- Section 1 Patients and their treatment
- Section 2 Background to medicine
- Section 3 Cell biology
- Section 4 Immunological mechanisms
- Section 5 Principles of clinical oncology
- Section 6 Old age medicine
- Section 7 Pain and palliative care
- Section 8 Infectious diseases
- Section 9 Sexually transmitted diseases
- Section 10 Environmental medicine, occupational medicine, and poisoning
- Section 11 Nutrition
- Section 12 Metabolic disorders
- Section 13 Endocrine disorders
- Section 14 Medical disorders in pregnancy
- Section 15 Gastroenterological disorders
- Section 16 Cardiovascular disorders
- Section 17 Critical care medicine
- Section 18 Respiratory disorders
- Section 19 Rheumatological disorders
- Section 20 Disorders of the skeleton
- Section 21 Disorders of the kidney and urinary tract
- Section 22 Haematological disorders
- Section 23 Disorders of the skin
- Section 24 Neurological disorders
- 24.1 Introduction and approach to the patient with neurological disease
- 24.2 Mind and brain: Building bridges between neurology, psychiatry, and psychology
- 24.3 Clinical investigation of neurological disease
- 24.4 Higher cerebral function
- 24.5 Epilepsy and disorders of consciousness
- 24.6 Disorders of the special senses
- 24.7 Disorders of movement
- 24.8 Headache
- 24.9 Brainstem syndromes
- 24.10 Specific conditions affecting the central nervous system
- 24.11 Infections of the central nervous system
- 24.12 Disorders of cranial nerves
- 24.13 Disorders of the spinal cord
- 24.14 Diseases of the autonomic nervous system
- 24.15 The motor neuron diseases
- 24.16 Diseases of the peripheral nerves
- 24.17 Inherited neurodegenerative diseases
- 24.18 Disorders of the neuromuscular junction
- 24.19 Disorders of muscle
- 24.19.1 Structure and function of muscle
- 24.19.2 Muscular dystrophy
- 24.19.3 Myotonia
- 24.19.4 Metabolic and endocrine disorders
- 24.19.5 Mitochondrial disease
- 24.20 Developmental abnormalities of the central nervous system
- 24.21 Acquired metabolic disorders and the nervous system
- 24.22 Neurological complications of systemic disease
- 24.23 Paraneoplastic neurological syndromes
- 24.24 Autoimmune encephalitis and Morvan’s syndrome
- Section 25 Disorders of the eye
- Section 26 Psychiatric and drug-related disorders
- Section 27 Forensic medicine
- Section 28 Sport and exercise medicine
- Section 29 Biochemistry in medicine
- Section 30 Acute medicine
Myotonia
- Chapter:
- Myotonia
- Author(s):
David Hilton-Jones
- DOI:
- 10.1093/med/9780198746690.003.0610
Myotonia is defined at an electrical level as repetitive discharge of the muscle fibre membrane after initial activation, which occurs due to dysfunction of the membrane’s ion channels, most commonly the chloride channel, less commonly the sodium channel. This manifests clinically as stiffness of the muscle and delayed relaxation after voluntary contraction (e.g. difficulty relaxing the grip after clenching the fingers, and stiffness in the thigh muscles and difficulty walking on first moving after rest). Disabling myotonia may respond to carbamazepine, phenytoin or, often most effectively, mexiletine, although supplies are now limited. This chapter takes a closer look at the condition, its symptoms, presentations, diagnosis, and treatment.
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- Section 1 Patients and their treatment
- Section 2 Background to medicine
- Section 3 Cell biology
- Section 4 Immunological mechanisms
- Section 5 Principles of clinical oncology
- Section 6 Old age medicine
- Section 7 Pain and palliative care
- Section 8 Infectious diseases
- Section 9 Sexually transmitted diseases
- Section 10 Environmental medicine, occupational medicine, and poisoning
- Section 11 Nutrition
- Section 12 Metabolic disorders
- Section 13 Endocrine disorders
- Section 14 Medical disorders in pregnancy
- Section 15 Gastroenterological disorders
- Section 16 Cardiovascular disorders
- Section 17 Critical care medicine
- Section 18 Respiratory disorders
- Section 19 Rheumatological disorders
- Section 20 Disorders of the skeleton
- Section 21 Disorders of the kidney and urinary tract
- Section 22 Haematological disorders
- Section 23 Disorders of the skin
- Section 24 Neurological disorders
- 24.1 Introduction and approach to the patient with neurological disease
- 24.2 Mind and brain: Building bridges between neurology, psychiatry, and psychology
- 24.3 Clinical investigation of neurological disease
- 24.4 Higher cerebral function
- 24.5 Epilepsy and disorders of consciousness
- 24.6 Disorders of the special senses
- 24.7 Disorders of movement
- 24.8 Headache
- 24.9 Brainstem syndromes
- 24.10 Specific conditions affecting the central nervous system
- 24.11 Infections of the central nervous system
- 24.12 Disorders of cranial nerves
- 24.13 Disorders of the spinal cord
- 24.14 Diseases of the autonomic nervous system
- 24.15 The motor neuron diseases
- 24.16 Diseases of the peripheral nerves
- 24.17 Inherited neurodegenerative diseases
- 24.18 Disorders of the neuromuscular junction
- 24.19 Disorders of muscle
- 24.19.1 Structure and function of muscle
- 24.19.2 Muscular dystrophy
- 24.19.3 Myotonia
- 24.19.4 Metabolic and endocrine disorders
- 24.19.5 Mitochondrial disease
- 24.20 Developmental abnormalities of the central nervous system
- 24.21 Acquired metabolic disorders and the nervous system
- 24.22 Neurological complications of systemic disease
- 24.23 Paraneoplastic neurological syndromes
- 24.24 Autoimmune encephalitis and Morvan’s syndrome
- Section 25 Disorders of the eye
- Section 26 Psychiatric and drug-related disorders
- Section 27 Forensic medicine
- Section 28 Sport and exercise medicine
- Section 29 Biochemistry in medicine
- Section 30 Acute medicine