Clinical, Electrophysiological, and Serological Evaluation of Patients with Cramp-Fasciculation Syndrome

• Published in: Noro-Psikiyatri Arsivi Vol. 54; no. 2; pp. 183 - 186
• Main Authors: Poyraz, Mürüvvet, Matur, Zeliha, Aysal, Fikret, Tüzün, Erdem, Hanoğlu, Lütfü, Öge, A Emre
• Format: Journal Article
• Language: English
• Published: Turkey AVES 01-06-2017; BAYT Ltd. Co; Turkish Neuropsychiatric Society
• Subjects: Antibodies; Chronic fatigue syndrome; Diagnosis; Dosage and administration; Fasciculation; Health aspects; Immunoglobulins; Laboratories; Muscle pain; Myalgia; Nerves, Peripheral; NMR; Nuclear magnetic resonance; Patients; Proteins; Short Research Report; Studies; Tomography; Viral antibodies; Voltage-gated potassium channels; Cramp-fasciculation syndrome (CFS); neuropathic pain; peripheral nerve hyperexcitability; voltage-gated potassium channel (VGKC)-complex proteins
• ISSN: 1300-0667; 1309-4866
• DOI: 10.5152/npa.2016.14816

Cramp-fasciculation syndrome (CFS) is a rare peripheral nerve hyperexcitability syndrome. There are only a few reports on clinical and serological profile of a CFS cohort that was followed up by a single outpatient clinic.
Clinical, electrophysiological, and serological features of 6 CFS patients (5 men, 1 woman; 27-65 years old) were investigated.
All patients presented with cramps, fasciculations, muscle pain, and autonomic symptoms, and 2 also reported numbness and burning sensation in limbs, suggestive of neuropathic pain. Antibodies to uncharacterized voltage-gated potassium channel (VGKC)-complex proteins were found in 2 patients and to contactin-associated protein-like 2 (CASPR2) in 1 patient. None of the patients had a tumor. Most of the patients revealed prolonged after-discharges following tibial nerve stimulation. Nerve conduction studies and R-R interval variability tests were normal, whereas sympathetic skin responses were increased in amplitude in 3 seronegative patients. Five patients showed favorable response to carbamazepine or pregabalin treatment, whereas 1 VGKC-antibody-positive patient was resistant to carbamazepine and immunosuppressant treatment.
Neuropathic pain and VGKC-complex antibodies may be encountered in CFS patients. Although autonomic symptoms are commonly found in CFS, routine autonomic system tests which are done in electrophysiology laboratories might yield normal results.