and how they can help me. Please
Great video
I literally have have that muscle twitch rn
What’s the difference between BFS and Issacs syndrome?
I started working out on my chest heavy lifting … can that be the cause of my chest twitching/jumping
Hello…Do I have als? It all started at the end of my 16 year old. I've had whole body fasciculations for over 5 years. I've had times of improvement and worsening, especially when I'm stressed. I get itches and it gets worse when I'm stopped. I'm very scared. Thanks.
I have bfs with bad cramping. Legs back stomach.had emgs they say no als but still bothers me
So am I the only one that find muscle twitching satisfying ?like every time it happen I like to look at it then touch it
For years I used to have sporadical twitches in different muscles of my body. Now, almost for a week I am experiencing an onset of intensive, constant fasciculations in legs, calves, and less frequent in my arms, back and abs… I am really anxious, because I have got also some muscular pain like numbness in my left leg and do not know what to expect. The twitching appeared during a period of stress and anxiety, and after a flu-viral infection and a relatively intesive exercise session in the gym. The doctors have checked reflexes and strenght, all seems fine, and have not considered necessary an – EMG. How much I would like to change this situation because it is affecting my life…
OMG right when I started to develop sleep apnea I developed this….woah!
My eye used to twitch but I’ve gotten to wear I can control it and do it voluntarily. Now my pinky on my left hand is twitching involuntarily.
BORINGGGGG
Thank you so much for this video. Subbed.
I'm looking for info on CFS (Cramp Fasciculation Syndrome) as I'm wondering if that may be what's going on with me. I've got muscles that tighten up on me without me doing anything and it's painful! (am showing signs of thoracic outlet syndrome as well with nerve pain through the shoulder, all down the arm, and into the hand with numbness of fingers with a major sensitivity to cool/cold)
I'm also starting to feel this really weird feeling in some of these muscles that feels like something is moving around under the skin there! Reminds me of the feeling in late pregnancy when the baby would move around… except that one was fun and neat and didn't hurt. This muscle cha-cha hurts! And I'm having some of my muscles just cramp up when I try to use them. And there's been an underlying myoclonic twitching and jerking that's been worsening for years.
I have carbamazepine for my trigeminal neuralgia but I wasn't taking it cuz my TN is in remission currently. But I started taking it again about 2 weeks ago and it has helped quite a bit! Still had some intruding strong pain randomly but it was MUCH better than without it. And last week I went to pain management and got an epidural in my cervical area (steroids) and that together with the carbamazepine are helping SO much!
But these are just treating symptoms. I need a diagnosis. I'm thinking an EMG is a good place to start. What about you?
Man I’ve had it on my ass, knee, hand just like that first guy, palms of hands, eye lids, now it’s my fucking bottom lip and it’s annoying 😩
I can't control my twitching mostly my leg
can this be parkinsons disease?
Like popcorn all over my body. I feel a wave like sensation over the parts that are about to twitch. Exercise can be painful.
It’s been happening to me in my legs for years but I just now noticed it after I accidentally kicked my cat off the bed
both my left and right eye been twitching on and off every 20 mins for like 2 weeks now, driving me mental
How to make this shit go away i don't want to have it every single day.
I think this happens to my Face like When right now My face is moving on the left side of my lip like its BOUNCING like “bubA bubA bubAaa” then i try to in the mirror IT STOPS then when i go back to my bed IT STARTS AGAIN
This doctor is bad ass. He's very well spoken, and intelligent.
Crying because I have all these symptoms. I've had them for years . What do you do to treat it? I was I could come see you so you could help me.
My left butt cheek is twitching right now.. really
does anybody have problems swallowing pills? or feeling discomfort in the throat?
My right Index finger has been twitching on an off for 2 weeks
I twitch all over my body. Even my butt and toes. It's so weird
Twitching for over 4 months now. Everywhere but no weakness or atrophy. Clinical was clean reflexes fine. Absent reflex in left bicep but doctor told me it’s the hardest reflex to hit.
