Neuromuscular consequences of prolonged hunger strike: an electrophysiological study

Objectives: The purpose of this study was to determine the electrophysiolog ical consequences of neuromuscular and central nervous system involvement i n a group of patients presented with the neurological complications of a lo ng-term hunger strike (HS). Methods: Motor and sensory nerve conduction (NCV), F wave, somatosensory ev oked potential (SEP) and motor evoked potential (MEP) studies were performe d in 12 male and 3 female patients (mean age: 29.4) following HS. Results: All patients whose weight loss was 11-31 (mean: 22.8) kg after 69- day HS, had neurological findings consistent with Wernicke's encephalopathy or Wernicke-Korsakoff syndrome. Abnormally prolonged latency and/or low am plitude sensory nerve action potentials were found in 7 patients. The ampli tudes of compound muscle action potentials were significantly reduced in ul nar, median and tibial motor NCV studies as compared to the controls. F wav es elicited by median nerve stimulation at wrist and muscle responses evoke d by cervical and lumbar magnetic stimulation had significantly prolonged l atencies. MEPs recorded from the lower extremities showed a slight prolonga tion in central conduction times. The cortical response latencies were prol onged in tibial SEPs. Conclusions: The most prominent finding in this patient group was the low a mplitude of CMAPs elicited in motor NCV studies which was Concluded to be r esulted from the reversible muscular changes. The other electrophysiologica l findings suggested that peripheral nerves and long central nervous system pathways were also mildly involved. (C) 2000 Elsevier Science Ireland Ltd. All rights reserved.