Benign fasciculations and corticosteroid use: possible association? An update

Area of Science:

• Neurology
• Clinical Medicine

Background:

• Fasciculations, or muscle fiber contractions, are typically associated with motor neuron diseases or metabolic disorders.
• However, fasciculations can also occur in individuals without underlying pathology, a condition known as Benign Fasciculation Syndrome (BFS).

Observation:

• A 28-year-old patient developed migratory and diffuse fasciculations after tapering oral corticosteroids used for Minimal Change Glomerulopathy.
• Clinical examination, electroneuromyography (ENMG), and laboratory tests revealed no other neurogenic disorders or pathological findings.

Findings:

• The patient was diagnosed with Benign Fasciculation Syndrome (BFS) based on persistent fasciculations without other neurological signs or laboratory abnormalities.
• The study hypothesizes that high-dose corticosteroid use and subsequent tapering may have contributed to the fasciculations by altering ionic channels.

Implications:

• This case highlights that fasciculations, even when diffuse and migratory, can be benign and potentially linked to corticosteroid withdrawal.
• It underscores the importance of considering medication side effects when evaluating fasciculations and suggests complete corticosteroid tapering may lead to symptom remission.