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Published in: Current Neurology and Neuroscience Reports 1/2010

01-01-2010

Nocturnal Leg Cramps

Authors: Renee S. Monderer, Winfred P. Wu, Michael J. Thorpy

Published in: Current Neurology and Neuroscience Reports | Issue 1/2010

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Abstract

Nocturnal leg cramps are a frequent cause of sleep disturbance among the general population, especially among the elderly. These painful episodes can delay sleep onset and awaken the patient from sleep, as well as delay subsequent return to sleep. Different mechanisms have been proposed to explain this phenomenon. Although most cases of leg cramps are idiopathic, multiple secondary causes of sleep-related leg cramps have been identified as well. In this article, we review the epidemiology, pathophysiology, and risk factors and discuss the salient features of the diagnosis and workup. Finally, we review the wide array of behavioral and pharmacologic treatments that have been studied for nocturnal leg cramps.
Literature
1.
go back to reference Riley JD, Anthony SJ: Leg cramps: differential diagnosis and management. Am Fam Physician 1995, 52(6):1794–1798.PubMed Riley JD, Anthony SJ: Leg cramps: differential diagnosis and management. Am Fam Physician 1995, 52(6):1794–1798.PubMed
2.
go back to reference Oboler SK, Prochazka AV, Meyer TJ: Leg symptoms in outpatient veterans. West J Med 1991, 155:256–259.PubMed Oboler SK, Prochazka AV, Meyer TJ: Leg symptoms in outpatient veterans. West J Med 1991, 155:256–259.PubMed
3.
4.
go back to reference Young GL, Jewell D: Interventions for leg cramps in pregnancy. Cochrane Database Syst Rev 2002, 1:CD000121. Young GL, Jewell D: Interventions for leg cramps in pregnancy. Cochrane Database Syst Rev 2002, 1:CD000121.
5.
go back to reference • Hensley JG: Leg cramps and restless legs syndrome during pregnancy. J Midwifery Womens Health 2009, 54(3):211–218. This article provides the most recent data on nocturnal leg cramps in pregnant women. CrossRefPubMed • Hensley JG: Leg cramps and restless legs syndrome during pregnancy. J Midwifery Womens Health 2009, 54(3):211–218. This article provides the most recent data on nocturnal leg cramps in pregnant women. CrossRefPubMed
6.
go back to reference Leung AK, Wong BE, Chan PY, Cho HY: Nocturnal leg cramps in children: incidence and clinical characteristics. J Natl Med Assoc 1999, 91:329–332.PubMed Leung AK, Wong BE, Chan PY, Cho HY: Nocturnal leg cramps in children: incidence and clinical characteristics. J Natl Med Assoc 1999, 91:329–332.PubMed
7.
go back to reference Criggs RC: Episodic muscle spasms, cramps, and weakness. In Harrison’s Principles of Internal Medicine, edn 14. Edited by Fauci AS, Braunwald E, Isselbaucher KJ, et al. New York: McGraw Hill International; 1998:119. Criggs RC: Episodic muscle spasms, cramps, and weakness. In Harrison’s Principles of Internal Medicine, edn 14. Edited by Fauci AS, Braunwald E, Isselbaucher KJ, et al. New York: McGraw Hill International; 1998:119.
8.
go back to reference Butler JV, Mulkerrin EC, O’Keeffe ST: Nocturnal leg cramps in older people. Postgrad Med J 2002, 78:596–598.CrossRefPubMed Butler JV, Mulkerrin EC, O’Keeffe ST: Nocturnal leg cramps in older people. Postgrad Med J 2002, 78:596–598.CrossRefPubMed
9.
