Gold myokymia syndrome

ABSTRACT

Neurological complications of gold therapy appear to be uncommon. The authors report the second of two patients with rheumatoid arthritis seen at the Cleveland Clinic who experienced a particularly rare and largely unknown reaction to gold consisting of myokymia and dysautonomic symptoms (gold myokymia syndrome). Myokymia is a peculiar rhythmic rippling of muscles that must be distinguished from other forms of spontaneous muscle activity. The clinical and electrophysiologic characteristics of this problem, which consistently resolves with cessation of gold administration, are discussed. Because gold therapy remains a prominent modality in the management of rheumatoid arthritis, increased awareness of this adverse reaction is necessary.