Postgastrectomy Muscle Cramps: A Syndrome or Coincidence?

Abstract

To the Editor.— Painful muscle cramps may occur under a variety of conditions, such as during pregnancy, after dehydration and salt depletion, in hypothyroidism, thyrotoxic myopathy, uremia, and hypomagnesemia. 1 The mechanism of muscle cramps in these conditions may not be the same. In the past two years we have seen five patients who underwent gastrectomy with postoperative muscle cramps. Their ages ranged from 40 to 64 years. Four were men and one a woman. Painful exertional muscle cramps in them began mostly from four to six years after subtotal gastrectomy for a peptic ulcer. On neurological examination deep tendon reflexes of the extremities were mostly hyperactive, and two patients exhibited scattered fasciculations. Mild muscle atrophy was noted in two cases. In one subject muscle cramps were induced by repetitive tapping of the muscle tendon as well as by strong voluntary contractions. In another patient manual muscle testing during neurological