go back to reference Weiner IH, Weiner HL: Nocturnal leg muscle cramps. JAMA 1990, 150:511–518. Weiner IH, Weiner HL: Nocturnal leg muscle cramps. JAMA 1990, 150:511–518.
10.
go back to reference Sontag SJ, Wanner JN: The cause of leg cramps and knee pains: a hypothesis and effective treatment. Med Hypotheses 1988, 25:35–41.CrossRefPubMed Sontag SJ, Wanner JN: The cause of leg cramps and knee pains: a hypothesis and effective treatment. Med Hypotheses 1988, 25:35–41.CrossRefPubMed
11.
go back to reference Jacobsen JH, Rosenberg RS, Huttenlocher PR, Spire JP: Familial nocturnal cramping. Sleep 1986, 9:54–60.PubMed Jacobsen JH, Rosenberg RS, Huttenlocher PR, Spire JP: Familial nocturnal cramping. Sleep 1986, 9:54–60.PubMed
12.
go back to reference Chiba S, Saitoh M, Hatanaka Y, et al.: Autosomal dominant muscle cramp syndrome in a Japanese family. J Neurol Neurosurg Psychiatry 1999, 67:116–119.CrossRefPubMed Chiba S, Saitoh M, Hatanaka Y, et al.: Autosomal dominant muscle cramp syndrome in a Japanese family. J Neurol Neurosurg Psychiatry 1999, 67:116–119.CrossRefPubMed
13.
go back to reference American Academy of Sleep Medicine: Sleep related leg cramps. In The International Classification of Sleep Disorders, edn 2. Diagnostic and Coding Manual. Westchester, IL: American Academy of Sleep Medicine; 2005. American Academy of Sleep Medicine: Sleep related leg cramps. In The International Classification of Sleep Disorders, edn 2. Diagnostic and Coding Manual. Westchester, IL: American Academy of Sleep Medicine; 2005.
14.
go back to reference Kannan N, Sawaya R: Nocturnal leg cramps: clinically mysterious and painful—but manageable. Geriatrics 2001, 56(6):34–42. Kannan N, Sawaya R: Nocturnal leg cramps: clinically mysterious and painful—but manageable. Geriatrics 2001, 56(6):34–42.
15.
go back to reference Man-Son-Hing M, Wells G: Meta-analysis of efficacy of quinine for treatment of nocturnal leg cramps in elderly people. BMJ 1995, 310:13–17.PubMed Man-Son-Hing M, Wells G: Meta-analysis of efficacy of quinine for treatment of nocturnal leg cramps in elderly people. BMJ 1995, 310:13–17.PubMed
16.
go back to reference Man-Son-Hing M, Wells G, Lau A: Quinine for nocturnal leg cramps: a meta-analysis including unpublished data. J Gen Intern Med 1998, 13:600–606.CrossRefPubMed Man-Son-Hing M, Wells G, Lau A: Quinine for nocturnal leg cramps: a meta-analysis including unpublished data. J Gen Intern Med 1998, 13:600–606.CrossRefPubMed
17.
go back to reference Daniell HW: Simple cure for nocturnal leg cramps. N Eng J Med 1979, 301:216. Daniell HW: Simple cure for nocturnal leg cramps. N Eng J Med 1979, 301:216.
18.
go back to reference Coppin RJ, Wicke DM, Little PS: Managing nocturnal leg cramps—calf stretching exercises and cessation of quinine treatment: a factorial randomised controlled trial. Br J Gen Pract 2005, 55:186–191.PubMed Coppin RJ, Wicke DM, Little PS: Managing nocturnal leg cramps—calf stretching exercises and cessation of quinine treatment: a factorial randomised controlled trial. Br J Gen Pract 2005, 55:186–191.PubMed
19.
go back to reference Diener HC, Dethlefsen U, Dethlefsen-Gruber S, et al.: Effectiveness of quinine in treating muscle cramps: a double-blind, placebo-controlled, parallel-group, multicentre trial. Int J Clin Pract 2002, 56(4):243–246.PubMed Diener HC, Dethlefsen U, Dethlefsen-Gruber S, et al.: Effectiveness of quinine in treating muscle cramps: a double-blind, placebo-controlled, parallel-group, multicentre trial. Int J Clin Pract 2002, 56(4):243–246.PubMed
