21/128. Internalised capillaries, neuromyopathy and myalgia.Internalised capillaries are described in the muscle fibres of two adult males who complained of exertional myalgia. In one patient, "bundles" of internalised capillaries were found in 2% of the Type 1 fibres and many of the Type 1 fibres exhibited non-specific cytoarchitectural changes. The other had hereditary motor and sensory neuropathy (HMSN) Type 2 and his muscle biopsy exhibited the more conventional single and double internalised capillaries in 3% of the muscle fibres in addition to the anticipated neuropathic changes. Electron microscopy revealed the presence of paracrystalline inclusions in the mitochondria of muscle of both patients. dystrophin was normal on both immunogold/silver staining and immunoblotting. Sixty five of 77 recorded patients with evidence of internalisation of capillaries have been males and 10 are known to have complained of muscle cramps or severe myalgia. An ischaemic pathogenetic predisposition is proposed as a possible stimulus to the capillary internalisation, formation of paracrystalline mitochondrial inclusions and myalgia.- - - - - - - - - - ranking = 1keywords = cramp, muscle cramp, muscle (Clic here for more details about this article) |
22/128. A rare form of painful nondystrophic myotonia.OBJECTIVE: In this paper we report a painful nondystrophic myotonia which has not been previously described. pain is a rare symptom in myotonia. We report a myotonic disorder in a 34-year-old woman and her 14-year-old daughter. Painful cramps occur during and after exercise in the mother, and both patients can demonstrate unusual contractions in the tongue. In the present study we try to evaluate the mechanisms behind the unique finding of trains of high amplitude of positive waves, not seen in the earlier known myotonic conditions. methods: Clinical investigations and electromyography with single and dual channel recordings and muscle morphometry were performed. RESULTS: The electromyographic recordings reveal positive waves, fibrillation potentials and myotonic discharges. In addition, extraordinary findings were made of trains of high frequency positive potentials with very high amplitudes and with conduction block along the muscle fibres. CONCLUSIONS: In this new form of myotonia with likely dominant heredity, the specific finding of trains of high amplitude positive waves indicates ephaptic transmission within bundles of neighbouring muscle fibres.- - - - - - - - - - ranking = 0.55978325417616keywords = cramp, muscle (Clic here for more details about this article) |
23/128. Hereditary neuropathy with liability to pressure palsies (HNPP) in a toddler presenting with toe-walking, pain and stiffness.The typical clinical presentation of hereditary neuropathy with liability to pressure palsies is an adult-onset recurrent, painless monoparesis. Electrophysiological abnormalities--decreased nerve conduction velocities and delayed distal latencies--can be detected even in asymptomatic patients. We describe a toddler, who presented with asymmetric toe walking, painful cramps and stiffness in the legs. He had calf hypertrophy, brisk tendon reflexes and bilateral Babinski signs and the electrophysiological examination was normal. The unlikely diagnosis of hereditary neuropathy with liability to pressure palsies was reached 5 years later, when the boy started to complain of episodic numbness and weakness in the upper extremities. His father, paternal aunt and grandmother had similar symptoms, but they had never been investigated. The typical 1.5 Mb deletion on chromosome 17p11.2-12 was found in our patient and his affected relatives.- - - - - - - - - - ranking = 0.55962454099385keywords = cramp (Clic here for more details about this article) |
24/128. back school programs. The young patient.CC's treatment goals were all met with the exception of eliminating the AMNT sign. Slump-sit right knee extension (-15 degrees), right SLR (80 degrees coupled with dorsiflexion), and lumbar flexion (85% coupled with neck flexion) all continued to reproduce right buttock cramping and pain. Currently he is playing basketball without restriction, performing an individualized exercise program that emphasizes lower extremity muscle stretching, AMNT stretching, and advanced truncal stabilization exercises. He has a very good understanding of body mechanics and an awareness of safe SFP during activities of daily living and on the basketball court. His motivation, along with the motivation of parents, coaches, athletic trainer, and physical therapist, greatly assisted CC in returning to competitive basketball. CC is intermittently evaluated to monitor the AMNT sign and the effectiveness of the home exercise program. Currently CC's AMNT appears to regress if he is not monitored on a monthly basis; thus he warrants intermittent treatment. Monitoring of the patient is an integral aspect of long-term management of chronic discogenic disease that is often neglected. It can be hypothesized that monitoring may prevent serious complications in the future for many patients. CC is a patient who needed specific therapeutic intervention beyond rest, general instructions about body mechanics and exercise, modalities, and traditional back school. The history of this patient's problem revealed that rest and general exercises had failed, thus necessitating specific therapeutic treatment. This patient is an excellent example of how physical therapy in the form of manual therapy, specific therapeutic exercise, education through repetition of functional tasks, and the team approach to patient care can lead to a successful treatment outcome.- - - - - - - - - - ranking = 0.55967744538796keywords = cramp, muscle (Clic here for more details about this article) |
