Syndromes of abnormal muscular activity: overlap between continuous muscle fibre activity and the stiff man syndrome.

Four patients with muscular pain, fasciculations, contractures or cramps are presented. Evidence of peripheral nerve involvement was revealed by electromyography and nerve conduction studies. Muscle biopsy showed mild signs of denervation and reinnervation and, at electron microscopy, dilatations of terminal cisternae were found. All patients showed a remarkable improvement after therapy with diphenylhydantoin or carbamazepine. These clinical, neurophysiological and morphological data underline the role of peripheral nerve pathology in various syndromes of abnormal continuous muscular activity.

[1]  R. Tomasulo.  Aberrant conduction in human peripheral nerve , 1982, Neurology.

[2]  C. Coërs,et al.  Neurogenic benign fasciculations, pseudomyotonia, and pseudotetany. A disease in search of a name. , 1981, Archives of neurology.

[3]  H. Soininen,et al.  Electromyographic and nerve conduction findings in a patient with neuromyotonia, normocalcemic tetany and small‐cell lung cancer , 1980, Acta neurologica Scandinavica.

[4]  H. Isaacs.  Stiff man syndrome in a black girl. , 1979, Journal of neurology, neurosurgery, and psychiatry.

[5]  S. Barron,et al.  Continuous muscle fiber activity: a case with unusual clinical features. , 1979, Archives of neurology.

[6]  M. Devor,et al.  Ephaptic transmission in chronically damaged peripheral nerves , 1979, Neurology.

[7]  D. Burke,et al.  Hyperexcitability of motor and sensory neurons in neuromyotonia , 1979, Annals of neurology.

[8]  F. Lublin,et al.  Myokymia and impaired muscular relaxation with continuous motor unit activity. , 1979, Journal of neurology, neurosurgery, and psychiatry.

[9]  A Wettstein,et al.  The origin of fasciculations in motoneuron disease , 1979, Annals of neurology.

[10]  W. Brown,et al.  The muscular pain‐fasciculation syndrome , 1978, Neurology.

[11]  M. Mumenthaler,et al.  The syndrome of 'continuous muscle fiber activity.'. , 1978, Archives of neurology.

[12]  D. Passerini,et al.  F‐WAVE VELOCITY IN MOTOR NEURONE DISEASE , 1976, Acta neurologica Scandinavica.

[13]  S. Stahl,et al.  A pharmacologic study of the stiff‐man syndrome , 1975, Neurology.

[14]  J. Heffron,et al.  The syndrome of `continuous muscle-fibre activity' cured: further studies , 1974, Journal of neurology, neurosurgery, and psychiatry.

[15]  J Kimura,et al.  F‐wave velocity in the central segment of the median and ulnar nerves , 1974, Neurology.

[16]  D. Riley,et al.  The effects of inactivity, programmed stimulation, and denervation on the histochemistry of skeletal muscle fiber types. , 1973, Experimental neurology.

[17]  O. Appenzeller,et al.  Peripheral neuropathy with myokymia, sustained muscular contraction, and continuous motor unit activity , 1972, Neurology.

[18]  C. Guilleminault,et al.  [Syndromes of permanent contracture (stiff-man syndrome of Moersch and Woltman; Isaacs' syndrome of continual activity of the muscle fibers, other permanent contractures). Attempted classification and pathogenic interpretation. Discussion of the role of the interneurons and of the terminal expansion , 1971, Revue neurologique.

[19]  F. Plum,et al.  Generalized muscular stiffness, fasciculations, and myokymia of peripheral nerve origin. , 1970, Archives of neurology.

[20]  L. Kaufman,et al.  A critical survey of stiff-man syndrome. , 1967, The American journal of medicine.

[21]  H. Isaacs.  Continuous muscle fibre activity in an Indian male with additional evidence of terminal motor fibre abnormality. , 1967, Journal of neurology, neurosurgery, and psychiatry.

[22]  Mulder Dw,et al.  "STIFF-MAN" SYNDROME: A REVIEW OF THE LITERATURE, REPORT OF THREE ADDITIONAL CASES AND DISCUSSION OF PATHOPHYSIOLOGY AND THERAPY. , 1964, Mayo Clinic proceedings.

[23]  H. Isaacs.  A SYNDROME OF CONTINUOUS MUSCLE-FIBRE ACTIVITY , 1961, Journal of neurology, neurosurgery, and psychiatry.

[24]  F. Morrell,et al.  Effect of Diphenylhydantion on Peripheral Nerve , 1958, Neurology.

[25]  H. W. Woltman,et al.  Progressive fluctuating muscular rigidity and spasm ("stiff-man" syndrome); report of a case and some observations in 13 other cases. , 1956, Proceedings of the staff meetings. Mayo Clinic.

[26]  G. Fenichel,et al.  Familial cramps and muscle pain. , 1981, Archives of neurology.

[27]  B. Bady,et al.  Une observation de pseudo-myotonie guérie par la carbamazepine. , 1969 .

[28]  D. W. Mulder,et al.  "STIFF-MAN" SYNDROME: A REVIEW OF THE LITERATURE, REPORT OF THREE ADDITIONAL CASES AND DISCUSSION OF PATHOPHYSIOLOGY AND THERAPY. , 1964, Mayo Clinic proceedings.

[29]  F. Morrell,et al.  Effect of diphenylhydantoin on peripheral nerve. , 1958, Neurology.