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April 1976

Myotonia and Chloride

Author Affiliations

School of Pharmacy South Australian Institute of Technology North Terrace, Adelaide, South Australia

Arch Neurol. 1976;33(4):304. doi:10.1001/archneur.1976.00500040088018

To the Editor.—  Dr Barchi's article, "Myotonia: An Evaluation of the Chloride Hypothesis" (Arch Neurol 32:175, 1975), confirms many of the conclusions regarding low membrane chloride conductance that I have previously arrived at, using a similar mathematical model of myotonia.1.2However, I am in disagreement with Dr Barchi regarding the following points.1. He has apparently neglected the important resistive-capacitive pathway of the sarcotubular system in order to simplify his computations. By contrast, my work has illustrated the pronounced effect of small changes in the electrical properties of this system on the pattern of repetitive electrical activity in myotonia.2. Several of Dr Barchi's "suggestions" are difficult to justify. For example, his suggested explanation for the "warm-up" phenomenon must be considered with regard to other workers' opposing views, especially for the effects of altered external potassium ion concentration.3.43. Although Dr Barchi has presented convincing evidence of the