25/128. Disabling foot cramping in a runner secondary to paramyotonia congenita: a case report.An 18-year-old male runner was referred to the authors' clinic with a 1-year history of cramping left foot pain. His symptoms developed insidiously when he increased his training, with an onset of severe left foot pain and tightness that would develop after about 20 minutes of exercise. The more he continued to run, the more the symptoms were aggravated and evolved to the toes curling with intrinsic muscle spasm. This symptom was easily provoked when he was exposed to cold temperature. A family history of similar symptoms was revealed in his sister and uncle. physical examination including neurologic examination was normal. Diagnostic workup revealed generalized myotonia. According to the history, physical examination, and diagnostic workup, his diagnosis was considered to be most compatible to paramyotonia congenita. He was given phenytoin, which lessened his symptoms and allowed him to continue running with minimal symptoms, but he stopped running because he was not able to maintain mileage high enough to compete successfully.- - - - - - - - - - ranking = 2.7981756093634keywords = cramp, muscle (Clic here for more details about this article) |
26/128. Cramps, muscle pain, and fasciculations: not always benign?fasciculation and cramps without weakness or muscle atrophy are recognized as a benign syndrome. The authors report a patient with cramp and fasciculation, which persisted for 1 year without abnormal motor unit morphology on EMG before progressive weakness, muscle atrophy, and EMG abnormalities developed. This observation raises the possibility that lower motor neuron hyperexcitability may precede motor neuron death in motor neuron disease.- - - - - - - - - - ranking = 1.1195665083523keywords = cramp, muscle (Clic here for more details about this article) |
27/128. Spanish family with myalgia and cramps syndrome.A Spanish family is reported with dystrophinopathy of myalgia and cramps syndrome type. There were five affected males and three females, and also six asymptomatic carriers. Muscle biopsy showed a dystrophic pattern, but immunohistochemistry carried out with three anti-dystrophin antibodies was normal. dystrophin analysis by western blot revealed a dystrophin of reduced quantity and molecular weight. dna analysis showed a deletion of the dystrophin gene involving exons 45-52. The natural history of this disorder and the large intrafamilial clinical variability are discussed.- - - - - - - - - - ranking = 2.7981227049693keywords = cramp (Clic here for more details about this article) |
28/128. Symptomatic bradycardia probably due to tizanidine hydrochloride in a chronic hemodialysis patient.A 71-year-old woman was admitted to the Wakayama Medical University Hospital with dizziness and loss of body balance. She had started hemodialysis at the age of 70. During the 33 days before admission, she received oral tizanidine hydrochloride at 3 mg/day for leg cramps. An admission electrocardiogram (ECG) demonstrated sinus bradycardia of 47 bpm. A 24-h ECG showed a total number of heartbeats of 68,779 and an average heart rate of 48 bpm. The maximum RR interval was 3720 msec. The electrophysiology test demonstrated slight sinus node dysfunction. There was no major organic heart disease. We suspected that tizanidine was the cause of bradycardia and stopped administration of this drug. After discontinuation symptoms gradually disappeared. The serum concentration of the tizanidine showed a higher trough of 1.78 ng/mL. In conclusion, because there was a disappearance of symptoms and a lightening of bradycardia due to the discontinuation of this medication, tizanidine was strongly suspected as the cause of severe bradycardia.- - - - - - - - - - ranking = 0.55962454099385keywords = cramp (Clic here for more details about this article) |
29/128. Significance of Beevor's sign in facioscapulohumeral dystrophy and other neuromuscular diseases.An atypical presentation of facioscapulohumeral dystrophy (FSH) is described, where the presence of a positive Beevor's sign led to genetic testing and subsequent probable diagnostic confirmation. This prompted evaluation of a further 68 patients for the presence of Beevor's sign. Among these, 19/20 patients with FSH had a positive Beevor's sign, compared with 2/28 with other muscle diseases, and 0/20 in a neurological control group. Beevor's sign should be considered as an additional criterion for the diagnosis of FSH.- - - - - - - - - - ranking = 5.2904394103112E-5keywords = muscle (Clic here for more details about this article) |
30/128. Statin-associated myopathy with normal creatine kinase levels. Case report from a Norwegian family.Troseid M, Henriksen OA, Lindal S. Statin-associated myopathy with normal creatine kinase levels - case report from a Norwegian family. APMIS 2005;113:635-7.Recent reports suggest that statins may cause myopathy with normal creatine kinase levels. We describe four related patients with statin-associated muscle symptoms and normal creatine kinase levels. In two out of the four patients (mother and son), pathological findings on EMG suggested myopathy, and muscle biopsies showed evidence of mitochondrial pathology. A third patient (daughter) had slight myopathic findings on EMG and muscle biopsy, but not enough to be classified as pathological. In a fourth patient, there were no pathological findings. creatine kinase levels were normal and symptoms diminished after discontinuation of drugs in all four patients. Our findings are consistent with other reports of statin-associated myopathy with normal creatine kinase levels. An inherited vulnerability, possibly a mitochondrial pathology, might cause or aggravate symptoms in some patients.- - - - - - - - - - ranking = 0.00015871318230934keywords = muscle (Clic here for more details about this article) |
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