Hello everyone. This is my first time on this site, my brother told me about it. Myself, my brother and sister all have myotonia, Beckets type. We have never experienced any serious events from this condition, just the muscle stiffness and inability to run on command :-) However, I am now pregnant, with twins, and was wondering if anyone out there has myotonia and has had children. Just curious about increased manifestations during pregnancy. I went to a high risk doctor, and he told us that pregnancy can exacerbate symptoms of myotonia, but that there was no cases of mytonia with twin pregnancy...apparently I'm the first...I hope not though. If anyone has any thoughts, or personal experiences I would appreciate it.

Thank you,
Mary

Type of Myotonia: Beckets

Country: United States

Welcome, Mary!

If you go to the search box above and type in "pregnancy" you'll see lots of posts related to pregnancy and childbirth with MC.

The high levels of hormones related to pregnancy often increase symptoms of myotonia. For some women that's the only time they experience severe stiffness.

Having MC doesn't put you at any higher risk for complications except for anesthesia. Since you are more likely to have a C-section with twins, it's a good idea to meet with your hospital/birth center's anesthesia team in advance to be sure you go over everything. Epidurals are fine and so are locals without epinephrine. But general anesthesia can trigger a malignant hyperthemia-type reaction that they should be aware of. I'll paste in the anesthesia protocol below.

Jan


Change tubing and filter medium if inhalation anesthesia is to be used. Evacuate air in operating theater for at least 10 minutes. There are mixed reports about reactions to halothane compounds with myotonia congenita.

Succinylcholine is contraindicated. Vecuronium seems to be the safest muscle paralyzing agent.

Reverse the paralyzing agent carefully (no atropine). Patients with myotonia congenita tend to have lower levels of cholinesterase.

Keep patient warm during surgery to avoid triggering a shivering response. Some teams warm the operating table and IV fluids and keep warm blankets on patient.

Monitor potassium levels throughout surgery. Patients with myotonia congenita are susceptible to cardiac arrest. Do not give IV solution containing potassium unless testing confirms abnormally low levels.

Avoid glucose IVs during surgery. Heightened insulin response can increase myotonia because of potassium shift.

Monitor phosphorus levels and watch for hypophosphatemia during and after surgery.Use sodium phosphate for repletion, not potassium phosphate.

Avoid local anesthetics containing epinephrine.

Avoid pain medications that can cause hyperkalemia (i.e. NSAIDs, especially indomethacin).

Type of Myotonia: Thomsen's

Country: USA

Hi Mary,
My myotonia is fairly mild with stiffness aggravated by the cold, but when I was pregnant with my 2 kids the only thing I noticed was that the stiffness after sitting was worse and I just had to give myself a few minutes when standing to get my legs working. It was more a nuisance than anything. I had my kids without any surgery or epideral so I cannot comment on use of anesthesia.

Type of Myotonia: TBD-Probably Thomsen

Country: USA