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]

• Pain

  Get Your Pain Relief Guide Are you or a loved one suffering from constant 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]

  pain, sleep disruption and distress. [ncbi.nlm.nih.gov]

  The muscle remains in a cramped and contracted position, which accounts for the intensity of the pain. [olympichottub.com]

  This painful tightening of the muscle can last from a few seconds to several minutes. [bpac.org.nz]

  I also take action at the least hint of an impending cramp, any tiny pain or twinge so I can head off a painful wakening in the night. “With all this, I usually avoid most cramps. Recently, though, I had cramps threaten every night for over a week. [peoplespharmacy.com]

• Fatigue

  The exact mechanism is unknown, but the cramps are probably caused by muscle fatigue and nerve dysfunction rather than electrolyte or other abnormalities. [aafp.org]

  Changes in circulation and nerves (muscle fatigue) – this is usually through exercise; ignoring the signs when fatigue starts to show after prolonged exercise can cause the muscle to cramp as the energy levels in that muscle have decreased greatly. [ergoflex.co.uk]

  Often, it’s simply muscle fatigue or nerve issues. Peripheral artery disease (PAD) is one problem that can be behind nocturnal leg cramps. PAD is the blockage of arteries going to an extremity. [abellahealth.com]

  In general, night leg cramps are likely to be related to muscle fatigue and nerve problems. The risk of having night leg cramps increases with age. Pregnant women also have a higher likelihood of having night leg cramps. [mayoclinic.org]

• Weakness

  A weak pulse or low ankle:brachial BP ratio in an affected limb may indicate ischemia. [merckmanuals.com]

  […] 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, weight loss, weakness [bpac.org.nz]

  Statins (a type of cholesterol-lowering medicine) are known to be associated with side effects such as muscle soreness and weakness in some people, and may also cause leg cramps. [mydr.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]

• Movement Disorder

  G47.53 Recurrent isolated sleep paralysis G47.54 …… in conditions classified elsewhere G47.6 Sleep related movement disorders G47.61 Periodic limb movement disorder G47.62 Sleep related leg cramps G47.63 Sleep related bruxism G47.69 Other sleep related [icd10data.com]

  Periodic Limb Movement Disorder Periodic limb movement disorder (PLMD) is also known as nocturnal myoclonus. Characteristics of PLMD include: Nighttime episodes that usually peak near midnight (similar to RLS). [mountsinai.org]

  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]

  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]

  Medications such as statins, diuretics, and oral contraceptives may increase the risk of leg cramps, too. 1,6 Restless leg syndrome (RLS) can be confused with leg cramps, but they are 2 distinct conditions. 5 RLS is a neurologic movement disorder that [pharmacytimes.com]

• Anemia

  Other conditions that can be related to night leg cramps include: Kidney failure Anemia Hyperthyroidism Type 1 diabetes Type 2 diabetes Those with diabetes commonly experience leg pain and cramping. [abellahealth.com]

  You're also at risk if you have a health condition that doesn't allow your body to properly absorb vitamin B12, as is the case for people with pernicious anemia who lack sufficient intrinsic factor (needed for your body to properly absorb B12), and people [vitamins.lovetoknow.com]

  Other conditions that may sometimes be associated with night leg cramps may include: Structural disorders Peripheral artery disease (PAD) Spinal stenosis Metabolic problems Acute kidney failure Addison's disease (adrenal insufficiency) Anemia Chronic [mayoclinic.org]

  Abnormalities of Iron Metabolism Iron deficiency, even at a level too mild to cause anemia, has been linked to RLS in some people. [mountsinai.org]

  Less common causes include diabetes, Parkinson's disease, hypoglycemia, anemia, thyroid and endocrine disorders and use of some medications. [diagnose-me.com]

• 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]

• 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]

• Hypotension

  […] haemolytic anaemia, neutropenia, disseminated intravascular coagulation Dermatological Photosensitive eczema, lichen planus, toxic epidermal necrolysis Renal Thrombotic microangiopathy, interstitial nephritis, acute kidney failure Others Chills, fever, hypotension [academic.oup.com]

  Other signs include anorexia, nausea, skin flushing, hypotension, bradycardia/heart block and cardiac arrest.15 When considering magnesium supplements, ensure patients take a product containing magnesium only. [nps.org.au]

