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Kazuaki Kanai, MD, PhD; Satoshi Kuwabara, MD, PhD

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

We read the article by França et al¹ with great interest. We thank them for confirming our previous results regarding the high frequency of and disability associated with muscle cramps² in a larger sample of patients with Machado-Joseph disease (MJD). We would like to raise some concerns regarding the authors' interpretation of the findings.

First, França and colleagues proposed that altered excitatory inputs from the corticospinal fibers rather than the peripheral motor axonal changes might be responsible for muscle cramps in MJD. Muscle cramps and fasciculations arise from spontaneous motor unit activities frequently associated with lower motor neuron disorders, and ectopic firing usually originates from the distal motor axons, especially the intramuscular nerve terminals.³ We have shown that muscle cramp severity correlates with an increased index of peripheral axonal excitability, suggesting that cramps in MJD are associated with underlying peripheral axonal loss . . . [Full Text of this Article]

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RELATED ARTICLE

Muscle Excitability Abnormalities in Machado-Joseph Disease
Marcondes C. França, Jr, Anelyssa D’Abreu, Anamarli Nucci, and Iscia Lopes-Cendes
Arch Neurol. 2008;65(4):525-529.
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RELATED LETTER

Motor Nerve Hyperexcitability and Muscle Cramps in Machado-Joseph Disease—Reply
Marcondes C. França, Jr, Anelyssa D’Abreu, Anamarli Nucci, and Iscia Lopes-Cendes
Arch Neurol. 2009;66(1):139-140.
EXTRACT | FULL TEXT