Neuromyotonia is a rare nerve disorder causing uncontrollable muscle activity, with symptoms including muscle contractions, stiffness, and poor reflexes. Causes include autoimmune disease, exposure to toxic substances, and genetics. Diagnosis is difficult, but electromyography and blood tests can help. Anticonvulsant drugs are the most common treatment.
Neuromyotonia is a rare type of nerve disorder that causes excessive, uncontrollable muscle activity. Symptoms can include frequent muscle contractions, stiffness, cramps, and poor reflexes. Most people with this condition have problems with their arms and legs, although other muscle groups in the torso, neck, or head may also be affected. Research into the causes of neuromyotonia is limited because it is such a rare discovery and doctors have not yet discovered a reliable cure for the disorder. Most patients are able to experience long-term symptom relief with antiepileptic drugs.
Abnormal functioning of nerves can have many different causes. Most cases of chronic neuromyotonia appear to be related to an autoimmune disease in which the protective sheaths around nerve cells become inflamed and damaged. Environmental factors such as exposure to toxic substances and heavy metals can cause sudden symptoms of neuromyotonia. Cancer patients with lymphomas or lung tumors have a higher risk of developing symptoms, although the connection between some cancers and nerve cell damage isn’t well understood. Finally, a small number of people who develop neuromyotonia have family histories of the disease, suggesting that genetic factors may be involved.
Symptoms develop when nerve cells fire faster than normal, causing muscles to twitch and contract. Muscles in the legs, arms, or other parts may spontaneously twitch, tremble, or become very stiff. People with neuromyotonia often feel weak and fatigued and may have difficulty engaging in certain physical activities that require a large amount of motion and fine muscle control. If the face is affected, a person may have occasional or constant difficulty speaking, chewing food, and swallowing. Additional health problems may also exist, depending on the underlying cause.
Neuromyotonia can be difficult to diagnose due to its rarity. Patients who have muscle tremors are usually scheduled for a series of tests to determine the severity of their problems and look for possible causes. Electromyography, a painless test that involves placing electrodes on different parts of the body, can be extremely useful in identifying and quantifying nerve abnormalities. Blood samples are also taken to check for unusual toxins and antibodies that can suggest an autoimmune condition. In addition, computed tomography scans are useful for cancer screening and for measuring the extent of nerve sheath inflammation.
The most common treatment for mild to moderate neuromyotonia is a daily regimen of anticonvulsant drugs such as carbamazepine. Such drugs depress the activity of the nervous system and allow the muscles to relax. Patients with severe symptoms and known autoimmune involvement may be candidates for blood plasma transfusions. Other treatment options may include botulinum toxin injections into particularly active muscles and physical therapy to help patients remain mobile despite their disabilities.
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