20.
go back to reference • Woodfield R, Goodyear-Smith F, Arroll B: N-of-1 trials of quinine efficacy in skeletal muscle cramps of the leg. Br J Gen Pract 2005, 55(512):181–185. This is the most recent study looking at the efficacy of quinine in the treatment of leg cramps. PubMed • Woodfield R, Goodyear-Smith F, Arroll B: N-of-1 trials of quinine efficacy in skeletal muscle cramps of the leg. Br J Gen Pract 2005, 55(512):181–185. This is the most recent study looking at the efficacy of quinine in the treatment of leg cramps. PubMed
21.
go back to reference Halfdanarson TR, Sigfusson A, Haraldsdottir V, et al.: Severe adverse effects of quinine: report of seven cases. Laeknabladid 2002, 88(10):717–722.PubMed Halfdanarson TR, Sigfusson A, Haraldsdottir V, et al.: Severe adverse effects of quinine: report of seven cases. Laeknabladid 2002, 88(10):717–722.PubMed
22.
go back to reference Mandal AK, Abernathy T, Nelluri SN, et al.: Is quinine effective and safe in leg cramps? J Clin Pharmacol 1995, 35:588–593.PubMed Mandal AK, Abernathy T, Nelluri SN, et al.: Is quinine effective and safe in leg cramps? J Clin Pharmacol 1995, 35:588–593.PubMed
23.
go back to reference Dahle LO, Berg G, Hammer M, et al.: The effect of oral magnesium substitution on pregnancy-induced leg cramps. Am J Obstet Gynecol 1995, 173:175–180.CrossRefPubMed Dahle LO, Berg G, Hammer M, et al.: The effect of oral magnesium substitution on pregnancy-induced leg cramps. Am J Obstet Gynecol 1995, 173:175–180.CrossRefPubMed
24.
go back to reference Frusso R, Zarate M, Augustovski F, et al.: Magnesium for the treatment of nocturnal leg cramps: a crossover randomized trial. J Fam Pract 1999, 48:868–871.PubMed Frusso R, Zarate M, Augustovski F, et al.: Magnesium for the treatment of nocturnal leg cramps: a crossover randomized trial. J Fam Pract 1999, 48:868–871.PubMed
25.
go back to reference Roffe C, Sills S, Crome P, et al.: Randomised, cross-over, placebo controlled trial of magnesium citrate in the treatment of chronic persistent leg cramps. Med Sci Monit 2002, 8(5):CR326–CR330. Roffe C, Sills S, Crome P, et al.: Randomised, cross-over, placebo controlled trial of magnesium citrate in the treatment of chronic persistent leg cramps. Med Sci Monit 2002, 8(5):CR326–CR330.
26.
go back to reference Baltodano N, Gallo BV, Weidler DJ: Verapamil vs quinine in recumbent nocturnal leg cramps in the elderly. Arch Intern Med 1988, 148:1969–1970.CrossRefPubMed Baltodano N, Gallo BV, Weidler DJ: Verapamil vs quinine in recumbent nocturnal leg cramps in the elderly. Arch Intern Med 1988, 148:1969–1970.CrossRefPubMed
27.
go back to reference Voon WC, Sheu SH: Diltiazem for nocturnal leg cramps [letter]. Age Ageing 2001, 3(1):91–92.CrossRef Voon WC, Sheu SH: Diltiazem for nocturnal leg cramps [letter]. Age Ageing 2001, 3(1):91–92.CrossRef
28.
go back to reference Ayers S Jr, Mihan R: Leg cramps (systremma) and “restless legs” syndrome. Response to vitamin E (tocopherol). Calif Med 1969, 111:87–91. Ayers S Jr, Mihan R: Leg cramps (systremma) and “restless legs” syndrome. Response to vitamin E (tocopherol). Calif Med 1969, 111:87–91.
29.
go back to reference Roca AO, Jarjoura D, Blend D, et al.: Dialysis leg cramps. Efficacy of quinine versus vitamin E. ASAIO J 1992, 38:481–485.CrossRef Roca AO, Jarjoura D, Blend D, et al.: Dialysis leg cramps. Efficacy of quinine versus vitamin E. ASAIO J 1992, 38:481–485.CrossRef