  A condition called hypotensive akathisia is caused by failure in the autonomic nervous system. Unlike RLS, it occurs at any time of the day, and only when the patient is sitting -- not lying down. [mountsinai.org]

• Sweating

  These reports noted that the workers suffered from cramping whilst sweating profusely in these hot environments, and proceeded to link cramping to excessive sweating and dehydration. [bbc.co.uk]

  (Marathon runners sweating out the miles are particularly prone to this variety.) Certain drugs, such as diuretics have also been cited as a cause of leg cramps. Dialysis patients often complain of leg cramps, and pregnancy is also a factor. [diagnose-me.com]

  Certain factors however, may contribute to their onset: age - older people are more likely to experience cramping; electrolyte or fluid imbalances (may be caused by medication, dialysis, and excessive sweating, among others); exercising; certain seated [medicineshoppe.ca]

  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]

• Hyperhidrosis

  In addition to muscle cramps, stiffness, and myokymia, some patients with neuromyotonia develop paresthesia, hyperhidrosis, confusion, mood change, and hallucination (Morvan syndrome). [pediatrics.aappublications.org]

• 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]

• Muscle Tenderness

  They can affect the: calf muscle, below the knee at the back of the leg muscles in the feet or the thighs (less often) After the cramp has stopped, the muscle might feel tender for up to 24 hours. [nhs.uk]

• 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]

• Hyperactivity

  It is suggested that lower motor neurons with hyperactive, high-frequency, involuntary nerve discharge are responsible for these cramps. [medcaretips.com]

  Attention Deficit Hyperactivity Disorder There is significant overlap between some of the symptoms and treatments for RLS and attention deficit hyperactive disorder (ADHD). [mountsinai.org]

  Electromyographic studies suggest that leg cramps originate in the lower motor neurons with hyperactive, high-frequency, involuntary nerve discharge.4 Some scientists hypothesize that our “civilized” lifestyle no longer requires repetitive squatting that [aafp.org]

  Sontag explained, as the muscle fibers may become hyperactive. When the muscle is "on" and can't relax, you end up getting a cramp. If you get leg cramps from standing, make sure to take a seat before your muscles feel too tired. [health.com]

  A distal origin in the intramuscular motor nerve terminals has been suggested.5 Mechanisms that may contribute to motor unit hyperactivity include spinal disinhibition, abnormal terminal motor nerve excitability, and enhanced muscle contraction propagation [pmj.bmj.com]

• Irritability

  If leg cramps, also called charley horses, persist, they can become even more irritating, perhaps knocking you off your typical exercise or sleep routine. [health.com]

  […] treatment muscle fatigue vascular disease Parkinson’s disease peripheral artery disease (PAD) restless legs syndrome pregnancy, especially in the later stages motor neuron disease Lou Gehrig’s disease (amyotrophic lateral sclerosis, or ALS) spinal nerve irritation [medicalnewstoday.com]

  […] hypothyroidism) Metabolic problems (e.g., acute kidney failure, anemia, chronic kidney disease, Type 1 diabetes, Type 2 diabetes) Seeking Medical Attention Visual News Like regular cramps, nocturnal leg cramps are sometimes nothing more than a temporary irritant [wimp.com]

  […] onset in elderly above 50 Nocturnal leg cramps Restless leg syndrome Periodic Limb Movement Disorder Pain ✓ Intensely pain ✓ From seconds to maximum 10 minutes ✓ Calf or foot, seldom thigh ✓ Persisting pain afterwards ✓ Sleep disruption ✓ Distress* ✓ Irritating [ncbi.nlm.nih.gov]

• Tremor

  Magnesium depletion leads to increased neuronal excitability and enhanced neuromuscular transmission16 with symptoms that include muscle tremor, ataxia, tetany, and cramps. 17 Although magnesium therapy has shown positive results for the treatment of [mdedge.com]

  These effects include nausea, vomiting, heartburn, dizziness, and tremor. Some athletic coaches and physicians recommend pickle juice for muscle cramping, but data concerning its efficacy are insufficient. Leg cramps are common. [merckmanuals.com]

  Neurologic disease may also manifest as tremor, gait disturbance, or asymmetry. [aafp.org]

• 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]