Fasciculation: Does distance really matter?

The needle electromyography (EMG) discloses fasciculation potentials (FPs) so frequently in amyotrophic lateral sclerosis (ALS) that neurophysiologists are reluctant to accept this diagnosis unless FPs are shown (de Carvalho et al., 2008). Their presence has also been associated with hyperexcitability in ALS (de Carvalho et al., 2017), recently confirmed by the finding that the most excitable lower motor neuron is the one more susceptible to fasciculate (de Carvalho and Swash, 2017). Moreover, the presence of FPs is a very early finding in muscles of ALS patients (Lambert, 1969) and antedates morphological changes of the motor units (MUs) or signs of end-plate dysfunction (de Carvalho and Swash, 2013).

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