Cases reported "Muscle Cramp"

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1/2. Generator sites for spontaneous activity in neuromyotonia. An EMG study.

    A 16-year-old female patient with symptoms and signs compatible with neuromyotonia was studied with various neurophysiological tests and with muscle biopsy. Nerve conduction studies revealed signs of axonal motor neuropathy. EMG showed denervation in distal muscles, and moderate neurogenic changes in other muscles. Abundant spontaneous motor unit activity was recorded in all muscles. This activity did not disappear upon proximal nerve blockade with local anaesthetics. Based on the shape of spontaneous discharges and their behaviour on nerve stimulation and during voluntary effort, the site of generation was suggested. This varied for different discharges, from proximally in the nerve, to various sites along the intramuscular nerve tree. In some axons there were signs of conduction block proximal to the generation site for the spontaneous discharges. Different axons showed various degrees of abnormality; local hyperexcitability triggering new impulses only after the passage of a preceding impulse, increased hyperexcitability generating spontaneous activity, total impulse blocking, and finally axonal degeneration. Treatment with dihydantoin reduced the spontaneous activity with concomitant clinical improvement.
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2/2. quinine for cramps.

    BACKGROUND: The bark of the cinchona tree was used by the Incas of south america to treat tropical fevers. It was brought back to europe by the Jesuit priests and used in error to treat all types of fever. Because of its cost and lack of availability, apothecaries found an alternative antipyretic in willow bark. Subsequently salicylates were isolated from willow and quinine from cinchona bark. quinine is used worldwide for the treatment of fever due to malaria, but in the Western environment has long been used for muscle cramps because of its neuro muscular junction blocking action. DISCUSSION: quinine is a widely used medication which has been reported to cause thrombocytopenia on occasion. This potentially life threatening complication should be borne in mind when it is prescribed for minor symptoms such as muscle cramps.
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