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Paramyotonia Congenita

Paramyotonia congenita is an autosomal-dominant myotonic condition with at least two distinct genetic etiologies involving the sodium channel: α subunit (SCN4A) located at chromosome 17q35 and a mus­cle chloride channel (CLCN1) located at chromosome 7q35.

The worsening of the myotonia with exercise is referred to as paradoxical myotonia. Weakness or stiffness may occur together or separately, there is cold and exercise aggravation, hypertrophy of mus­culature, and more severe involvement of hands and muscles of the face and neck. Myotonic episodes usu­ally subside within a matter of hours, but may last days. Some patients become worse with a potassium load. On electrodiagnostic studies, there is a drop in CMAP amplitude with cooling. Dense fibrillations dis­appear below 28 degrees Celsius, myotonic bursts dis­appear below 20 degrees Celsius, and electrical silence may occur below 20 degress Celsius. Treatment has involved mexiletine or tocainide.

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Source: Alexander M.A., Matthews D.J.. Pediatric Rehabilitation: Principles and Practice. 4 th. åd. — New York: Demos Medical Publishing,2010. — 540 ð.. 2010
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