Bertolasi L, De Grandis D, Bongiovanni L G, Zanette G P, Gasperini M
Clinica Neurologica, Universitá degli Studi di Verona, Italy.
Ann Neurol. 1993 Feb;33(2):176-80. doi: 10.1002/ana.410330207.
Muscle cramps induced by voluntary contraction and by electrical stimulation of the peripheral nerve were studied electrophysiologically in 10 healthy subjects. The aim was to verify that cramps can be evoked by electrical stimulation of peripheral nerve and to clarify the physiological mechanism responsible by analyzing the effect of muscular stretching on cramps. Our results showed: (1) Cramps can be induced even after peripheral nerve block by electrical stimulation distal to the block. (2) No cramps were recorded during or following maximal voluntary contraction without muscular shortening, while 7 of 10 subjects showed a true cramp following maximal effort with shortening of the muscle. (3) Muscle stretching caused a sudden interruption of cramps induced by either voluntary contraction or electrical stimulation of the peripheral nerve, even after the induction of nerve block. (4) The lengthening state of the muscle can strongly influence the possibility of evoking cramps by electrical stimulation of nerve. Our study verifies the experimental model proposed by Lambert in 1969, emphasizing the relevance of frequency of stimulation and confirming the hypothesis that cramps are of peripheral origin. The effects of muscle stretch and lengthening on cramp interruption and development also have a peripheral mechanism.
我们对10名健康受试者进行了电生理研究，以观察由随意收缩和外周神经电刺激诱发的肌肉痉挛。目的是验证外周神经电刺激能否诱发痉挛，并通过分析肌肉拉伸对痉挛的影响来阐明其生理机制。我们的结果显示：（1）即使在进行外周神经阻滞之后，通过刺激阻滞部位远端的神经仍可诱发痉挛。（2）在最大随意收缩且肌肉无缩短的过程中及之后均未记录到痉挛，而在10名受试者中有7名在最大用力且肌肉缩短时出现了真正的痉挛。（3）即使在诱发神经阻滞后，肌肉拉伸也会使由随意收缩或外周神经电刺激诱发的痉挛突然中断。（4）肌肉的拉长状态可强烈影响通过神经电刺激诱发痉挛的可能性。我们的研究验证了兰伯特于1969年提出的实验模型，强调了刺激频率的相关性，并证实了痉挛起源于外周的假说。肌肉拉伸和拉长对痉挛中断及发展的影响同样具有外周机制。
