A case of myokymia-cramp syndrome successfully treated with gabapentin

We report a case of "myokymia-cramp syndrome", a rare and benign disease co nsisting of muscular cramps in the upper and lower limbs associated with ge neralized myokymias. In our patient, cramps had been present since adolesce nce and had increased in frequency and duration during the last 3 years, oc curring about 8 or 9 times a day. Cramps were mainly nocturnal and also pre cipitated by walking; a previous treatment with carbamazepine did not impro ve the symptoms. Gabapentin therapy proved to be very satisfactory in relie ving muscular cramps with a relatively low dosage (600 mg/day) and without any remarkable side effects. The possible interpretation of the mechanism i nvolved in gabapentin induced relief of cramps is discussed. Gabapentin sho uld be considered as a safe alternative treatment for muscular cramps.