30.
go back to reference Connolly PS, Shirley EA, Wasson JH, et al.: Treatment of nocturnal leg cramps. A crossover trial of quinine vs vitamin E. Arch Intern Med 1992, 152(9):1877–1880.CrossRefPubMed Connolly PS, Shirley EA, Wasson JH, et al.: Treatment of nocturnal leg cramps. A crossover trial of quinine vs vitamin E. Arch Intern Med 1992, 152(9):1877–1880.CrossRefPubMed
31.
go back to reference Chan P, Huang TY, Chen YJ, et al.: Randomized, double-blind, placebo-controlled study of the safety and efficacy of vitamin B complex in the treatment of nocturnal leg cramps in the elderly patient with hypertension. J Clin Pharmacol 1998, 38(12):1151–1154.PubMed Chan P, Huang TY, Chen YJ, et al.: Randomized, double-blind, placebo-controlled study of the safety and efficacy of vitamin B complex in the treatment of nocturnal leg cramps in the elderly patient with hypertension. J Clin Pharmacol 1998, 38(12):1151–1154.PubMed
32.
33.
go back to reference Latta D, Turner E: An alternative to quinine in nocturnal leg cramps. Curr Ther Res 1989, 45:833–837. Latta D, Turner E: An alternative to quinine in nocturnal leg cramps. Curr Ther Res 1989, 45:833–837.
34.
go back to reference Chang YJ, Wu CL, Chen RS, et al.: Case of Isaacs syndrome successfully treated with phenytoin. J Formos Med Assoc 1993, 92(11):1010–1012.PubMed Chang YJ, Wu CL, Chen RS, et al.: Case of Isaacs syndrome successfully treated with phenytoin. J Formos Med Assoc 1993, 92(11):1010–1012.PubMed
35.
go back to reference Mueller ME, Gruenthal M, Olson WL, et al.: Gabapentin for relief of upper motor neuron symptoms in multiple sclerosis. Arch Phys Med Rehabil 1997, 78(5):521–524.CrossRefPubMed Mueller ME, Gruenthal M, Olson WL, et al.: Gabapentin for relief of upper motor neuron symptoms in multiple sclerosis. Arch Phys Med Rehabil 1997, 78(5):521–524.CrossRefPubMed
36.
go back to reference Serrao M, Rossi P, Cardinali P, et al.: Gabapentin treatment for muscle cramps: an open-label trial. Clin Neuropharmacol 2000, 23(1):45–49.CrossRefPubMed Serrao M, Rossi P, Cardinali P, et al.: Gabapentin treatment for muscle cramps: an open-label trial. Clin Neuropharmacol 2000, 23(1):45–49.CrossRefPubMed
37.
go back to reference Prateepavanich P, Kupniratsaikul V, Charoensak T: The relationship between myofascial trigger points of gastrocnemius muscle and nocturnal calf cramps. J Med Assoc Thai 1999, 82:451–459.PubMed Prateepavanich P, Kupniratsaikul V, Charoensak T: The relationship between myofascial trigger points of gastrocnemius muscle and nocturnal calf cramps. J Med Assoc Thai 1999, 82:451–459.PubMed
38.
go back to reference Bertolasi L, Priori A, Tomelleri G, et al.: Botulinum toxin treatment of muscle cramps: a clinical and neurophysiological study. Ann Neurol 1997, 41:181–186.CrossRefPubMed Bertolasi L, Priori A, Tomelleri G, et al.: Botulinum toxin treatment of muscle cramps: a clinical and neurophysiological study. Ann Neurol 1997, 41:181–186.CrossRefPubMed
Metadata
Title
Nocturnal Leg Cramps
Authors
Renee S. Monderer
Winfred P. Wu
Michael J. Thorpy
Publication date
01-01-2010
Publisher
Current Science Inc.
Published in
Current Neurology and Neuroscience Reports / Issue 1/2010
Print ISSN: 1528-4042
Electronic ISSN: 1534-6293
DOI
https://doi.org/10.1007/s11910-009-0079-5

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