I have had the muscles all over my body twitch mainly my right hand which is strange since my left hand is double jointed on the thumb it's not as bad same with my arms and legs and even my ears. This video helped me calm down about it and has made me feel less stressed about it now thank you for making the video it helped alot
ive had this occur most of my life, nothing to worry about, it happens every blue moon. from my experience it happens after the muscles have been in heavy use. thing is that heavy use is not simply be means of working out, but rather general use that your likely unaware of. when the muscles are relaxed is when the twitching occurs. and from my experience its likely due to one of several things. Lack of fluids ie water and bloodflow, lack of potassium, lack of electrolytes, as such the muscles are quite literally gulping for nutrients.
My foot and my head always twitch
The dreaded twitching inside the ear. Only had it once, I stuffed an earplug in until it went away after a week!
I have this all over. Very intense in my eye right now. I have had this for 18 years. It makes me want to shoot myself . gabapentin helped at first but not anymore. Ugh its so annoying. Very debilitating. Ive tried all the remedies. Acupuncture worked a couple times but not anymore. I need a cure!!! Help!!
I’m getting so mad right now like bruh omg
To me usually when I would look at the twitch it would just stop but when I dont it starts again
but this time it kept going even though I looked at it
this is scaring me so yeah please help ;-;
Ive had it for ages now and i just want it to go the only way I gst rid of it is when i press down the part thats twitching then another one shows up all over my body its driving me mental righy now my eye lid and feet is twitching i have to close my left eye its just not going
I went to the doctor and I’m getting my results and I’ll update
mine is in left thumb it sometimes annoys me and then it stops and then months later it happens again but I am used to.
I have this near my 2nd finger im prob not eating much
My BFS started when I was 13 and lost 50lbs off weight watchers. Hasn’t stopped since /:
You guys my results were I’m low on vitamin d and the internet says that muscle spasm can be caused from that so I guess that’s why but I’m gonna pick up some tablets
I think of everybody feels okay and are having these I think we all may have hypocalcemia
My chiropractor helped me with my BFS by doing a series of neck adjustents
As far as treatment is concerned, why is botox not mentioned as a option? I know it's temporary. But the times that one muscle area is twitching for days or weeks at a time, I feel like it would be a great relief.
Wow
have had random twitches all over body for 4 months……
omg this is happening all over my body rn 🙁
No i don’t twitch like that my arms my legs my feet my hands everything wil twitch they just move freely we’re ever they want to
are these basically seizures?
doc i am a pharmacist from india and i feel twiching and involuntary muscle movement near my eye.. its continous since last three days. i take proper sleep and have no stress at all neither i have any major tension and now i am taking tablets of vitamin B complex with vitamin B12 twice a day but see no significant results.. kindly suggest any tests or medication
I started to get this when drinking coffee and had a lot of stress and anxiety my body jerks in parts especially my legs.I come off the coffee I still have the jerks but not as bad as before I hope it goes away in time.
He hit the nail on the head about caffeine and stress and anxiety as I used to drink coffee and had stress and anxiety and got body jerks alot.
I accidentally ingested overdose crack cocaine into my body I had panic attack heart palpitations I felt milf pain in my lower spine but was not long after few hours I was into the hospital I started having muscle twitching on my face left arm weakness I started tripping dropping things the weakness and muscle stiffness is not getting better as I feel the weakness in my both arms and lower limbs I have had occasional impaired and slurred speech though I was having pins and needles pin with numbness and tingling I am just really devasted.
The muscles behind my ear would twitch only when I layed on my ear.
My left eye would twitch when I need a shower.
My legs twitch like crazy after a long walk in the heat. Only in the heat.
Not winter.
My toes twitch like crazy.
My ribs would twitch.
The biggest muscle on my leg would twitch.
My arms would twitch
why after stretching or after a big yawn I feel it even more? what's the direct relation with these can anyone help me pls
while watching this my leg and ass were twitching its so annoying now when i was younger i used to ignore the twitching
You can name any part of my body and it has probably twitched at one point in my life. Ofcourse it has to be a muscle
It’s so annoying mentally sometimes that I wanna break something and I’ve got anger problems … this is the worst condition I’ve ever had in my entire life