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]

triamterene ( Dyrenium, present in Dyazide and Maxzide ), spironolactone ( Aldactone, present in Aldactazide ) and eplerenone ( Inspra ). 3) Thiazide-like diuretics: chlorthalidone and hydrochlorothiazide. 4) Other meds that pose a small risk: furosemide [goodrx.com]

[…] is not a typical paraneoplastic presentation of neuroblastoma. [pediatrics.aappublications.org]

[…] 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]

Previous presentations: Presented as a short communication at the 9th Annual Conference of the French College of General Medicine; March 2015; Paris, France; and as a short communication at the 21st Wonca Europe Conference; June 15-18, 2016; Copenhagen [annfammed.org]

• Nocturnal Leg Cramp

  […] has proven to treat nocturnal leg cramps. [winchesterhospital.org]

  Outcome measures Participants recorded the frequency of nocturnal leg cramps in a daily diary. Participants also recorded the severity of the pain associated with nocturnal leg cramps on a 10-cm visual analogue scale. [sciencedirect.com]

  Health Nocturnal Leg Cramps: Night-time Calf Muscle Pain Nocturnal leg cramps can lead to a rude awakening: You’re suddenly sleepless and in pain in the middle of the night. [dummies.com]

  Leg Cramps at Night Menu What are nocturnal leg cramps? Nocturnal leg cramps are pains that occur in the legs during the night. They usually cause awakenings from sleep, but they may also occur while awake at night during periods of inactivity. [my.clevelandclinic.org]

• Third Trimester Pregnancy

  Pregnant women are also prone to cramps, especially in the second and third trimesters. Pregnancy-related cramps also usually happen at night and affect the calf muscles. What causes cramps? Most leg cramps have no known cause and are not serious. [mydr.com.au]

• Nausea

  The patient should be monitored closely during the early stages for adverse effects (eg, tinnitus, hearing impairment, vertigo, headache, nausea, vomiting, diarrhoea, visual disturbances) as well as for benefits of treatment. [pharmaceutical-journal.com]

  One patient on quinine experienced nausea, myalgia, leucopenia and thrombocytopenia that resolved three days after quinine discontinuation. A small number of patients reported minor adverse effects with quinine. [bandolier.org.uk]

  Other adverse effects of quinine include headache, nausea, disturbed vision, chest pain, asthma and ringing of ears. In pregnant women, it can cause miscarriages and birth defects. [pchrd.dost.gov.ph]

  They can also cause headache, nausea, ringing in the ears, disturbed vision, chest pain and asthma. [sleepdisordersguide.com]

  Complications that can arise with therapeutic doses of quinine include ‘cinchonism’—a constellation of symptoms including nausea, vomiting, headache, vertigo, visual disturbances and tinnitus and hearing impairment. [academic.oup.com]

• Vomiting

  Finally, pregnant women, dieters, people taking diuretics, (medications that increase the amount of urine you produce) and people who’ve experienced a bout with vomiting and diarrhea may also experience leg cramps because their calcium and phosphorus [dummies.com]

  Factors that can contribute to dehydration or electrolyte or body fluid imbalances (eg, vomiting, diarrhea, excessive exercise and sweating, recent dialysis, diuretic use, pregnancy) are recorded. [merckmanuals.com]

  The patient should be monitored closely during the early stages for adverse effects (eg, tinnitus, hearing impairment, vertigo, headache, nausea, vomiting, diarrhoea, visual disturbances) as well as for benefits of treatment. [pharmaceutical-journal.com]

  Warning People that are pregnant, taking diuretic medications or suffering from diarrhea or vomiting can experience night leg cramping due to low phosphorus and calcium levels. [livestrong.com]

• Abdominal Pain

  However, adverse events may include: tinnitus impaired hearing headache *nausea disturbed vision confusion flushing abdominal pain. Treatment should be stopped if these occur. [gov.uk]

