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Marcondes C. França Jr, MD; Anelyssa D’Abreu, MD; Anamarli Nucci, MD, PhD; Iscia Lopes-Cendes, MD, PhD

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In reply

We are very pleased with the comments raised by Kanai and Kuwabara regarding our study. Our findings in the series of Brazilian patients with MJD indeed confirm previous results reported by Kanai et al,¹ indicating that muscle cramps are a frequent and disabling manifestation of the disease.

We failed to identify significant clinical and neurophysiological differences between patients with and without cramps in our study. However, cramps were mostly found in patients of clinical subtype 1. In addition, H-reflex and F-wave studies suggested increased excitability of the motor neuron pool in patients with cramps. These results led us to consider the possibility that pyramidal dysfunction might cause abnormal modulation of motor neuron excitability and thus might play an important role in the origin of cramps. However, it is important to point out . . . [Full Text of this Article]

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RELATED LETTER

Motor Nerve Hyperexcitability and Muscle Cramps in Machado-Joseph Disease
Kazuaki Kanai and Satoshi Kuwabara
Arch Neurol. 2009;66(1):139.
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