Cramps: a sign of motoneurone 'bistability' in a human patient

In a patient suffering from severe long-lasting cramps, cramps were triggered in the triceps surae by volleys in homonymous Ia afferents (elicited by electrical stimulation or by tendon taps) and were interrupted by antidromic invasion and Renshaw inhibition of triceps surae motoneurones (evoked by a single maximal stimulation of motor axons). This result suggests that the mechanisms which generate the cramps are intrinsic to alpha-motoneurone somata. A similar on-off switching of a self-sustained motor discharge has been observed in the decerebrate cat and recognized to depend on 'bistability' of the motoneuronal membrane. We propose that the same mechanism may be at the origin of the cramp discharge.