Presentation
The diagnosis of these disorders has presented a challenge to health care providers because of symptom overlap with other sensory and mo‑ tor disturbances with nocturnal predominance. [mayoclinic.pure.elsevier.com]
[…] heat Polysomnography (sleep recording) shows: Increased electromyographic (muscle) activity in the affected leg and associated awakening No evidence of any underlying medical disorder that could account for the sensation Other sleep disorders may be present [web.stanford.edu]
Figure 1 presents the selection of the studies through the review process. [bmcfampract.biomedcentral.com]
An elevated HbA1c was also associated with frequent NLC, as were diabetes and fasting glucose (but not insulin), and the former variable was present after overall health was removed from the stepwise regression. [journals.plos.org]
Entire Body System
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Non-Alcoholic Cirrhosis
At rest or at night Cirrhosis, vascular occlusive disease, peripheral neuropathy, diabetes mellitus, severe renal failure and postphlebitic syndrome Baskol 2004 [ 21 ] 6/9 The prevalence of muscle cramps in non-alcoholic cirrhosis patients. [bmcfampract.biomedcentral.com]
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Increased Susceptibility to Infections
Immune function can be affected increasing susceptibility to infection. When you can’t get a good night’s sleep on a regular basis there are even more serious consequences. [peoplespharmacy.com]
Liver, Gall & Pancreas
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Jaundice
[…] leg syndrome or periodic limb movement disorder Numbness, tingling and "electric" pain, with secondary cramps; unrelated to sleep or exercise Peripheral neuropathy Cramps accompanied by metabolic signs or symptoms Kidney failure Cramps accompanied by jaundice [bpac.org.nz]
Eyes
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Blurred Vision
vision, impaired hearing, confusion, headache, abdominal pain, vertigo, dizziness, nausea, vomiting, diarrhoea Severe toxicity Reduced consciousness, seizures, hypoglycaemia, deafness, peripheral visual field constriction, reduced visual acuity, blindness [academic.oup.com]
Musculoskeletal
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Muscle Cramp
Stimulating these TRP channels can stop muscle cramps in their tracks ( Muscle & Nerve, Sept. 2017 ). [peoplespharmacy.com]
As stated in the editorial, I do not believe that the use of quinine for muscle cramps should be banned. I concur with the conclusion of the systematic review with recommendations Dr. [cmaj.ca]
Male 38% Painful involuntary muscle cramps in the legs or feet during rest. It interrupts sleep. [bmcfampract.biomedcentral.com]
N-of-1 trials of quinine efficacy in skeletal muscle cramps of the leg. Br J Gen Pract 2005 ; 55 : 181 – 5. 31. Randomised controlled trial of hydroquinine in muscle cramps. Lancet 1997 ; 349 : 528 – 32. 33. [academic.oup.com]
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Myopathy
These include: Pregnancy Alcoholism Dehydration /electrolyte imbalances Parkinson’s disease Neuromuscular disorders ( neuropathy, myopathy, motor neuron disease) Structural disorders ( flat feet ) Endocrine disorders ( diabetes, hypothyroidism ) Diuretics [my.clevelandclinic.org]
"Statin-induced apoptosis and skeletal myopathy". Am. J. Physiol., Cell Physiol. 291 (6): C1208–12. doi : 10.1152/ajpcell.00226.2006. PMID 16885396. Lamperti C, Naini AB, Lucchini V, et al. (2005). [en.wikipedia.org]
With a normal CK, I think the major myopathies are less likely. [pediatrics.aappublications.org]
Finally, and more seriously, leg cramps may be linked to neurological disorders, including muscle disease (myopathies), nerve disease (neuropathies), motor neuron disease (ALS), and Parkinson’s disease, says Dr. Jaffee. [menshealth.com]
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Hip Pain
Do you ever have severe headaches, back pain, or joint or hip pain? If so, claim your FREE copy, right now, of our special guide on proven, effective pain relief. [universityhealthnews.com]
Neurologic
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Sleep Disturbance
NLC is characterized by abrupt muscle contraction, most often in the gastrocnemius or foot muscles, which occurs at night and may result in significant sleep disturbances. [mayoclinic.pure.elsevier.com]
This sleep-wake disorder is a frequent cause of sleep disturbance. Nocturnal leg cramps may delay sleep onset, wake the sleeper up, and delay the patient’s ability to fall back asleep, all of which results in lower sleep efficiency. [tuck.com]
Demographics, medical history, sleep disturbances, and cardiometabolic risk factors were evaluated using the 2005–2006 dataset. [journals.plos.org]
Article First Online: 09 January 2010 Abstract Nocturnal leg cramps are a frequent cause of sleep disturbance among the general population, especially among the elderly. [link.springer.com]
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Involuntary Movements
Restless leg syndrome in particular can cause leg discomfort and involuntary movements. People with blockages in the arteries of the legs also might have pain and cramping, though these occur with movement rather than at rest in bed. [eu.detroitnews.com]
Often the trigger is the involuntary movement of the foot downward from the ankle (plantarflexion). There is no easy way to avoid this from happening. [chicagohealthonline.com]
I should also point out that whenever involuntary muscle contraction is seen, the first step is to distinguish neuromuscular involuntary muscle contraction from involuntary movement disorders of the central nervous system (eg, chorea, myoclonic jerks, [pediatrics.aappublications.org]
