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@#Background & Objectives: Muscle cramps are present in more than three quarter of amyotrophic lateral sclerosis (ALS) cases. The objective of the present study was to translate and validate Columbia Cramp Scale (CCS) for use in Serbian ALS patients, and to identify the potential epidemiological and clinical factors which could influence worse overall CCS score. Methods: This study involved 21 patients with muscle cramps and 17 patients with no previous cramps history. Patients with cramps were retested 3 months after first assessment. Main socio-demographic and clinical data were obtained from patients at time of testing. The revised ALS functional rating scale (ALS-FRS-R) was used to score activities of daily living. The study subjects were assessed with CCS, Hamilton scales for the assessment of anxiety (HAM-A) and depression (HAM-D) and 36-Item Short Form Survey (SF-36). Results: Mean CCS score was 17.2±6.7 (range 6-30). The Cronbach’s alpha coefficient reflecting internal consistency was 0.76, which suggest acceptable internal consistency. Multiple linear regression analysis including all parameters associated with worse CCS scores, showed that lower ALSFRS-R scores (beta=0.55, p<0.01) and depression (beta=0.52, p<0.01), were independent predictors of the worse CCS score (adjusted R2=0.35, p<0.01 for overall model). Subjects with cramp history were retested after 3 months and no statistically significant difference between CCS scores in this two time points was noted. Conclusion: Selection of appropriate measure for assessing muscle cramps is important. In ALS patients we recommend CCS questionnaire. Results of our study also show that high CCS scores correlate with depression and anxiety, worse QoL and some epidemiological and clinical characteristics.
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Objective@#To investigate the prevalence of calf muscle cramps and possible influencing factors for pregnant women in China.@*Methods@#Using a multi-stage stratified probability proportional to size cluster randomization sampling method during 2010-2012. A total of 3 582 pregnant women were investigated at 150 counties from 31 provinces in China mainland. Information on calf muscle cramps, demographic socio-economic status, pregnancy information, and the physical activities was collected through questionnaires. The semi-quantitative food frequency questionnaire (FFQ) was used to collect food intake of pregnant women. Dynamic cluster analysis was used to assess dietary pattern. Multiple logistic regression was used to investigate the possible influencing factors for calf muscle cramps.@*Results@#The prevalence of calf muscle cramps was 32.9% (1 180/3 582) in Chinese pregnant women, which was 11.6% (87/748), 28.2% (420/1 492), and 50.2% (673/1 342), respectively, during the first, second and third trimester. There were significant differences between them (χ2=349.16, P<0.001). Dietary patterns of the pregnant women were classified into three groups, which called relatively balanced pattern, high vegetables and fruits pattern, and high dairy pattern. Among the three groups, the prevalence of calf muscle cramps was 32.0% (952/2 971), 37.2% (186/500), and 37.8% (42/111), with significant differences (χ2=6.39, P=0.041). The OR (95%CI) values of calf muscle cramps in the second and third trimester was 2.96 (2.28-3.83), and 8.02 (6.16-10.44), respectively, comparing with the first trimester. The OR (95%CI) values of calf muscle cramps in the women taking calcium before pregnant was 1.45 (1.19-1.76), comparing with the one who was not taken. The OR (95%CI) values of calf muscle cramps in the women who had been diagnosed by pregnancy-induced hypertension was 5.76 (2.06-16.12), comparing with the one who had not been diagnosed. The OR (95%CI) values of calf muscle cramps in the high vegetables and fruits pattern and high dairy pattern was 1.13 (0.91-1.41), and 1.18 (0.76-1.81), respectively, comparing with the relatively balanced pattern.@*Conclusion@#The prevalence of calf muscle cramps was relatively high in Chinese pregnant women, which was significantly different among three trimesters. The residential areas, occupation, and pregnancy-induced hypertension might be related to the prevalence of calf muscle cramps. However, there was no significant difference among different dietary patterns.
