Benign Fasciculation Syndrome-BFS (Part I)

The following multipart article / research paper has nothing to do with politics. It is about a neurological disorder I suffer from so I wrote the following statistical analysis of the disorder. I have not had any luck getting the paper published, but will continue to try as our sample size in the survey of people with this disorder approaches 250 people. I am hoping to bring more attention to the disorder.

ABSTRACT:

The purpose of this paper is to explore the statistical relationship between Benign Fasciculation Syndrome (BFS) symptoms, body areas affected by BFS, the potential causes of BFS, and potential remedies for BFS.

The method used was to collect data from a survey. Data was obtained from 161 people. Of the 161 (9 outliers) a total of 152 have been diagnosed with BFS. The data was modeled using a linear regression analysis to determine if there is statistical significance between symptoms, potential causes or triggers, body areas affected by BFS, and potential remedies.

The results from this data (Tables 1 through 7) show it is possible to identify nine unique forms of BFS that stem from a variety of triggers. Each BFS form has its own set of unique symptoms, conditions that make symptoms worse, and remedies that appear to work best.

To conclude, this paper will combat the fallacies about survey usefulness and accuracy and highlight inadequacies of controlled studies, clinical trials, and patient observation. Although BFS symptoms, on average, remain the same for BFS sufferers - only those sufferers whose trigger is stress related can significantly reduce symptoms over time. Many people who suffer from BFS claim multiple triggers have brought forth BFS symptoms. Their symptoms reflect a cross between different forms of BFS. For this reason, we speculate that it would be difficult to find a single cure for BFS.

INTRODUCTION:

Defining and understanding neurological disorders can be medically challenging. Benign Fasciculation Syndrome (BFS) is a disorder characterized by fasciculation or muscle twitching of unexplained causes. Other BFS symptoms may include muscle fatigue, cramps, pins and needles sensations, paraesthsia, muscle vibrations, headaches, itching, sensitivity to temperatures, numbness, muscle stiffness, muscle soreness and pain. [1] BFS is considered to be a disorder of Peripheral Nerve Hyperexcitability (PNH). BFS or PNH causes are not entirely understood. Some theories state that the cause of BFS or PNH may involve the potassium channel of the nerve terminal's inability to properly close its gates when a motor nerve impulse reaches the nerve terminal, resulting in a still-remaining active muscle fiber. [2] This imbalance is what causes involuntary impulses that consequently stimulate the nerve endings causing them to fire and twitch. [1,3,4]

OBJECTIVE:

Like many neurological disorders, there is no known cure for BFS. While this disorder is considered “benign” it contains symptoms that are very real and in some cases both psychologically and physically debilitating. [5] This is primarily due to the chronic and progressive nature of the disorder in some individuals. Most neurologists and doctors will tell chronic BFS sufferers that their symptoms are “no big deal”. This is a misconception about the disorder. The statistical analysis of BFS from our survey proves that symptoms in many people are chronic (high frequency and intensity) and progressive. One study claims that up to 1% of the population may suffer from BFS. [6] BFS for most people is benign and insignificant (no big deal), but those individuals with chronic symptoms 24/7, BFS can wreak havoc on their lives. Chronic BFS sufferers are prone to dealing with anxiety since their early onset symptoms are similar to other crippling disorders such as Parkinson’s disease, Amyotrophic Lateral Sclerosis (ALS), Multiple Sclerosis (MS), and even brain tumors. Because of their symptoms, BFS patients often have undergone advanced medical testing including Magnetic Resonance Imaging (MRI) performed on the brain as well as an Electromyography (EMG) to rule out other neurological disorders. [1] Based on a Microsoft Research Study conducted by White and Horvitz, there is a .50 probability that a quick internet search on “muscle twitching” leads them to sites related to ALS. Needless to say this causes a great deal of distress for the individual knowing the relationship of twitching and ALS. In fact, some fairly recent studies have cited rare cases of individuals who started with twitching and cramping symptoms and later developed ALS years later. [7] While these cases are extremely rare, the knowledge of them can cause continual anxiety in the chronic BFS sufferer.

Chronic BFS sufferers have similar symptoms to other neurological disorders including Neuromyotonia (NMT), Benign Cramp Fasciculation Syndrome (BCFS), fibromyalgia, Reflex Sympathetic Dystrophy (RSD), stiff person syndrome, continuous muscle fiber activity, continuous motor nerve discharges, and Isaac Syndrome, usually differentiated by an EMG. [1] For this reason many remedies attempted to relieve BFS symptoms are exactly the same as those remedies used for NMT, BCFS, RSD and other neurological disorders. [1] At this time there is no evidence that BFS sufferers are any more likely to acquire other more serious neurological disorders, such as ALS or MS, than any person without BFS. [4]

If BFS is “no big deal” in the eyes of most neurologists, then why do people with BFS go through advanced medical testing and take powerful medications such as anti-seizure, anti-depressant, sleeping pills, benzodiazepines, muscle relaxants and other strong medications to relieve symptoms? The answer is because there are people with extreme chronic cases of BFS.

What is being hypothesized in this study is that due to the unique symptoms of people afflicted with BFS, there may be variants to BFS. The objective was to identify the different types of BFS from various triggers in order to better understand the illness and its potential remedies.