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Clinical Reasoning: A 39-year-old man with abdominal cramps

Lookup NU author(s): Dr Stephan Jaiser, Professor Mark BakerORCiD, Professor Roger Whittaker, Dr Daniel Birchall, Professor Patrick Chinnery



This is the final published version of an article that has been published in its final definitive form by Lippincott Williams & Wilkins, 2013.

For re-use rights please refer to the publisher's terms and conditions.


A 39-year-old lawyer presented with intermittent spasms and pain in his abdominal muscles, particularly the right upper quadrant. These had occurred since his mid-20s and there had been long asymptomatic periods, including 8 years prior to the most recent 4-month exacerbation. Trivial movement triggered a spasm of the abdominal muscles, leading to severe pain, which made breathing uncomfortable and interfered with sleep. The symptoms subsided spontaneously after 4 to 5 days, leaving him with a sore abdomen for several weeks. Past attacks had also been precipitated by specific forms of repetitive exercise such as jogging. He described ill-defined numbness in the left leg, but denied any muscle twitching, weakness, back pain, or sphincter disturbance. There was no significant past medical or family history.

Publication metadata

Author(s): Jaiser SR, Baker MR, Whittaker RG, Birchall D, Chinnery PF

Publication type: Article

Publication status: Published

Journal: Neurology

Year: 2013

Volume: 81

Issue: 2

Pages: e5-e9

Print publication date: 09/07/2013

Date deposited: 22/04/2016

ISSN (print): 0028-3878

ISSN (electronic): 1526-632X

Publisher: Lippincott Williams & Wilkins


DOI: 10.1212/WNL.0b013e31829a335e

PubMed id: 23836948


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Funder referenceFunder name
096919Wellcome Trust
101876Wellcome Trust
MR/K000608/1Medical Research Council