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]

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]

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]

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

• Muscle Cramp

  […] cause muscle cramps.[6] Cramp definition is narrower than the definition of muscle spasm: spasms include any involuntary abnormal muscle contractions, while cramps are sustained and painful.[1][8] True cramps can be distinguished from other cramp-like [en.wikipedia.org]

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

  Selection criteria Inclusion criteria included randomised clinical trials, or observational studies reflecting NLC, muscle cramp, leg cramp, or rest cramp. [bmcfampract.biomedcentral.com]

• Myopathy

  "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]

  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]

• 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]

  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]

• 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. [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]

A basic laboratory workup should include sodium, potassium, calcium, magnesium, glucose, renal function, creatine phosphokinase (CPK) and thyroid function tests. [angiologist.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]

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]

In patients with severe symptoms, a trial of 4–6 weeks’ treatment with quinine is probably still justified, but patients should be warned of the risks, and the efficacy of treatment should be monitored. [pmj.bmj.com]

Treatment should be interrupted at intervals of approximately three months in order to assess the need for further quinine treatment. [pharmaceutical-journal.com]

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 No current treatments for leg cramps have been proven both safe and effective. [aafp.org]

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]

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

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]

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]

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]

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]

Treatment options and approaches are lacking, partially because of our currently incomplete understanding of the pathophysiological mechanisms underlying these conditions. [mayoclinic.pure.elsevier.com]

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

Physiological methods may be useful for preventing cramps in some people, but there have been no controlled trials of these approaches. Quinine is moderately effective in preventing nocturnal leg cramps. [pmj.bmj.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]

Drinking enough water daily (8 glasses) may help prevent dehydration. [alaskaveinclinic.com]

[…] 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]