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November 1981

Muscle Cramps After Gastrectomy

Author Affiliations

Department of Neurology Institute of Brain Research Faculty of Medicine University of Tokyo 7-3-1, Hongo, Bunkyo-ku Tokyo, 113, Japan

Arch Neurol. 1981;38(11):737. doi:10.1001/archneur.1981.00510110097022

To the Editor.—  In the past two years, we have seen four patients with muscle cramps after each patient underwent a subtotal gastrectomy.Our patients' ages ranged from 43 to 64 years. Painful exertional muscle cramps began from four to six years after each patient underwent a subtotal gastrectomy for a peptic ulcer. All of the patients were men. Cramps involved the upper and lower extremities in every case, as well as the abdominal wall in two cases. Cramps were sustained for several minutes with visible and palpable contraction of muscles (Figure, A). Electromyographically, irregular bursts of muscle action potentials were recorded from the affected muscle (Figure, B). Reflexes were hyperactive in three patients. Fasciculations and mild muscle atrophy were noted in two patients. In one patient, the cramps were induced by repetitive tapping of the muscle tendon, as well as by strong voluntary contractions. In another patient, manual muscle