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Updated: Mar 20, 2026

Assessment of Neuromuscular Function Using Percutaneous Electrical Nerve Stimulation
Published on: September 13, 2015
Therapeutic Implications of Peripheral Nerve Hyperexcitability in Muscle Cramping: A Retrospective Review
Rebecca L Hurst1, Lisa D Hobson-Webb
1*Neuromuscular Division, Department of Neurology, University of South Florida, Tampa, Florida, U.S.A.; and †Neuromuscular Division, Department of Neurology, Duke University, Durham, North Carolina, U.S.A.
Purpose:
Muscle cramping due to peripheral nerve hyperexcitability (PNH) is poorly characterized. This retrospective study examines the prevalence of PNH and response to treatment.
Methods:
The Duke EMG Database was queried to identify patients with muscle cramping tested for PNH from 2010 to 2015. Peripheral nerve hyperexcitability was defined by compound muscle action potential after-discharges on repetitive nerve stimulation. Response to treatment was determined by the treating physician's clinical impression 6 months after diagnosis or last documented visit.
Results:
Seventy-two patients met inclusion criteria. Twenty-three (32%) patients had electrodiagnostic evidence of PNH. Of the patients with PNH, 74% had a good response to treatment whereas 37% of treated patients in the PNH-negative group (P = 0.0258). Carbamazepine and gabapentin were the most frequently used treatments with response rates of 70% and 77%, respectively.
Conclusion:
Muscle cramps associated with PNH respond well to symptomatic treatment, particularly with carbamazepine and gabapentin.
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