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James Zisfein, MD; Mark Sivak, MD; Alan M. Aron, MD; Adam N. Bender, MD

Arch Neurol. 1983;40(4):241-242.

Abstract
• A 16-year-old boy was seen for severe episodic muscle cramps and generalized myokymia, consistent with Isaacs's syndrome. Bilateral calf hypertrophy (46-cm calf circumference) and ankle areflexia were noted. He was treated with phenytoin sodium, 300 mg/ day. Within three months there was marked decrease in myokymia, total relief of cramps, return of ankle reflexes, and 6-cm reduction in calf circumference. We suggest that the excess muscle activity in Isaacs's syndrome may be responsible for the associated phenomena of muscle hypertrophy and areflexia.

Author Affiliations
From the Departments of Neurology (Drs Zisfein, Sivak, Aron, and Bender) and Pediatrics (Dr Aron), Mount Sinai Medical Center, New York.

Footnotes
Accepted for publication July 12, 1982.

Reprint requests to Department of Neurology, Mount Sinai Medical Center, 1 Gustave Levy PI, New York, NY 10029 (Dr Bender).

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