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Spasmofilia

Pembimbing : dr. Bambang


Sp.S

Definition
Spasmophilia or tetanys -pathological
states of the central nervous system and
peripheralnervous system due to
extracellular ionic changes involved in the
function of neurons and peripheral nerves.
Spasmophilia is a condition in which the
motor nerves show abnormal sensitivity to
mechanical or electric stimulation, and the
patient shows a tendency to spasm,
tetany, and convulsions.

Pathophysiology
Ionized calcium is the necessary plasma
fraction for normal physiologic processes.
In the neuromuscular system, ionized
calcium levels facilitate nerve conduction,
muscle contraction, and muscle relaxation
Normocalcemia requires PTH and normal
target-organ response to PTH
PTH stimulates osteoclastic bone
reabsorption and distal tubular calcium
reabsorption and mediates 1,25dihydroxyvitamin D (1,25[OH]2 D)
intestinal calcium absorption.

Pathophysiology
Vitamin D stimulates intestinal absorption of
calcium, regulates PTH release by the chief
cells, and mediates PTH-stimulated bone
reabsorption
A reduction in total serum calcium can result
from a decrease in albumin secondary to liver
disease, nephrotic syndrome, or malnutrition.
Hypocalcemia causes neuromuscular irritability
and tetany.
Alkalemia induces tetany due to a decrease in
ionized calcium, whereas acidemia is
protective.

Manifestasi klinis

Tiredness,
Stiffness and twinges
Muscle cramps
Stomach and intestine complaints and
allergies.
Lower in the system spasms in the gall ducts
result in nausea and tendency to vomit. In
the lower intestinal region, spasmophilia
gives constipation, alternated with diarrhea.

Patients with spasmophilia are difficult "starters" in


the morning, and in the evening they are overactive.
In their hands and feet they feel needle and pin
pricks (like the complaints after pinching off arterial
circulation).
Ticks (eyelids) and tiny muscle twitches are typical
symptoms.
The extremities feel heavy and stiff.
Cramps show up when at rest and ameliorate during
exercise. Also there may be cramps in the belly and
back musculature, which initiate back and neck
pain.

Penatalaksanaan
Underlying it is an imbalance in the mineral
reserve especially of magnesium and calcium.
Also potassium is involved in this imbalance.
Thus magnesium supplementation is a major
part of the therapy, along with calcium and
potassium. Vitamin B6 (100 mg) supports
serotonin metabolism, and the absorption and
the cellular uptake of magnesium.
L-tryptophane (3 grams daily) is indicated in
case of acute stress.

Daftar Pustaka
Schuitemaker G. E. Spasmophilia.
Journal of Orthomolecular Medicine
Vol. 3, No. 3, 1988
Galland Leo. Magnesium, Stress and
Neuropsychiatric Disorders. [Cited
2015 Sept 09]. Available from
http://www.mdheal.org/magnesiu1.ht
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