Fasciculations due to verapamil in a patient with neuropathy

A patient with pre-existing peripheral neuropathy developed generalized fasciculations under verapamil which ceased after discontinuation of the drug. It is suggested that the increase in acetylcholine (ACh) release at the neuromuscular junction by verapamil may trigger fasciculation in the state of regeneration at ACh-sensitive sites of axon terminals and immature axon sprouts.