Muscle cramps--differential diagnosis and therapy

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Med Monatsschr Pharm. 2009 Mar;32(3):80-6.

Muscle cramps--differential diagnosis and therapy

Reichel G.

Kompetenzzentrum für Bewegungsstörungen, Paracelsusklinik Zwickau, Werdauer Str.

68, 08060 Zwickau.

Calf cramps are sudden, involuntary, painful contractions of part of or the

entire calf muscle that are visible, persist for seconds to minutes and then

spontaneously resolve. They can occur with no identifiable cause, and are then

referred to as common calf cramps. They may also be symptoms associated with

diseases of the peripheral and central nervous system and muscle diseases. They

also occur in association with metabolic disorders.

In such cases the cramps are more extensive, intense and persist for longer.

Cramp-fasciculation-myalgia syndrome additionally involves paresthesias and

other signs of hyperexcitability of peripheral nerves.

The recommended treatment for patients with frequent calf cramps causing

significant impairment of well-being is oral administration of quinidine and/or

botulinum toxin treatment of the calf muscles. During pregnancy both products

are contraindicated, while probatory administration of magnesium is indicated.