Bronchial involvement in the cramp-fasciculation syndrome.
OBJECTIVE
Cramp-fasciculation syndrome (CFS) is an acquired, chronic, usually benign and rather heterogeneous condition with isolated fasciculations and muscle cramps generally induced by physical exercise. They commonly involve calf and quadriceps muscles. The pathophysiology of CFS is related to peripheral nerve hyperexcitability, most often located at the motor nerve terminal or intramuscular arborization.


METHODS
A 21-year-old man presented with a progressive syndrome of bronchospasm, cramps and muscle twitches related to physical exercise. Spirography showed bronchial hyperresponsiveness, so he received inhaled corticosteroids and beta2-agonists that improved respiratory symptoms. Electrodiagnostic studies were consistent with CFS. Gabapentin was then introduced.


RESULTS
Both respiratory and muscle symptoms improved. A new spirogram after all inhaled medication had been discontinued was normal.


CONCLUSIONS
This picture suggests a concomitant involvement of the peripheral motor nerves of both skeletal and airway autonomic smooth muscle, a presentation not previously reported in CFS.
de Entrambasaguas
Manuel
M
Department of Clinical Neurophysiology, Hospital General de Castellón, Castellón, Spain. entrambasaguas_man@gva.es
Ortega-Albás
Juan-José
JJ
Martínez-Lozano
María-Dolores
MD
Díaz
José-Ramón
JR
D000280:Administration, Inhalation; D000293:Adolescent; D000328:Adult; D000588:Amines / Q000627:therapeutic use; D018927:Anti-Asthmatic Agents / Q000008:administration & dosage; D001250:Asthma, Exercise-Induced / Q000188:drug therapy / Q000209:etiology*; D003509:Cyclohexanecarboxylic Acids / Q000627:therapeutic use; D018691:Excitatory Amino Acid Antagonists / Q000627:therapeutic use; D000077206:Gabapentin; D006801:Humans; D008297:Male; D009046:Motor Neurons / Q000187:drug effects; D018482:Muscle, Skeletal / Q000294:innervation; D009130:Muscle, Smooth / Q000294:innervation; D009468:Neuromuscular Diseases / Q000150:complications* / Q000188:drug therapy; D005680:gamma-Aminobutyric Acid / Q000627:therapeutic use
D000588:Amines; D018927:Anti-Asthmatic Agents; D003509:Cyclohexanecarboxylic Acids; D018691:Excitatory Amino Acid Antagonists; D005680:gamma-Aminobutyric Acid; D000077206:Gabapentin