Sudden cramps and pain in both lower extremities after drinking too much alcohol

Introduction Alcoholic toxic myopathy is characterized by sudden onset of paralysis and pain, fatigue, edema and tenderness in both lower extremities. Alcoholic toxic myopathy refers to a muscle lesion caused by alcoholism that is unknown in pathogenesis, also known as alcoholic myopathy. Clinically, it is divided into acute type and chronic type, and the severity is related to the amount of drinking. Acute alcoholic myopathy is mostly caused by long-term alcoholics after a large amount of alcohol consumption. Acute myopathy is a disease that is serious and life-threatening. Chronic alcoholism in patients who have been drinking alcohol for a long time is more acute after an excessive drinking.

Cause

(1) Causes of the disease

Patients with this disease have a long history of heavy drinking, and alcoholic myopathy is closely related to alcohol toxicity, but its pathogenesis is still unclear.

(two) pathogenesis

Its pathogenesis is unclear, and speculation may be related to the following factors:

1. Alcohol and acetaldehyde reduce the activity of glycolytic enzymes and inhibit the metabolism of sugars.

2. Alcohol and metabolite acetaldehyde has toxic effects on muscle cells, causing toxic damage to sarcolemma and mitochondria, mitochondrial dysfunction, or blocking actin and myoglobin kinases, preventing troponin binding; Cell structure, affecting cell trafficking, leading to muscle cell damage.

3. Reduce free fatty acids in the main oxidized matrix of skeletal muscle.

4. Metabolic abnormalities such as hypokalemia, hyponatremia, hypophosphatemia, hypocalcemia, and hypomagnesemia, as well as vitamin B deficiency, cause secondary damage to the muscles.

5. Patients with alcoholism who have seizures, tremors, convulsions and high fever can increase physical activity and muscle cell metabolism, leading to muscle cell damage; seizures and limb compression can induce rhabdomyolysis.

The pathological manifestations of chronic myopathy are type II fiber atrophy and muscle fiber size; acute myopathy is muscle necrosis, with or without inflammation, muscle fiber regeneration, and type I fiber atrophy.

an examination

Laboratory examination

(1) Creatine kinase (CK): Elevation is a specific indicator of muscle damage sensitivity.

(2) Blood test: including blood biochemistry, kidney function, liver function, coagulation function and immunoglobulin.

(3) Determination of blood and urine alcohol concentration: The significance of the diagnosis and the degree of alcoholism.

2. Auxiliary inspection

(1) Electrocardiogram, electroencephalogram, brain CT or MRI examination: There is a differential diagnosis and the significance of the degree of poisoning assessment.

(2) Electromyography, neurophysiological examination: differential diagnosis.

Differential diagnosis

Differential diagnosis of sudden onset of paralysis and pain in both lower extremities after excessive drinking:

1, endocrine myopathy: endocrine myopathy (endocrinemyopathy) including thyroid myopathy, corticosteroid polymyopathy adrenal insufficiency, parathyroid and pituitary myopathy.

2. Inflammatory peripheral neuropathy: vasculitic peripheral neuropathy refers to an infarction or ischemic lesion of one or more nerves caused by inflammatory occlusion of the nourishing vasculature of the peripheral nerve.

3, toxic myopathy: toxic myopathy refers to the non-specific muscle disease caused by rhabdomyotoxicity when certain chemical substances are poisoned and the non-therapeutic effect of drugs or certain drugs, which is severely characterized by rhabdomyolysis (RMB). ), that is, the whole body or local striated muscles have horizontal striated disappearance, degeneration, varying degrees of sarcoplasmic lysis, and a group of clinical features characterized by muscle weakness, pain, swelling, increased muscle enzymes, electrolyte imbalance and myoglobinuria Syndrome. The toxic myopathy referred to herein is also a non-traumatic rhabdomyolysis sign caused by immunity, infectivity, and strenuous activity.

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