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Clinical, Electromyographical, and Ultrastructural Observations

FORBES H. NORRIS, JR., MD; BERNARD J. FANNER, MD

Arch Neurol. 1966;14(6):574-589.

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THE FIRST report of muscular changes in hypothyroidism was Kocher's¹ account of muscular enlargement, weakness, and slow movements in a young cretin. Many authors, however, credit Debré and Semelaigne,² who renewed interest in this childhood syndrome and cured one of their cases with thyroid. In the meantime, Hoffmann³ described an adult with enlarged muscles, weakness, slow movements, and delayed relaxation. He differentiated the abnormal relaxation from myotonia by its failure to improve after several contractions, as occurs in myotonia, a distinction not confirmed until after clinical application of electro-myography 39 years later.⁴ Hoffmann³ also reported a cure with thyroid. Later authors described numerous cases in myxedematous adults who also had painful muscle spasms and muscle percussion reactions similar to myotonia. Electromyography, however, demonstrated electrical silence in most cases during the myotonic-like manifestations, hence the descriptive terms pseudomyotonia and myotonoid reaction.^5,6

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Author Affiliations
ROCHESTER, NY

From the Division of Neurology, Department of Medicine, and the Department of Pathology, University of Rochester, Rochester, NY.

Footnotes
Submitted for publication Dec 10, 1965; accepted Feb 4, 1966.

Read before the 90th Annual Meeting of the American Neurological Association, Atlantic City, NJ, June 16, 1965.

Reprint requests to Department of Pathology, University of Rochester Medical Center, Rochester, NY 14620 (Dr. Panner) or Institute of Medical Sciences, Presbyterian Medical Center, San Francisco 94115 (Dr. Norris).

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