Calcium effect on generation and amplification of myokymic discharges

Maneuvers designed to manipulate ionized calcium (Ca++) were carried out in two patients with inflammatory polyradiculoneuropathy and myokymia. Increased clinical myokymia and myokymic burst amplification occurred when ionized Ca++ was lowered by plasma exchange or hyperventilation. Increasing ionized Ca++ (by intravenous infusion of CaCl2) decreased the myokymia. These findings indicate that myokymic discharges are altered by changes in serum ionized Ca++ and effects on axonal excitability.