To date, we still have to resort to several definitions in order to try to understand what spasmophilia. This term is very controversial because it is not a disease recognized in medical classifications, neither in France, nor internationally. The researchers did not agree; it is possible that the vicious cycle of symptoms or what makes it difficult to pinpoint.

It most often presents three symptoms: fatigue, neurodystonie et anguish.

THEhyperexcitabilité neuromuscular is identified by two signs present in spasmophilia: sign of Chvostek (= involuntary muscle contraction of the upper lip in response to percussion by the doctor’s reflex hammer) and the keychain sign (= contracture of the midwife’s hand).

The electromyogram shows a repetitive electrical hyperactivity of peripheral nerves, characteristic of neuromuscular excitability, not to be confused with discomfort due to hypoglycaemia, with symptoms associated with postural hypotension, with nervous breakdown, or with paroxysmal anxiety attacks. Lowered intracellular magnesium levels are often found with calcium and phosphorus levels normal.

The characteristics of this imbalance are thehypersensitivity environmental dependence, vulnerability to stress and a physiological and psychological instability.

Spasmophilia or tetany attack?

The term “spasmophilia” is widely used by the general public to describe anxiety attacks combining breathing difficulties (feeling of tightness, suffocation, hyperventilation) and muscle tetany. The symptoms of spasmophilia, tetany or even psychogenic hyperventilation can in some cases be similar to those present during panic attacks.

However, the concept of spasmophilia is still rather vague these days. There is little scientific literature on it¹ and there are unfortunately very few epidemiological studies on spasmophilia because, like similar syndromes, the reality of this disease is still in doubt (it is considered to be psychiatric illness). According to the classifications in force (the famous “DSM4“, American classification of mental illnesses), spasmophilia is a pathological form of anxiety. It currently falls into the category of “ panic disorders ”. However, far from being a recent notion, research on spasmophilia already existed at the end of 19^st century.

Who is affected?

Anxiety attacks most often occur in young people (between 15 and 45 years) and they are much more frequent in women than in men. They are said to be more common in developed countries.

Causes of the disease

The mechanisms of spasmophilia probably involve many factors of a biological, psychological, genetic et cardio-respiratory.

According to some theories, this would be a inappropriate or overreaction to stress, anxiety, or anxiety triggering hyperventilation (= acceleration of the respiratory rate) which itself would amplify the hyperventilation reaction until the attack of muscular tetany. Thus, different situations of fear and anxiety (including that of not being able to breathe) can trigger hyperventilation, which can itself cause certain symptoms, and in particular dizziness, numbness of the limbs, tremors and palpitations².

These symptoms in turn worsen the fear and anxiety. It is therefore a vicious circle which is self-sustaining.

This reaction mode is probably very consuming of magnesium and could predispose to a chronic magnesium deficiency intracellular. In addition, our diet increasingly poor in magnesium (due to refining and cooking method) could worsen this deficit.

Genetic fragility associated with recently identified tissue groups (HLA-B35) predispose 18% of the population in industrialized countries to develop spasmophilia.

For medical specialists working on the site www.sommeil-mg.net (general medicine and sleep), a deficit in sleep efficiency is believed to be the cause of spasmophilia:

1. Sleep is judged upon awakening and it seems obvious that that of spasmophiles no longer plays its role, since it is upon awakening that fatigue is most intense;

2. The often present increase in nocturnal diuresis (one gets up several times during the night to urinate) is the consequence of the collapse of an “antidiuretic” system;

3. La neurodystonie is the other consequence of this inefficiency of sleep;

4. Le voluntarist nature of patients (this resistant character allows them to fight for a long time on their own against their disease): “it’s true, I’m tired, but I’m holding on” … until the crisis. As evidenced by the unconditional refusal of any sick leave as soon as the crisis has passed. These personalities are often altruistic and hyperactive. For us, the crisis is the first sign of decompensation of sleep on a ground of functional insufficiency of sleep. The worsening of fatigue may lead to more severe and disabling pictures which will be expressed in a hyperalgesic mode as in fibromyalgia or in an asthenic mode as in the chronic fatigue syndrome (CFS). In practice, the crisis stops as soon as a sedative is powerful enough to “cut off the sound of the alarm”, which makes it possible to affirm that the remarkable effectiveness of benzodiazepines (a family of anxiolytics) in this situation (at a single but sufficient dose) confirms the neurodystonic nature of the malaise and should point to a chronobiological management. In our opinion, each crisis has the value of a decompensated “hyposleep” signal, hence the importance of this treatment.

Course and possible complications

Spasmophilic reactions are often associated with significant drop in quality of life and can lead to very disabling disorders such as afraid to go out, to be in presence of strangers or participate in various social or professional activities (secondary agoraphobia). In some people, the frequency of attacks is very high (several per day), this is called panic disorders. The risk of depression, suicidal thoughts, of suicidal act, ofabuse drug or alcohol use is increased in frequent panic attacks³.

However, with proper management, it is possible to control this anxiety and reduce the frequency of seizures.