Muskelzuckungen und Muskelkrämpfe – Differenzialdiagnosen und elektrophysiologische Diagnostik

Muskelzuckungen und -krämpfe sind Beschwerden, die vom harmlosen Symptom bis hin zu Symptomen einer schwerwiegenden neurologischen Erkrankung reichen können. Eine ausführliche Anamnese, gründliche neurologische Untersuchung und elektrophysiologische Untersuchungen ermöglichen die Unterscheidung der verschiedenen Ätiologien. In diesem Artikel werden verschiedene Ursachen unter Berücksichtigung deren Definition, der elektrophysiologisch zugrunde liegenden Phänomene und deren differenzialdiagnostischer Einordnung dargestellt.

Muscle jerks and muscle cramps are common and can range from harmless symptoms to symptoms that may indicate a serious neurological disease, e. g. amyotrophic lateral sclerosis (ALS). A detailed medical history, a careful examination including electrophysiological measurements usually differentiates between the various etiologies. In this article, various causes are named and differential diagnoses with corresponding electrophysiological phenomena are classified.

Abstract

Muscle jerks and muscle cramps are common and can range from harmless symptoms to symptoms that may indicate a serious neurological disease, e.g. amyotrophic lateral sclerosis (ALS). A detailed medical history, a careful examination including electrophysiological measurements usually differentiates between the various etiologies. In this article, various causes are named and differential diagnoses with corresponding electrophysiological phenomena are classified.

