Rowland L P
Rev Neurol (Paris). 1985;141(4):261-73.
Cramp syndromes pose a challenge for neuroscientists. The motor disorders of Isaacs syndrome have been ascribed to peripheral neuropathy, and sometimes there is ample supporting evidence of neuropathy. However, signs of overt neuropathy are found in a minority of cases and the essential findings (carpal and pedal spasm, pseudomyotonia and myokymia) may arise from abnormal excitability of the perikaryon because similar manifestations are seen in tetany and multiple sclerosis. The Moersch-Woltman (stiffman) syndrome differs from Isaacs' syndrome in essential characteristics. Hyperventilation syndromes may mimic either simple cramps, the Isaacs syndrome, the Moersch-Woltman syndrome, or the Foley and Denny-Brown syndrome of benign fasciculation and cramps. New approaches are needed to define the etiology and pathogenesis of these neurogenic disorders because the results of peripheral nerve block and spinal anesthesia have not been consistent in cases of typical Isaacs syndrome. Occupational cramps can be regarded as a form of action dystonia but that statement is a clue, not an "explanation". Myopathic disorders are only rarely a cause of cramp syndromes. In the glycogen storage disorders, the chemical basis of the cramp is still unproven. Whether myoadenylate deaminase is a cause of cramps is debated.
痉挛综合征给神经科学家带来了挑战。艾萨克斯综合征的运动障碍被归因于周围神经病变，有时有充分的神经病变支持证据。然而，在少数病例中发现明显的神经病变迹象，而基本表现（腕部和足部痉挛、假肌强直和肌束震颤）可能源于神经细胞体的异常兴奋性，因为在手足搐搦和多发性硬化症中也可见到类似表现。莫尔施 - 沃尔特曼（僵人）综合征在基本特征上与艾萨克斯综合征不同。过度通气综合征可能模仿单纯性痉挛、艾萨克斯综合征、莫尔施 - 沃尔特曼综合征或福勒和丹尼 - 布朗的良性肌束震颤和痉挛综合征。需要新的方法来确定这些神经源性疾病的病因和发病机制，因为在典型的艾萨克斯综合征病例中，周围神经阻滞和脊髓麻醉的结果并不一致。职业性痉挛可被视为一种动作性肌张力障碍，但这一说法只是一个线索，而非“解释”。肌病性疾病很少是痉挛综合征的病因。在糖原贮积病中，痉挛的化学基础仍未得到证实。肌腺苷酸脱氨酶是否是痉挛的病因存在争议。
