Hyperexcitability is a condition or state of being unusually or excessively excitable involving most or all the reflexes. It is an excessive reaction to stimuli and is said to be a neurological disorder.
Diseases that cause Hyper-excitability
Peripheral nerve hyperexcitability (PNH) is any disorders associated with twitching spasms, spontaneous muscular activities, facial tics etc. It is a generalised term that is used to cover a wide range of disorders that shows the signs and symptoms of continuous involuntary muscle activity. Variety of names has been used to describe these symptoms. Some of these descriptive terms include neuromyotonia (NMT), benign fasciculation syndrome, cramp fasciculation syndrome, benign cramp fasciculation syndrome, Isaac’s syndrome, continuous muscle fibre activity, continuous motor nerve discharges, and undulating or generalised myokymia.
• Neuromyotonia also known as Isaac syndrome is a form of PNH that causes continuous muscle activity characterized by muscle twitching at rest, cramps and impaired muscle relaxation.
• Benign Fasciculation Syndrome another neurological disorder characterized by twitching of any voluntary muscle group but is most common in the eyelids, arms, legs and feet. Even the tongue may be affected in some cases.
• Cramp Fasciculation Syndrome, a rare peripheral nerve hyperexcitability disorder that is more severe than benign fasciculation syndrome. The disorder causes cramps, fasciculations, fatigue, muscle pain and stiffness similar to that of neuromyotonia
Symptoms and Treatments of Peripheral Nerve Hyper-excitability
The primary symptoms caused by PNH is involuntary muscle fibre activity such as twitches, cramp and cramp like feelings together with muscular aches and pains, soreness and discomfort. Some people may also experience sleep disturbance and fatigue. Excessive sweating is also observed in some patients.
The first line of treatment for peripheral nerve hyperexcitability is by the use of drugs that are anticonvulsants. This kind of drug is used in the treatment of epilepsy. It has been reported that Phenytoin and Carbamazepine drugs are successful in reducing the symptoms. Other drugs that may be prescribed are Lamotrigine or Gabapentin. Each medication acts in a different way therefore; a combination can be more beneficial to the patient.
Painkillers and or Diazepam can also be effective for relieving pain for a short time if pain is the symptom. But these drugs are not for a long term solution due to their addictive qualities.
Other forms of treatment for patients with PNH include the use of plasma exchange and steroids. Plasma exchange can show reduction in the symptoms that the patient is suffering from and this can be observed in a number of weeks. On the other hand, plasma exchange can only be used in case where the signs and symptoms are weakening. This treatment may provide short-term relief for patients.
It is said that plasma exchange causes an inhibition with the function of the voltage-dependent potassium channels, one of the basic outcome of hyper-excitability.
Coping with PNH
When diagnosed with any of the above mentioned hyperexcitability disorders, can be frustrating. The twitches and spasms, aches and pains may also cause other mental illness. The inability to talk to someone who can relate to what the patient is going through may lead to other illnesses such as depression and anxiety. If you show signs of hyper-excitability in your family, it is a must that you discuss the problem as soon as possible and seek a professional’s help.
PNH may be a life-long condition. Once you are diagnosed with this kind of disorder, the challenge is accepting and getting used to it.
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