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Muscle cramp is one of the common symptoms of patients with liver cirrhosis and significantly affects patients' quality of life.In general,the research on liver cirrhosis mainly focuses on the management and prevention of causes or common complications,and there are relatively few studies on the treatment of muscle cramp.Therefore,it is very important to find safe and effective therapeutic regimens.This article describes the pathogenesis and manifestations of muscle cramp in patients with liver cirrhosis,summarizes the therapeutic regimens with clinical value,including new drugs such as baclofen,L-carnitine,and taurine,and further elaborates on the protective effect of taurine against liver fibrosis via its activation of extracellular matrix and hepatic stellate cells,in order to provide new evidence for the treatment of muscle cramp in liver cirrhosis.
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BACKGROUND: Nocturnal muscle cramps are sudden, involuntary, painful muscle contractions that occur in the night and are accompanied by hardening of the muscles. Many symptomatic treatments have been introduced for nocturnal muscle cramps, such as quinine, magnesium, and phenytoin. However, the efficacy and safety of these drugs have not been adequately evaluated. To demonstrate the efficacy and safety of phenytoin treatment for nocturnal muscle cramps, we conducted a retrospective study of 16 patients with nocturnal muscle cramps. METHODS: We reviewed 16 patients (6 men, 10 women) who suffered frequent nocturnal muscle cramps and were treated with phenytoin. The patients' clinical information (age, sex, disease duration, and locations of cramps), treatment dosage, and frequency of cramps were obtained by reviewing their medical records. RESULTS: The patients were aged 63.1+/-14.7 years (mean+/-SD; age range, 30-80 years; median age, 68 years). Twelve and four patients received phenytoin doses of 100 and 200 mg/day, respectively. The median duration of medication was 51 days (range, 14-378 days). Phenytoin treatment was effective in all patients; 13 patients (81.3%) experienced a total remission of their symptoms, and a significant reduction (66.7-85.7%) in the frequency of cramps was found in the remaining 3 patients. No adverse effects were reported by any of the patients. CONCLUSIONS: While this retrospective study was conducted with only a small number of patients, the clinical results suggest that phenytoin is a safe and helpful therapy for the treatment of nocturnal muscle cramps.
Subject(s)
Humans , Male , Drug Therapy , Magnesium , Medical Records , Muscle Contraction , Muscle Cramp , Muscles , Phenytoin , Quinine , Retrospective StudiesABSTRACT
Goreisan, a well-known hydrostasis modulating formula, has been traditionally used against edema, thirst, spontaneous sweating, and oliguria. Patients undergoing maintenance hemodialysis (HD) have a condition of chronic water metabolism abnormality. Acute changes in water metabolism due to HD therapy frequently cause disdialysis syndrome (including muscle cramps), therefore, the prevention and treatment of disdialysis syndrome is of importance. In this study, 20 patients with history of disdialysis syndrome undergoing HD were administered goreisan (5.0 g/day) and its effect was investigated. After 8 weeks of goreisan therapy, diagnostic <i>suitai </i>syndrome criteria (pre-treatment 40.9 ± 8.7, post-treatment 33.2 ± 7.8 points), total 10% NaCl dosages (20 mL/syringe) to treat muscle cramps during HD (pre 2.9 ± 0.6, post 1.9 ± 0.6 syringes/week), serum brain natriuretic peptide (BNP) concentrations after HD (pre 165.4 ± 48.3, post 148.4 ± 39.0 pg/mL), and systolic blood pressures (pre 90.8 ± 15.0, post 100.1 ± 13.5 mmHg) indicted statistical improvement (p < 0.01).These effects were observed not only in patients with no diabetes mellitus (DM), but also in patients with DM.These results indicate the possibility that goreisan is effective for prevention of disdialysis syndrome and muscle cramps in patients under HD.
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In hemodialysis patients, muscle cramps in the lower extremities are frequently seen. In order to prevent the occurrence of these cramps, Shakuyakukanzo-to was administered to five patients that frequently suffered from muscle cramps during dialysis. Before receiving dialysis, a dose of 2.5g was given to each of the five patients. The rates of efficacy were: effective for 2 patients, slightly effective for 2 patients and not effective for 1 patient. No severe side effects such as increases in serum potassium levels were observed. The results therefore suggested that Shakuyakukanzo-to is useful in the prevention of muscle cramps during dialysis.