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背景:特发性肌肉颤搐在临床表现及肌电图方面均具有独特性,但临床上比较罕见,人们对其认识不足,容易误诊。目的:探讨特发性肌肉颤搐的临床特征、诊断与治疗。设计:以诊断为依据的回顾性研究。地点和对象:2000-01/2003-12解放军总医院的门诊及住院患者7例,男3例。女4例;发病年龄26～58岁,平均年龄36岁。方法:对7例特发性肌肉颤搐诊疗过程进行回顾性分析。主要观察指标:临床表现、肌电图资料、实验室检查、治疗与预后结果。结果:7例均有典型的波动性和虫蠕状肌肉颤搐。全部病例的肌肉颤搐均出现在双侧腓肠肌,5例还出现在双上肢,2例在面部、腰背部及腹部。肌肉颤搐活动后可加重,在睡眠时仍持续存在。虫蠕状波动在肌肉松弛状态时更易观察。5例肌电图提示有肌肉颤搐放电,但2例肌电图表现正常。卡马西平或苯妥英钠治疗有明显效果。结论:特发性肌肉颤搐具有特殊的临床表现,且有较好的治疗效果。
Background: Idiopathic muscle twitching is unique in both clinical manifestations and electromyography, but it is rare in clinic. People do not know enough about it and are easily misdiagnosed. Objective: To investigate the clinical features, diagnosis and treatment of idiopathic muscle twitching. Design: A retrospective study based on diagnosis. Place and subject: Outpatient and inpatient 7 cases of PLA General Hospital from January 2000 to December 2003, 3 males. 4 females; age of onset of 26 to 58 years, mean age 36 years. Methods: A retrospective analysis of 7 cases of idiopathic muscle twitch diagnosis and treatment process. MAIN OUTCOME MEASURES: Clinical manifestations, EMG data, laboratory tests, treatment and prognostic outcomes. Results: All the 7 patients had typical fluctuation and vermicular muscle twitch. Muscle twitching occurred in both gastrocnemius muscles in all cases, in 5 of the upper extremities and in 2 of the face, lower back and abdomen. Muscle twitching activity can be aggravated, still persist in sleep. Vibrating worms are more easily observed when the muscles are relaxed. Five cases of EMG suggest muscle twitch discharge, but two cases of normal EMG performance. Carbamazepine or phenytoin treatment has a significant effect. Conclusion: Idiopathic muscle twitch has a special clinical manifestations, and has a good therapeutic effect.