Irradiating muscle fasciculations

kkollins at pop3.concentric.net kkollins at pop3.concentric.net
Thu Nov 26 22:50:07 EST 1998


You give the +* info, and it points right to Researchers who study "Sleep"...
specifically, those who study the waking-consciousness/sleeping-consciousness
transition, and those who study stuff like Sleep-Walking and Sleep-Talking.
During the waking-consciousness/sleeping-consciousness transition, the
musculature becomes relatively-inhibited... so folks don't have to deal with
effector-activation during REM-Sleep.

Your Patient's difficulties stem, certainly, from stuff that the above
Researchers have the best-"grasp" of. She has a deficit in either the
Neuroanatomy, or the Neurophysiology, which governs the
waking-consciousness/sleeping-consciousness transition. Seek out the above
folks, even if only through correspondence, and ask them, also, to refer you to
Neuropharmacologists that have a waking-consciousness/sleeping-consciousness
transition bent.

It might be that your Patient can serve the whole field that I've referred to,
above, because her symptoms are a relatively-well-refined subset of the overall
waking-consciousness/sleeping-consciousness transition problem. If that's the
case, the above Researchers might have keen interest, and that'd, possibly, be
a very-good thing for your Patient. ken collins

Richard Hall wrote:

> I recently made the acquaintance of a woman, age 44, who suffers prolonged
> episodes of painful fasciculations.   Contractions begin in the calf and
> over a period of minutes irradiate up the leg causing intense tetanic
> contractions.  The attacks are usually asymmetrical (usually the left side,
> sometimes the right, and occasionaly both).  I observed one attack and the
> increasing frequency of contration of the gastrocnemius was palpable.  The
> muscle groups involved seem to include the hamstrings and the tensor fascia
> lata and possibly the gluteus.  The episode lasted for over 18 hours and in
> subsequence conversations over the past three weeks she reports several
> incidents lasting days.  The attacks typically begin in the evening as she
> falls asleep.  She is also very sensitive to light touch which makes her
> ill at ease, possibly nauseous, and may trigger attacks.
>
> She is bright, trim, athletic, well muscled, and normally very active.  Her
> left side was traumatized in a boating accident possibly twenty years ago.
> I am not clear on this but her mother was apparently abusive, possibly
> physically as early as age 6.  About 18 years ago she joined AA after 14
> years of intense alcohol abuse.  The attacks began about 8-10 years ago and
> have been at times unrelenting.  She states that Valium (5 mg) alleviates
> the symptoms completely but sets off an addictive cycle that she
> desparately wishes to avoid.  Consequently, she has been into massage,
> accupuncture, diet therapies, and nothing seems to work.  I have suggested
> she return to the states for medical attention, but she has no insurance
> and chooses to live in the British Virgin Islands where a physician will
> prescribe muscle relaxants which help but do not provide total or reliable
> relief.  The fatigue and pain seem not to have eroded her clarity of
> thought but she is emotionally all over the place.  Most likely because she
> fears sleep and never knows when the next attack will occur.
>
> It is my hope that some sound ideas on the pathogenesis of this condition
> will persuade her to seek qualified medical assistance.
>
> rlh
>
> Richard Hall
> Comparative Animal Physiologist
> Division of Sciences and Mathematics
> University of the Virgin Islands
> St. Thomas, USVI  00802
>
> 809-693-1386
> rhall at uvi.edu






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