  The painful muscle contractions occur during the time in bed, although they may arise from either wakefulness or sleep. The pain is relieved by forceful stretching of the affected muscles, thus releasing the contraction. [academic.oup.com]

• Vascular Disease

  Examination findings may indicate a potential underlying medical cause, such as peripheral vascular disease. [aafp.org]

  Comorbidities were categorized in five domains: Heart and vascular diseases: coronary artery disease, peripheral vascular disease, hypertension, varicose veins, ankle oedema, vascular occlusive disease and leg claudication. [ncbi.nlm.nih.gov]

  Physical examination is usually normal though a potential underlying medical cause such as peripheral vascular disease may be suggested. [medcaretips.com]

• Venous Insufficiency

  Venous insufficiency is also linked to leg cramps, but research has not demonstrated that cramps are caused by tissue hypoxia or toxic metabolites, and treatment of venous insufficiency has not been shown to relieve cramps.15 Pregnancy historically has [aafp.org]

  insufficiency (when the veins don’t pump the blood back up to the heart, due to leaky valves) Pregnancy Medication side effects (certain anti-inflammatories, inhalers, osteoporosis treatments, a few antidepressants, clonazepam, other sleep aids, chemotherapy [quickanddirtytips.com]

  insufficiency Clinical Presentation Painful cramps in the night are main symptoms. [medcaretips.com]

• Muscle Cramp

  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]

  What causes muscle cramps? The cause of muscle cramps isn't always known. Muscle cramps may be brought on by many conditions or activities, such as: Exercising, injury, or overuse of muscles. Pregnancy. [healthlinkbc.ca]

  Selection criteria Inclusion criteria included randomised clinical trials, or observational studies reflecting NLC, muscle cramp, leg cramp, or rest cramp. [ncbi.nlm.nih.gov]

  A muscle cramp (charley horse) is a sudden, brief, involuntary, painful contraction of a muscle or group of muscles. [merckmanuals.com]

• Restless Legs Syndrome

  Nocturnal leg cramps Periodic limb movements Restless legs syndrome Cite this Apa Standard Harvard Vancouver BIBTEX RIS @article{df7e7423b53e480184a0d4de76fd2990, title = "Restless legs syndrome and nocturnal leg cramps: A review and guide to diagnosis [mayoclinic.pure.elsevier.com]

  Are nocturnal leg cramps the same as restless legs syndrome? No. While both types of leg disturbances tend to happen at night, or at rest, restless leg syndrome does not cause pain or cramping. [my.clevelandclinic.org]

  Restless leg syndrome (RLS) is a different condition. RLS is generally not painful, whereas leg cramps are. Preventing nocturnal leg cramps Research suggests that regular physical activity can help decrease the risks of cramping during the night. [abellahealth.com]

  Restless legs syndrome/Willis-Ekbom disease diagnostic criteria: updated International Restless Legs Syndrome Study Group (IRLSSG) consensus criteria--history, rationale, description, and significance. [ncbi.nlm.nih.gov]

• 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]

  […] signs of myopathy, that were presumably due to the consumption of alcoholic beverages.20,41 Cramps are one of the symptoms of alcoholic myopathy and is characterized histologically by selective atrophy of type II fibers.40,42 We hypothesize that, since [annfammed.org]

  With a normal CK, I think the major myopathies are less likely. [pediatrics.aappublications.org]

  "Statin-induced apoptosis and skeletal myopathy". Am. J. Physiol., Cell Physiol. 291 (6): C1208–12. doi:10.1152/ajpcell.00226.2006. PMID 16885396. S2CID 13313618. ^ Lamperti C, Naini AB, Lucchini V, et al. (2005). [en.wikipedia.org]

• Myalgia

  Corked Thigh Fatigue-related Myalgia DOMS - Delayed Onset Muscle Soreness Cramps RSI - Repetitive Strain Injury Piriformis Syndrome Systemic Causes of Myalgia Fibromyalgia Rheumatoid Arthritis More Information: Myalgia Muscle Strain (Muscle Pain) FAQs [physioworks.com.au]