Long-term treatment with levodopa can also lead to drug-induced dyskinesia, a condition characterized by exaggerated involuntary movements or uncontrolled muscle contractions. [mountsinai.org]
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Reduced Consciousness
consciousness, seizures, hypoglycaemia, deafness, peripheral visual field constriction, reduced visual acuity, blindness, cardiac arrhythmias Drug interactions Increased quinine toxicity with concurrent use of potent CYP3A4 inhibitors including azole [academic.oup.com]
Workup
In this article, we review the epidemiology, pathophysiology, and risk factors and discuss the salient features of the diagnosis and workup. [link.springer.com]
The SEAHAWKS had an incredibly busy and arduous year as workups began Latarian milton 2017 Before stopping Marseilles the SEAHAWKS hosted French EC Hawkeyes day of carrier launch and recovery operations. [anitaussie.net]
A basic laboratory workup should include sodium, potassium, calcium, magnesium, glucose, renal function, creatine phosphokinase (CPK) and thyroid function tests. [angiologist.com]
While the team was discussing the need for additional diagnostic workup, additional laboratory results returned. [pediatrics.aappublications.org]
Diagnosing Iron Deficiency Anemia and Its Causes Because of the high association between RLS and iron deficiency, a test for low iron stores should be part of the diagnostic workup in RLS. [mountsinai.org]
EEG
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Rhythmic Slowing
Periodic limb movement disorder is a nonpainful, repetitive, rhythmic, slow dorsiflexion of the toes, knees, and hips during sleep. The movements last for seconds and recur at intervals of seconds to about one minute. [aafp.org]
Treatment
Patients should be monitored closely during the early stages of treatment for adverse effects. After an initial trial of 4 weeks, treatment should be stopped if there is no benefit. [gov.uk]
Is there an effective treatment? Unfortunately, treatment options are limited, but lifestyle modifications and gentle stretching may have some effect. Pharmacological treatment may be considered for people with frequent, severe leg cramps. [bpac.org.nz]
Treatment should be interrupted at intervals of approximately three months in order to assess the need for further quinine treatment. [pharmaceutical-journal.com]
The treatment period was, however, only 2 weeks in most of the trials. Table 2. [academic.oup.com]
Treatment Talk with your doctor about the best plan for you. This may include treatment for any underlying causes of the nocturnal leg cramps. [cancercarewny.com]
Prognosis
Source: iStock What is the prognosis of recurrent muscle cramps? Although cramps can be a great nuisance, they are a benign condition. [medicinenet.com]
Her prognosis is guarded: Children with high-risk neuroblastoma treated with surgery, intensive induction chemotherapy, radiation, and bone marrow transplant have a 2-year event-free survival of 50%. [pediatrics.aappublications.org]
Etiology
In practice, physicians often have very little to offer in terms of either a clear explanation of the etiology or treatment options. [ahcmedia.com]
Leg cramps (charley horses) are a common nocturnal symptom that can be difficult to manage because of uncertainties about etiology, appropriate diagnostic evaluation, and optimal treatment. [aafp.org]
Potential medication etiologies include inhaled long-acting beta-agonists, statins, and diuretics[ 9 ]. Existing prevalence data suggest that 37–50% of older adults have such leg cramps[ 4, 5, 10 ]. [journals.plos.org]
Epidemiology
In this article, we review the epidemiology, pathophysiology, and risk factors and discuss the salient features of the diagnosis and workup. [link.springer.com]
Design Cross-sectional epidemiology. Participants National Health and Nutrition Examination Survey, 2005–2006 and 2007–2008 waves. [journals.plos.org]
Clinical epidemiology of nocturnal leg cramps in male veterans. Am J Med Sci 1997 ; 313 : 210 –4. Mackie MA, Davidson J. Prescribing of quinine and cramp inducing drugs in general practice. BMJ 1995 ; 311 : 1541. Fowler AW. Relief of cramps. [pmj.bmj.com]
Pathophysiology
Treatment options and approaches are lacking, partially because of our currently incomplete understanding of the pathophysiological mechanisms underlying these conditions. [mayoclinic.pure.elsevier.com]
In this article, we review the epidemiology, pathophysiology, and risk factors and discuss the salient features of the diagnosis and workup. [link.springer.com]
Pathophysiology and Causes of Nocturnal Leg Cramps The exact mechanism of leg cramps is not known. It is suggested that lower motor neurons with hyperactive, high-frequency, involuntary nerve discharge are responsible for these cramps. [medcaretips.com]
PATHOPHYSIOLOGY The pathophysiology of muscle cramps is still uncertain. [pmj.bmj.com]
Prevention
Drinking enough water daily (8 glasses) may help prevent dehydration. [alaskaveinclinic.com]
Posture of the legs when resting in bed: positions which prevent the calf muscle from shortening when you are asleep may help. [psmgroup.com.au]
[…] diphenhydramine hydrochloride (benadryl hydrochloride ), 50 mg. at bedtime, with complete prevention of his [jamanetwork.com]
How to prevent nocturnal leg cramps recurring in the future There are ways to help prevent leg cramps from recurring in the future; some of the more common ways are: Exercise/stretch daily – you should always stretch pre and post-workout to prevent any [ergoflex.co.uk]
Preventive Steps You should begin now to increase the calcium consumption, to alleviate leg cramps and prevent the long-term problems associated with calcium deficiency. [sleepdisordersguide.com]