Muskelkrämpfe - Spasmen - Muskelzuckungen - Elektromyografie

muscle cramps - spasm - electromyography

Publication History

Article published online:
14 March 2023

• Literatur

• 1 Miller TM, Layzer RB. Muscle cramps. Muscle Nerve 2005; 32: 431-442 DOI: 10.1002/mus.20341.
• 2 Parisi L, Pierelli F, Amabile G. et al. Muscular cramps: proposals for a new classification. Acta Neurol Scand 2003; 107: 176-186 DOI: 10.1034/j.1600-0404.2003.01289.x.
• 3 Butler JV, Mulkerrin EC, O’Keeffe ST. Nocturnal leg cramps in older people. Postgrad Med J 2002; 78: 596-598 DOI: 10.1136/pmj.78.924.596.
• 4 Zierz S. Muskelerkrankungen. 4. Aufl.. Stuttgart: Thieme; 2014
• 5 Schwellnus MP, Drew N, Collins M. Muscle cramping in athletes – risk factors, clinical assessment, and management. Clin Sports Med 2008; 27: 183-194 ix–x DOI: 10.1016/j.csm.2007.09.006.
• 6 Duyff RF, van den Bosch J, Laman DM. et al. Neuromuscular findings in thyroid dysfunction: a prospective clinical and electrodiagnostic study. J Neurol Neurosurg Psychiatry 2000; 68: 750-755 DOI: 10.1136/jnnp.68.6.750.
• 7 Maeda SS, Fortes EM, Oliveira UM. et al. Hypoparathyroidism and pseudohypoparathyroidism. Arq Bras Endocrinol Metabol 2006; 50: 664-673 DOI: 10.1590/s0004-27302006000400012.
• 8 Mehta SS, Fallon MB. Muscle Cramps in Cirrhosis: A Moving Target. Clin Gastroenterol Hepatol 2015; 13: 1544-1546 DOI: 10.1016/j.cgh.2015.02.033.
• 9 Garrison SR, Dormuth CR, Morrow RL. et al. Nocturnal leg cramps and prescription use that precedes them: a sequence symmetry analysis. Arch Intern Med 2012; 172: 120-126 DOI: 10.1001/archinternmed.2011.1029.
• 10 Dressler D, Bhidayasiri R, Bohlega S. et al. Defining spasticity: a new approach considering current movement disorders terminology and botulinum toxin therapy. J Neurol 2018; 265: 856-862 DOI: 10.1007/s00415-018-8759-1.
• 11 Dengler R, de Carvalho M, Shahrizaila N. et al. AANEM – IFCN glossary of terms in neuromuscular electrodiagnostic medicine and ultrasound. Clin Neurophysiol 2020; 131: 1662-1663 DOI: 10.1016/j.clinph.2020.03.014.
• 12 Huang CY, Wang CH, Hwang IS. Characterization of the mechanical and neural components of spastic hypertonia with modified H reflex. J Electromyogr Kinesiol 2006; 16: 384-391 DOI: 10.1016/j.jelekin.2005.09.001.
• 13 Naumann M, Reiners K. Long-latency reflexes of hand muscles in idiopathic focal dystonia and their modification by botulinum toxin. Brain 1997; 120: 409-416 DOI: 10.1093/brain/120.3.409.
• 14 Almas T, Niaz MA, Zaidi SMJ. et al. The Spectrum of Clinical Characteristics and Complications of Tetanus: A Retrospective Cross-Sectional Study From a Developing Nation. Cureus 2021; 13: e15484 DOI: 10.7759/cureus.15484.
• 15 Ricker K, Eyrich K, Zwirner R. Seltenere Formen von Tetanuserkrankung. Klinische und elektromyographische Untersuchung. Arch Psychiatr Nervenkr (1970) 1971; 215: 75-91 DOI: 10.1007/BF00342824.
• 16 Shahani M, Dastur FD, Dastoor DH. et al. Neuropathy in tetanus. J Neurol Sci 1979; 43: 173-182 DOI: 10.1016/0022-510x(79)90113-8.
• 17 Balint B, Meinck HM. Pragmatic Treatment of Stiff Person Spectrum Disorders. Mov Disord Clin Pract 2018; 5: 394-401 DOI: 10.1002/mdc3.12629.
• 18 Rakocevic G, Floeter MK. Autoimmune stiff person syndrome and related myelopathies: understanding of electrophysiological and immunological processes. Muscle Nerve 2012; 45: 623-634 DOI: 10.1002/mus.23234.
• 19 Liewluck T, Klein CJ, Jones LK. Cramp-fasciculation syndrome in patients with and without neural autoantibodies. Muscle Nerve 2014; 49: 351-356 DOI: 10.1002/mus.23935.
• 20 Hutto SK, Harrison TB. Electrodiagnostic Assessment of Hyperexcitable Nerve Disorders. Neurol Clin 2021; 39: 1083-1096 DOI: 10.1016/j.ncl.2021.06.009.
• 21 Bischoff C, Dengler R. Hrsg. EMG NLG – Elektromyografie, Elektroneurografie. 4. Aufl.. Stuttgart: Thieme; 2018
• 22 Mills KR. Characteristics of fasciculations in amyotrophic lateral sclerosis and the benign fasciculation syndrome. Brain 2010; 133: 3458-3469 DOI: 10.1093/brain/awq290.
• 23 Mitsikostas DD, Karandreas N, Coutsopetras P. et al. Fasciculation potentials in healthy people. Muscle Nerve 1998; 21: 533-535 DOI: 10.1002/(sici)1097-4598(199804)21:4<533::aid-mus14>3.0.co;2-y.
• 24 Orsini M, Sztajnbok FR, Oliveira AB. et al. Benign fasciculations and corticosteroid use: possible association? An update. Neurol Int 2011; 3: e11 DOI: 10.4081/ni.2011.e11.
• 25 Finsterer J, Aliyev R. Fasciculations in human hereditary disease. Acta Neurol Belg 2015; 115: 91-95 DOI: 10.1007/s13760-014-0335-6.
• 26 Duarte ML, Iared W, Oliveira ASB. et al. Ultrasound versus electromyography for the detection of fasciculation in amyotrophic lateral sclerosis: systematic review and meta-analysis. Radiol Bras 2020; 53: 116-121 DOI: 10.1590/0100-3984.2019.0055.
• 27 Liu J, Li Y, Niu J. et al. Fasciculation differences between ALS and non-ALS patients: an ultrasound study. BMC Neurol 2021; 21: 441 DOI: 10.1186/s12883-021-02473-5.
• 28 Nagado T, Arimura K, Sonoda Y. et al. Potassium current suppression in patients with peripheral nerve hyperexcitability. Brain 1999; 122: 2057-2066 DOI: 10.1093/brain/122.11.2057.
• 29 Auger RG. AAEM minimonograph #44: diseases associated with excess motor unit activity. Muscle Nerve 1994; 17: 1250-1263 DOI: 10.1002/mus.880171103.
• 30 Katirji B. Peripheral nerve hyperexcitability. Handb Clin Neurol 2019; 161: 281-290 DOI: 10.1016/B978-0-444-64142-7.00054-0.
• 31 Partanen JV. Ephaptic transmission from type ii afferents to static γ and β efferents causes complex repetitive discharge: An hypothesis. Muscle Nerve 2016; 53: 508-512 DOI: 10.1002/mus.25056.
• 32 Posa A, Niśkiewicz I, Emmer A. et al. Complex Repetitive Discharges: A Sign of Motor Axonal Reinnervation. Brain Sci 2020; 10 DOI: 10.3390/brainsci10060349.