Presentation
Cases Journal 2009 2 :7952 licensee BioMed Central Ltd. 2009 Received: 25 May 2009 Accepted: 20 July 2009 Published: 8 September 2009 Abstract We present a 37-year-old male subject who presented with burning sensations in his hands and feet with generalised [casesjournal.biomedcentral.com]
Cataracts present in nearly all over the age of 20 by slit lamp examination. 17 Overall, life expectancy is much closer to normal. [now.aapmr.org]
As a result of muscular hyperactivity, patients may present with muscle cramps, stiffness, myotonia -like symptoms (slow relaxation), associated walking difficulties, hyperhidrosis (excessive sweating), myokymia (quivering of a muscle), fasciculations [en.wikipedia.org]
A 17-yr-old Hispanic female presented for evaluation of bilateral lower-extremity hypertrophy and muscle twitching. The patient’s symptoms began approximately 5 yrs before presentation, with muscle twitching and cramps. [journals.lww.com]
Cardiovascular
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Heart Disease
Family history should include any neuromuscular disease, family history of cataracts and the age of onset, and history of heart disease or arrhythmias. Ophthalmologic history should include cataracts, especially any developing before age 50. [now.aapmr.org]
Musculoskeletal
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Muscle Twitch
Clinical myokymia refers to the presence of focal or generalized continuous muscle twitching, often exhibiting a rippling, “bag of worms” appearance under the skin. [medlink.com]
The major manifestations are cramps, muscle twitching or stiffness, pseudomyotonia, paraesthesias, numbness and hyperhydrosis [ 2 ]. [casesjournal.biomedcentral.com]
It is caused by rapid bursts of nerve impulses, resulting in muscle twitching, cramping, increase sweating and delayed muscle relaxation. In very few cases speech and breathing may be affected if pharyngeal or laryngeal muscles are involved. [drthindhomeopathy.com]
Marcelo ***@**** I've had muscle twitching for more than 2 years with joint pain, not much muscle cramping, mornings suck. My biggest concern are the tongue fasiculations. [medhelp.org]
A 17-yr-old Hispanic female presented for evaluation of bilateral lower-extremity hypertrophy and muscle twitching. The patient’s symptoms began approximately 5 yrs before presentation, with muscle twitching and cramps. [journals.lww.com]
Workup
Careful examination with prolonged eccentric gaze should be performed to achieve a correct diagnosis and avoid an extensive unnecessary workup. PMC Free PDF PMC Free Full Text FREE Publisher Full Text New Search Next [unboundmedicine.com]
Translation into Practice and Clinical Pearls: A diagnostic workup should be considered even in patients who are taking medications with known myotonic potential as drugs can unmask an underlying disease. 5 Presence of cataracts at a young age should [now.aapmr.org]
X-Ray
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Atelectasis
[…] cases with methylphenidate, as recommended by the American Academy of Sleep Medicine for patients with DM1. 20 DM1: Special precautions are needed during anesthesia given the prevalence of cardiopulmonary involvement especially the increased risk for atelectasis [now.aapmr.org]
Microbiology
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Staphylococcus Aureus
There have been case reports of neuromyotonia following Staphylococcus aureus spinal epidural abscess with septicaemia [ 3, 4 ], and there is also a report of ocular neuromyotonia following cavernous sinus thrombosis due to mucormycosis [ 5 ]. [casesjournal.biomedcentral.com]
Biopsy
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Muscle Biopsy Abnormal
Muscle biopsy abnormalities are more common in dystrophic myopathies compared to more variable findings in nondystrophic myotonia, including normal, myopathic or hypertrophied muscles. [now.aapmr.org]
Treatment
There is no cure or specific treatment for this disorder. However, treatments for some of the symptoms are available. [autoimmunesociety.org]
However, in recent years increased understanding of the basic mechanisms of NMT and autoimmunity has led to the development of novel treatment strategies. NMT disorders are now amenable to treatment and their prognoses are good. [en.wikipedia.org]
REHABILITATION MANAGEMENT AND TREATMENTS Available or current treatment guidelines Multidisciplinary treatment with education, genetic counseling and symptom modification with physical therapy as well as close monitoring and treatment of systemic features [now.aapmr.org]
