Abstract Details

Title Neurotonia/Myokymia in Ulnar Nerve Innervated Muscles and Response to Onabotulinumtoxin A

Topic Clinical Neurophysiology

Presentation(s) P02 - (-)

Poster/Presentation
Number 230

Objective

Background BACKGROUND: Neurotonia / impulse induced neurotonia and myokymia generates from the peripheral nerve. Cramp and muscle contraction is usually the presentation of this type of electrophysiologic findings.

Design/Methods DESIGN/METHODS: Two men (62 yr, 45 yr) presented with contraction of ulnar nerve innervated muscles. In each EMG and nerve conduction studies are performed . These include conduction studies of the ulnar / median nerves and needle EMG of the arm / forearm and hand muscles. Neurotonia / myokymia noted in ulnar nerve innervated muscles and treated with antiepieptic drugs (gabapentin / carbamezapine / phenytoin / pregabalin) and subsequently treated with EMG guided Botx injection in the finger flexors of the fourth and fifth digits.

Results RESULTS: Clinical examination revealed flexor contraction of the 4th and 5 th digit on the effected side. The EMG/NCV studies revealed normal conduction parameters of the median and ulnar nerves, but presence of neurotonia, impulse induced neurotonia and myokymia in the long flexors of the 4th and 5th digits (ulnar nerve innervated) were noted. Treatment with antiepileptic drugs (gabapentin / carbamezapine / phenytoin pregabalin) was ineffective. Subsequent injection treatment with BotxA (EMG guided) in the targeted muscles (upto 150 units). Adequate response with BotxA was noted with improvement of symptoms and EMG findings.

Conclusions CONCLUSIONS: BotxA can be used in symtomatic neurotonia / myokymia secondary to defective accomodation of peripheral intramuscular nerve with good response and eventual recovery of the clinical / EMG findings.

Authors/Disclosures
Jitendra K. Baruah, MD PRESENTER	No disclosure on file
	No disclosure on file
	No disclosure on file

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