A 35-year-old male patient presented with symptoms of a cramp-fascicul
ation syndrome, but also reported difficulties swallowing. Esophageal
manometry showed spontaneous nonperistaltic contractions, pathological
ly increased amplitudes and duration of the contractile complexes, and
an asynchronous propagation. Electromyographic evidence of fasciculat
ions in the sternocleidomastoid and pectoralis muscles was found. Appa
rently all types of peripheral motor fibers can be involved in this he
terogeneous syndrome, including cranial motor nerves, the vagal nerve,
and enteric motor fibers of the gastrointestinal tract. (C) 1998 John
Wiley & Sons, Inc.