In this update, the author offers a clinical and electromyographic guide to the diagnosis and treatment of these intriguing syndromes. [medlink.com]
Prognosis depends on prophylactic treatment. •Yoga and meditation helps a lot to relax •Regular but slow exercise. •Proper diet. •Hold/support while walking. [drthindhomeopathy.com]
Prognosis
What is the prognosis? There is no cure for Isaac's syndrome. The long-term prognosis for individuals with the disorder is uncertain. [medic8.com]
Prognosis [ edit ] The long-term prognosis is uncertain, and has mostly to do with the underlying cause; i.e. autoimmune, paraneoplastic, etc. [en.wikipedia.org]
Little research is being done on this disease, so the long-term prognosis for individuals with the disorder is uncertain. Visit Forum [autoimmunesociety.org]
Prognosis depends on prophylactic treatment. •Yoga and meditation helps a lot to relax •Regular but slow exercise. •Proper diet. •Hold/support while walking. [drthindhomeopathy.com]
Prognosis There is no cure for Isaacs' syndrome. The long-term prognosis for individuals with the disorder is uncertain. x Prognosis There is no cure for Isaacs' syndrome. The long-term prognosis for individuals with the disorder is uncertain. [ninds.nih.gov]
Etiology
The overlap between various syndromes and etiologies can be confusing. [now.aapmr.org]
The prognosis is solely dependent upon the underlying etiologies. Myokymia is considered benign when detected in patients after strenuous exercise. Prognosis Prognosis is related directly to the underlying etiology. [emedicine.medscape.com]
It contains detailed illustrations of each nerve along with a discussion of its anatomy, followed by a thorough outline of the clinical conditions and entrapment syndromes that affect the nerve, including a list of the etiologies, clinical features, and [books.google.es]
Clinical evidence suggesting a possible autoimmune etiology included the presence of oligoclonal bands in the spinal fluid of some patients and clinical improvement following plasma exchange (13). [ispub.com]
Asthma: Epidemiology, etiology and risk factors. CMAJ. 2009; 181(9):E181-E190. DOI: [ Links ] 3. British Thoracic Society, Scottish Intercollegiate Guidelines Network. British guideline on the management of asthma. UK; 2014. p. 11-75. [scielo.org.mx]
Epidemiology
ISAAC, The I nternational S tudy of A sthma and A llergies in C hildhood, is a unique worldwide epidemiological research programme established in 1991 to investigate asthma, rhinitis and eczema in children due to considerable concern that these conditions [isaac.auckland.ac.nz]
Asthma: Epidemiology, etiology and risk factors. CMAJ. 2009; 181(9):E181-E190. DOI: [ Links ] 3. British Thoracic Society, Scottish Intercollegiate Guidelines Network. British guideline on the management of asthma. UK; 2014. p. 11-75. [scielo.org.mx]
K Channel Disorder Episodic Ataxia CA 2 Channel Disorder Primarily Electrical with variable clinical myotonia Other* Medications / Agents * Electrical Myotonia with Clinical Myotonia: Myotonic dystrophy EPIDEMIOLOGY According to the NIH, myotonic dystrophy [now.aapmr.org]
Epidemiology Frequency Although myokymia can be seen in patients with different neurological and medical conditions and occasionally even in healthy subjects, it is a relatively rare clinical manifestation. [emedicine.medscape.com]
Pathophysiology
Pathophysiology The clinical phenomenon is characterized by its classic quivering movement of the involved muscle without movement of the joint. Myokymia can be seen in muscles innervated by cranial or spinal nerves. [emedicine.medscape.com]
Prevention
Standard Therapies Treatment Acquired neuromyotonia may be treated with anticonvulsant drugs such as phenytoin or carbamazepine, which may stop the abnormal impulses and prevent the symptoms from reoccurring. [rarediseases.org]
When Isaac was a boy, God tested Abraham's faith by ordering him to sacrifice his son, though an angel prevented the act at the last moment. Isaac went on to become the father of Esau and Jacob with his wife Rebecca. [behindthename.com]
This is a rare but preventable and treatable condition, so keep high index of suspicion to make early diagnosis so that appropriate preventive and therapeutic measures with immune modulators and membrane stabilizers can be applied. References 1. [annalsofneurosciences.org]
National Asthma Education and Prevention. Program Expert Panel Report 3: Guidelines for the Diagnosis and Management of Asthma Full Report 2007. J Allergy Clin Immunol. 2007;120(5 Suppl):S94-S138. [ Links ] 23. [scielo.org.mx]