Use of Clinical and Electrical Myotonia to Differentiate Childhood Myopathies

J Child Neurol. 2015 Sep;30(10):1300-6. doi: 10.1177/0883073814559646. Epub 2015 Jan 30.

Abstract

We retrospectively reviewed 2030 childhood electromyograms performed over an 11-year period (2004-2014). Twenty children (1%) with myotonic discharges were identified and placed into 2 groups. Group A (electrical and clinical myotonia) comprised 9 children (8 with myotonia congenita and 1 with paramyotonia congenita); all of them had diffuse myotonic discharges without clinical weakness or elevated creatine kinase. Group B (electrical myotonia without clinical myotonia) comprised 11 children (4 with inflammatory myopathy; 3, congenital myopathy, 3, muscular dystrophy; and 1, congenital muscular dystrophy). Clinical weakness was demonstrated in all of them and elevated creatine kinase in 6; all had a myopathic electromyogram and scattered myotonic discharges. We conclude that myotonic discharges are a rare but characteristic spontaneous discharge identified during electrodiagnostic studies in children. The presence of electrical and clinical myotonia provides helpful clues to differentiate between various muscle disorders in children.

Keywords: children; electromyography; muscle disorders; myotonia; myotonic discharges.

MeSH terms

  • Adolescent
  • Child
  • Child, Preschool
  • Creatine Kinase / metabolism
  • Diagnosis, Differential
  • Electromyography
  • Female
  • Humans
  • Male
  • Muscle, Skeletal / physiopathology
  • Muscular Diseases / diagnosis*
  • Muscular Diseases / physiopathology*
  • Myotonia / diagnosis
  • Myotonia / physiopathology*
  • Neural Conduction
  • Retrospective Studies

Substances

  • Creatine Kinase