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Calcium and myokymia of brainstem origin

Department of Neurology, West Virginia University School of Medicine, Morgantown, WV.

In five patients with Guillain-Barré syndrome, clinical myokymia increased and myokymic burst amplification occurred when ionized Ca⁺⁺ was lowered by hyperventilation. Myokymia decreased when ionized Ca⁺⁺ was increased after IV infusion of CaCl₂. These responses were absent or diminished in the four patients with myokymia due to brainstem lesions, suggesting that the blood-brain barrier impedes the effects of altered serum ionized Ca⁺⁺ on axonal excitability. Altering serum Ca⁺⁺ can distinguish peripheral and central myokymia.

Address correspondence and reprint requests to Dr. Gutmann, Department of Neurology, West Virginia University Medical Center, Morgantown, WV 26506.

Presented in part at the thirty-seventh annual meeting of the American Academy of Neurology. Dallas, TX. April 1985.

Accepted for publication April 30, 1985.