Tag Archives: Muscle Pain

Cramp Facilitation, The Same as Restless Leg Syndrome?

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The patient Restless Leg Syndrome (RLS) experience is a creepy crawly, twitching, involuntary underlying skin movement sensation and also may be associated with aching mostly in the knee down to the foot.  The symptoms can also occur in the arms with a feeling as if you are in a constant state of a flexing sensation.  This experience also induces insomnia for many that experience restless nights because of involuntary muscle movement.  There are now several potential causes identified with restless leg syndrome.  These causes are mostly to do within diet.  And the other causes could be something of concern that could stay undiagnosed for years until a neurological specialist rules out one thing or the other.

Caffeine and low levels of blood glucose have a known cause-effect associated with RLS.   It is recommended if you have RLS like symptoms, to rule out specific causes possibly through diet and that you seek a referral from your primary care physician to see a neurologist.  Until you get this referral try eliminating coffee, tea, sodas and cocoa from the diet.  This will provide some feedback to your neurologist when you get the consult.  By eliminating these potential causes from diet, either RLS symptoms are relieved, not relieved, or in remission.  If symptoms disappear, don’t cancel your neurology appointment.   The remission of symptoms could simply be due to infrequent muscle facilitation caused by something else.  And when you see your neurologist asks the following questions:  Can I also be evaluated for functional “hypoglycemia (low blood sugar),” and/or deficiencies of folic acid, iron or magnesium.

And if the lab results rule out these diet deficiencies, also ask if consideration of vitamin E and L-tryptophan trials would be worthwhile to assist in determining treatment.  It has been proven in clinical trials that vitamin and mineral deficiencies can and do cause hyper excitable muscle sensations (RLS) and that supplementation in clinical studies have proven to remove, or substantially reduce the symptoms associated with RLS.  But it is important to note while anyone can supplement their diet, using proper dosages under a physicians care is very important for the safety and success of such treatment.

Now let’s take a look at RLS syndrome’s close cousin [Cramp Facilitation Syndrome].  Why do I say cousin?  Because there are many close symptomatic similarities that could confuse the necessity to look further into your condition and unknowingly push off identification and treatment of a more severe and insidious disease.

What is cramp facilitation syndrome and how do you know you have it?  It is a rare condition characterized by muscle pain, twitching, cramps, creepy crawly sensations typically felt within the legs and arms.  These symptoms have also been characterized and confused by patients as restless leg syndrome at the onset.

It is also not common knowledge that there is a whole host of diseases that can cause these symptoms.  Other disease pathology mimics less serious diagnosis than others.  For a piece of mind, if you experience any of these symptoms [RLS, or Cramp Facilitation Syndrome] to seek a referral from your primary care physician to see a neurological to rule out other potential serious disease (Parkinson’s, MS, Cancer, etc.).  I recommend being adamant in pursuing this referral if you have RLS like symptoms.

I’ve become very familiar with RLS through commercialization of this conditional diagnosis as seen on infomercials.  But have never heard of “Cramp Facilitation Syndrome, and in some cases known as Isaac’s syndrome.”  These syndromes also mimic [although typically more pronounced and severe symptoms] very similar conditions, I only knew to be RLS.  Cramp Facilitation Syndrome is also medically transcribed and known as Neuromyotonia (NMT).

NMT or Isaac’s syndrome is a form of peripheral nerve hyperexcitabilty and is very rare.  There are no known cures for Isaac’s syndrome.  And from all I’m reading about it and as discussed with a neurologist, there are a lot of unknowns about the origins of these syndromes.  The 3 causes of spontaneous repetitive muscular activity “throughout” the body triggered by muscle fiber action potential with regard to NMT are: 1) Acquired  2) Paraneoplastic  3) Hereditary.

1)      The Acquired is the most common form of NMT and is thought to be caused by antibodies against the neuromuscular junctions; suspected to be an immune deficiency [80% of all cases).  If the immune system suspects foreign bodies at these neuromuscular junctions, they attempt to neutralize the foreign matter.  These antibodies are produced by our white blood cells and promote various antibodies to deal with perceived invasion of our internal body.  By binding to a perceived internal threat our defense mechanisms cause muscle fasciculation to occur.

2)   What is Paraneoplastic cause of muscle fasciculation – The immune or hormonal response from a tumor sends chemical signal to cause an antibody reaction at neuromuscular junctions within muscle cells.  The cause of this action is the presence of cancer in the body; excreted by tumor cells that trigger the body’s hormones or immune system.  And the muscle hyperexcitability can be triggered before a tumor is diagnosed as malignant!  Tumor cells usually present themselves within the lung, breast, ovaries or lymphatic system.

3)   Hereditary – Genetic predisposition to have NMT symptoms with like biological pathogen source passed down through family genes.

In many cases, cramp facilitation syndrome is treatable.  In rare occasions, those with more severe conditions where antibodies work against voltage-gated potassium channels [a chemical action necessary for muscle movement] impact the central nervous system and could be fatal (e.g., Morvan’s Syndrome).  Rest assured RLS and NMT is not fatal [exception: Paraneoplastic cause appears to have statistical probability associated with fatalities].

NMT does mimic other serious disease that could be fatal.  Most NMT cases are autoimmune and not associated with cancer [80 percent of all cases and is suspected to be autoimmune mediated, which is usually caused by antibodies].  For a piece of mind, having the correct diagnosis allows one to seek appropriate and applicable treatment as soon as possible, which also helps to reduce anxiety and mitigate outcome of insidious disease through early diagnosis and proper treatment.

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Marc T. Woodard, MBA, BS Exercise Science, USA Medical Services Officer, CPT, RET. 2011 Copyright, All rights reserved, Mirror Athlete Publishing @: www.mirrorathlete.org,  Sign up for your Free eNewsletter.