夜间下肢痛性痉挛临床电生理研究

Clinical and electrophysiological study of nocturnal leg cramps

目的探讨夜间下肢痛性痉挛的临床和神经电生理特点。方法回顾性分析2018年1月至2021年12月于西京医院神经内科就诊的以“夜间下肢通性痉挛”为诊断的符合入组标准的患者,对入组的夜间下肢痛性痉挛患者临床资料和神经电生理进行分析,并随访。结果共纳入4例符合夜间下肢痛性痉挛患者,男性2例,女性2例,症状均为单侧下肢夜间突发痛性抽痛,持续15 s至20 min不等,每晚发生0~3次,严重影响睡眠。24 h视频脑电图多导睡眠监测(video electroencephalogram polysomnography,V-EEG-PSG)监测期间共记录到下肢痛性痉挛9次,7次(7/9)发生于非快速眼动期(non-rapid eye movement stage,N)2期,N1期、快动眼睡眠(rapid eye movement,REM)期各发生1次,发作期肌电活动的波幅为30~220μV,持续时间为11~51 s。47次肢动,39次(83.0%)发生于N2期,6次(12.8%)发生于N1期,2次(4.3%)发生于REM期。结论夜间下肢痛性痉挛常累及单侧腓肠肌,易发生于N2期,发作期肌电活动持续至少11 s,波幅在30μV以上,同步脑电图无癫痫样放电。

Objective To describe the electro-clinical features of nocturnal leg cramps(NLC).Methods Our retrospective study included the patients diagnosed with NLC from January 2018 to December 2021 in the Xijing Hospital,Xian,China.The clinical and electrophysiological characteristics were studied and followed up.Results Four patients including two males and two females were recruited.The typical symptoms were sudden unilateral and painful contractions of the calf muscles which lasted 15 seconds to 20 minutes and occurred 0-3 times every night.The patients’sleep was disturbed.A total of 9 nocturnal leg cramps were recorded including seven in the non-rapid eye movement stage2(N2),one in the rapid eye movement(REM)and one in non-rapid eye movement stage(N1),respectively.During the cramps,the amplitudes of surface electromyography was 30-220μV and the duration of it was 11-51s.A total of 47 limb movements were recorded including thirty-nine in N2,six in N1 and two in REM,respectively.Conclusion Nocturnal leg cramps usually occur in the fixed unilateral lower extremity involving the gastrocnemius muscle.The ictal PSG showed that cramps usually occurred during N2,the amplitudes and the duration of surface electromyography was 30μV and 11s at least,respectively,and awake without epileptic discharge was monitored.