Neurogenic muscle cramps


Muscle cramps are sustained, painful contractions of muscle and are prevalent in patients with and without medical conditions. The objective of this review is to present updates on the mechanism, investigation and treatment of neurogenic muscle cramps. PubMed and Embase databases were queried between January 1980 and July 2014 for English-language human studies. The American Academy of Neurology classification of studies (classes I–IV) was used to assess levels of evidence. Mechanical disruption, ephaptic transmission, disruption of sensory afferents and persistent inward currents have been implicated in the pathogenesis of neurogenic cramps. Investigations are directed toward identifying physiological triggers or medical conditions predisposing to cramps. Although cramps can be self-limiting, disabling or sustained muscle cramps should prompt investigation for underlying medical conditions. Lifestyle modifications, treatment of underlying conditions, stretching, B-complex vitamins, diltiezam, mexiletine, carbamazepine, tetrahydrocannabinoid, leveteracitam and quinine sulfate have shown evidence for treatment.

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The author would like to acknowledge the assistance of Ms. Kimberly Chin in the generation of Fig. 1, Pathophysiology of Neurogenic Muscle Cramps.

Conflicts of interest

Dr. Katzberg drafted the manuscript and performed literature review. He has received travel support from Genzyme Corporation and grants from CSL Behring and Grifols, Canada, Ltd. There are no direct conflicts of interest in the preparation of this manuscript.

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This study does not contain clinical data or patient information.

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Correspondence to Hans D. Katzberg.

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Katzberg, H.D. Neurogenic muscle cramps. J Neurol 262, 1814–1821 (2015).

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  • Muscle crampscharlie horse
  • Chopper
  • Motor nerve hyperexcitability
  • Spasms