[Syndrome of painful muscle fasciculations. Case report and differential diagnostic review]

Abstract

The case of a patient with spontaneous painful muscular activity is described. We diagnosed the muscular pain fasciculation syndrome. Biopsy of the sural nerve and electrophysiological examination provided evidence of the neurogenic nature of the disturbance showing a remarkable axonal degeneration. In addition, when immunohistochemical studies were performed, the detection of immunoglobulins and complement components suggested an immunological process in the etiology of the disease. The patient made a good response to carbamazepine therapy. This effect is found in various syndromes of abnormal continuous muscle activity. Clinical, neurophysiological and morphological features of this case are discussed in relation of pathogenesis, possible drug effects and related diseases.