Other disorders can mimic a cramp:
A muscle spasm (cramp) is a sudden, brief, involuntary, painful contraction of a muscle or muscle group. Cramps often occur in healthy people (mostly middle-aged and elderly) on, sometimes alone, v. a. . However, during or after exercise or at night (including while sleeping Nocturnal leg cramps usually occur in the calf and cause a plantar flexion of the foot and toes Other disorders can mimic a cramp. Dystonia can cause muscle spasms, symptoms but are usually longer lasting and recurring and refer other muscles one than the one by typical leg cramps (z. B. neck, hands, face, muscles throughout the body) are affected. also a tetany can cause muscle spasm, but the cramp usually lasts longer (often with repeated short muscle twitching). It usually occurs bilaterally and diffuse, but isolated Karpopedalspasmen may occur. muscular ischemia during exercise in patients with peripheral arterial disease (intermittent claudication) ka nn lead to pain in the calf. This pain, however, due to the insufficient blood flow to the muscles, and the muscles do not contract like a cramp. Under illusory cramping sensation of cramps with no muscle contraction or ischemia is understood. Causes are the most common types of leg cramps benign idiopathic leg cramps (without causative disorder, typically at night) Training Associated muscle cramps (during exercise or immediately after) muscle spasms occur in almost every front at some point, however, raise certain factors the risk and severity of seizures. They include the following tests: Tight calf muscles (eg due to lack of stretching, inactivity or sometimes in chronic Unterschenkelödem.) Dehydration electrolyte abnormalities (eg, low potassium or magnesium levels.) Neurological or metabolic disorders drug with muscle spasms associated drugs and diseases due suspects findings diagnosis confirmed by drugs involved drugs: ARB, ?-adrenergic agonists (including bronc. hodilatoren and some beta-receptor blockers), cisplatin, clofibrate, diuretics, donepezil, lovastatin, oral contraceptives, pyrazinamide, raloxifene, stimulants (eg. , Amphetamines, caffeine, cocaine, ephedrine, nicotine, pseudoephedrine), teriparatide, tolcapone, vincristine withdrawal symptoms: alcohol, barbiturates, benzodiazepines, sedative hypnotics in patients a causal drug taking clinical evaluation, including Absetzversuch the suspected drug disorders extracellular volume depletion. and / or electrolyte abnormalities (eg. B. decrease the ionized calcium, low potassium or magnesium levels) Sometimes excessive sweating, vomiting, diarrhea, diuretics use, signs of dehydration sometimes occur during or after hemodialysis or during late pregnancy (probably related to low M agnesiumspiegel) If necessary, Serum-potassium-magnesium and / or ionized calcium metabolic disorders (. For example alcoholism, hypothyroidism) Alcoholism: history of an excessive use; sometimes ascites, gynecomastia, spider nevi, testicular atrophy hypothyroidism: cold hypersensitivity, constipation, fatigue, delayed reflexes Alcoholism: Clinical evaluation hypothyroidism: review of thyroid function Peripheral neuropathies plexopathies radiculopathy motor neuron disease myopathies weakness, sensory loss, pain and / or hyporeflexia in the innervation of peripheral nerves, plexus or nerve root fasciculations in motor neuron disease: in one hand or one foot incipient weakness Clinical examination EMG examination of nerve conduction and / or spinal cord MRI Musculoskeletal Anoma lien Hard calf muscles, constant sitting in patients with structural disorders (eg. As flat feet, genu recurvatum) Clinical Investigation Training Associated muscle spasms spasms of the muscles involved during exercise or within a few hours afterwards Clinical examination Benign idiopathic leg cramps unprovoked and unexplained spasms, typically in the calf muscles and at night usually hard calf muscles Clinical examination ARB = angiotensin II receptor blockers, EMG = electromyography. Rating There is a concentration on the recognition of what is treatable. In many cases, a disturbance that contributes to cramps or caused other symptoms, which go beyond annoying cramps, already diagnosed. Cramps are indistinguishable from the claudication and of dystonia; a clinical evaluation is usually displayed. History The history of existing disease should include a description of the