In two subjects with paramyotonia congenita the isometric torque generated by the abductor digiti minimi and the surface EMG recorded over ADM decreased during prolonged or repetitive contractions, whether these were voluntarily or electrically induced. Isometric twitch times did not alter significantly during this muscle fatigue. Cooling greatly accelerated the fatiguing process. It is suggested that this local muscle weakness is due to a progressive decrease in excitability of the muscle cell membrane.
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