Tahmoush A J, Alonso R J, Tahmoush G P, Heiman-Patterson T D
Department of Neurology, Thomas Jefferson University, Philadelphia, PA 19107.
Neurology. 1991 Jul;41(7):1021-4. doi: 10.1212/wnl.41.7.1021.
We report nine patients with muscle aching, cramps, stiffness, exercise intolerance, and peripheral nerve hyperexcitability. Neurologic examination showed calf fasciculations in seven, quadriceps myokymia in two, and deltoid myokymia in one patient. Two patients had mild increase in serum creatine kinase. Muscle biopsy showed either no abnormality (three patients) or mild neurogenic changes (four patients). Fasciculations were the only abnormality on routine electrodiagnostic studies. Supramaximal stimulation of the median, ulnar, peroneal, and posterior tibial nerves at frequencies of 0.5, 1, 2, and 5 Hz produced showers of electrical potentials following the M response in at least one nerve. In three patients, the fasciculations and evoked electrical potentials were abolished by regional application of curare but not nerve block. Carbamazepine therapy caused moderate-to-marked reduction of symptoms and nerve hyperexcitability. We designate this hyperexcitable peripheral nerve disorder as the "cramp-fasciculation syndrome."
我们报告了9例出现肌肉酸痛、痉挛、僵硬、运动不耐受以及周围神经兴奋性增高的患者。神经系统检查显示，7例患者存在小腿肌束震颤，2例患者有股四头肌肌纤维颤搐，1例患者有三角肌肌纤维颤搐。2例患者血清肌酸激酶轻度升高。肌肉活检显示无异常（3例患者）或有轻度神经源性改变（4例患者）。肌束震颤是常规电诊断检查中唯一的异常表现。以0.5、1、2和5Hz的频率对正中神经、尺神经、腓总神经和胫后神经进行超强刺激时，至少在一条神经中，M波之后会出现一连串电位。3例患者中，局部应用箭毒可消除肌束震颤和诱发电位，但神经阻滞无效。卡马西平治疗使症状和神经兴奋性增高得到中度至显著缓解。我们将这种周围神经兴奋性增高的疾病命名为“痉挛-肌束震颤综合征”。