  Weakness, myalgias, disorders of movement, and imbalance. In: Harrison TR, Braunwald E, et al., eds. Harrison's Principles of Internal Medicine. 15th ed. New York, NY: McGraw-Hill; 2001:120. 5. Sontag SJ, Wanner JN. [aafp.org]

  One patient on quinine experienced nausea, myalgia, leucopenia and thrombocytopenia that resolved three days after quinine discontinuation. A small number of patients reported minor adverse effects with quinine. [bandolier.org.uk]

  Differential Diagnoses Exercise-associated muscle cramping Hypnic myoclonus Myositis, myalgias Periodic limb movement disorder Peripheral neuropathy Restless legs syndrome Investigations There is no investigation specific to nocturnal leg cramps. [medcaretips.com]

• 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]

  Demographics, medical history, sleep disturbances, and cardiometabolic risk factors were evaluated using the 2005–2006 dataset. [journals.plos.org]

  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]

  Leg cramps at night are defined as spasmodic, painful, involuntary, contraction of skeletal muscle that occur during the night when a person is sleeping, causing sleep disturbances. [physiotherapy-treatment.com]

• Myoclonus

  Differential Diagnoses Exercise-associated muscle cramping Hypnic myoclonus Myositis, myalgias Periodic limb movement disorder Peripheral neuropathy Restless legs syndrome Investigations There is no investigation specific to nocturnal leg cramps. [medcaretips.com]

  Nocturnal myoclonus is a sudden, involuntary contraction of the calf muscles that occurs during the night, or while at rest. These cramps can affect persons in any age group, but they tend to occur more often in middle-aged and older populations. [fultonmassagetherapy.com]

  Hypnic myoclonus is a sudden jerk that often occurs at the onset of sleep. Periodic limb movement disorder is a nonpainful, repetitive, rhythmic, slow dorsiflexion of the toes, knees, and hips during sleep. [aafp.org]

  These include simple muscle strain, restless legs, nocturnal myoclonus and ischemia. Leg cramps are associated with many medications. Some of these are very prevalent. For example diuretics, statins, steroids and others. [angiologist.com]

• 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]

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]

In this article, we review the epidemiology, pathophysiology, and risk factors and discuss the salient features of the diagnosis and workup. [link.springer.com]

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]

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. [stjosepheureka.myhospitalwebsite.com]

We reviewed the medical literature to provide a comprehensive assessment of RLS and NLC with a focus on improved diagnostic accuracy and treatment approaches. [mayoclinic.pure.elsevier.com]

Outlook / Prognosis Can leg cramps be cured? Leg cramps don’t have a cure at this time. [my.clevelandclinic.org]

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]

Source: iStock What is the prognosis of recurrent muscle cramps? Although cramps can be a great nuisance, they are a benign condition. [medicinenet.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]

In practice, physicians often have very little to offer in terms of either a clear explanation of the etiology or treatment options. [ahcmedia.com]

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]

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]

The STrengthening the Reporting of OBservational studies in Epidemiology (STROBE) statement was used to guide the reporting of the study. The study was approved by the Ethics Committee of the Mulhouse Hospital. [annfammed.org]

Clinical epidemiology of nocturnal leg cramps in male veterans. Am J Med Sci1997;313:210–4. ↵ Mackie MA, Davidson J. Prescribing of quinine and cramp inducing drugs in general practice. BMJ1995;311:1541. ↵ Fowler AW. Relief of cramps. [pmj.bmj.com]

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 The pathophysiology of muscle cramps is still uncertain. [pmj.bmj.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]

[…] diphenhydramine hydrochloride (benadryl hydrochloride®), 50 mg. at bedtime, with complete prevention of his [jamanetwork.com]

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]

Can leg cramps be prevented? Certain exercises might help you to prevent cramps. [pregnancybirthbaby.org.au]

Is there anything I can do to stop or prevent them?  — Martin L., Manila A. [pchrd.dost.gov.ph]