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Myotonia in colchicine myoneuropathy
S B Rutkove1, U De Girolami, D C Preston
1Department of Neurology, Beth Israel Hospital, Boston, MA 02215, USA.
Muscle & Nerve
|July 1, 1996
Summary
Colchicine can cause myoneuropathy in patients with kidney problems. This study found that colchicine-induced myoneuropathy can present with myotonia, a muscle disorder, which resolves upon medication withdrawal.
Area of Science:
- Neurology
- Toxicology
Background:
- Colchicine is a medication used to treat inflammatory conditions.
- Renal insufficiency is a known risk factor for colchicine toxicity.
- Myotonia, a condition causing muscle stiffness, has not been previously associated with colchicine-induced myoneuropathy.
Observation:
- Four patients with renal insufficiency treated with routine colchicine doses developed severe myoneuropathy.
- Electromyography revealed prominent myotonic discharges in all patients.
- One patient exhibited profound clinical myotonia.
- Muscle biopsies showed marked myopathic changes with intracytoplasmic vacuolization.
Findings:
- Colchicine-induced myoneuropathy can manifest with significant clinical and electrophysiologic myotonia.
- Discontinuation of colchicine led to rapid improvement in all affected patients.
- Electrophysiologic studies confirmed complete resolution of myotonic discharges after medication cessation.
Implications:
- This study expands the understanding of colchicine-induced myoneuropathy by identifying myotonia as a potential feature.
- Clinicians should consider colchicine toxicity in patients with renal insufficiency presenting with myopathy and myotonia.
- Early recognition and withdrawal of colchicine can lead to complete recovery from myoneuropathy and myotonia.