cramps, incl. Duration, frequency, localization, apparent causes and all the associated symptoms provide. The symptoms that may be associated with neurological or muscle disorders include muscle stiffness, weakness, pain and sensory disturbances. are added factors that can contribute to dehydration, electrolyte imbalances or volume (eg. as vomiting, diarrhea, excessive sweating and Sport, recent dialysis, diuretics use, pregnancy). In reviewing the organ systems should be sought, which indicate possible causes, including the following for symptoms: amenorrhea, or menstrual disorders: Pregnancy-related leg cramps cold intolerance weight gain and skin changes: Hypothyroidism Weakness Neurological disorders pain or loss of sensation: Peripheral neuropathy or radiculopathy the medical history should include all disorders that can cause cramps. A complete drug history, including the use of alcohol, erhoben.Körperliche investigation is to general examination includes the skin; is looked for signs of alcoholism, by edema, in which no dent can be pressed, or loss of the eyebrows (reference to hypothyroidism) and after changes in humidity or the turgor of the skin. A neurological examination, incl. The muscle stretch reflexes, is performed. The pulse should palpated, blood pressure in all extremities are measured. A weak pulse or low ankle-brachial blood pressure ratio in an affected limb an ischemic anzeigen.Warnhinweise are the following findings of particular importance: Upper extremity or involvement of the trunk hyperreflexia muscle weakness fasciculations alcoholism hypovolemia pain or loss of sensation in the innervation of peripheral nerves plexus, or a nerve root interpretation of the findings Focal seizures put benign idiopathic leg cramps, workout associated muscle cramps, muskuloskekelettale abnormalities, causes the peripheral nervous system or an early close degenerative disease that can be asymmetrical such. As a motor neuron disorder. Focal hyporeflexia indicates a peripheral neuropathy, plexopathy or radiculopathy. In patients with diffuse spasm (in particular jitter) indicated hyperreflexia to systemic cause down (z. B. decrease the ionized calcium, optionally alcoholism, a motor neuron disorder or a drug), although the effects on muscle stretch reflexes may vary depending on the active ingredient. A generalized hyporeflexia may indicate hypothyroidism and alcoholism or, especially in the elderly, be a normal finding. A normal examination and a compatible history have benign idiopathic leg cramps or muscle spasms associated workout hin.Testing Testing is done according to the abnormal clinical findings. No test is performed routinely. Blood glucose, renal function tests and electrolyte level, incl. Calcium and magnesium should be determined if patients have diffuse spasm of unknown cause, particularly in hyperreflexia. Ionized calcium and arterial blood gases (ABG) (for confirmation of respiratory alkalosis) are measured in patients with tetanus. Electromyography is performed when cramping muscles are weak. An MRI of the brain and spinal cord is often placed at diffuse muscle weakness. Therapy elongation The circumstances underlying be identified and then treated. When a spasm that often relieves the strain of the affected muscles. To z. to alleviate as a calf cramp, patients can toes and feet with your hand upwards (dorsiflexion). Prevention Preventive measures for cramps include: No sport immediately after eating Gentle stretching the muscles before exercise or before going to bed after doing exercise drink plenty of fluids (especially potassium-containing beverages) No stimulants (such as caffeine, nicotine, ephedrine. , pseudoephedrine) No smoking following stretching exercise for runners is extremely useful: the person standing on two legs, one is in front with the knee bent, the other rear (with knee-pressed lunge). The hands can be supported on the wall. Both heels remain on the floor. The front knee is flexed further, until a strain on the back of the other leg is felt. The greater the distance between the feet and the greater the diffraction of the front knee, the more pronounced is the elongation. The stretch is held for 30 seconds and repeat five times. The exercise is then repeated with the other leg. Most often prescribed to prevent seizures medicines (eg. As Suppelementierung with calcium, quinine, magnesium, benzodiazepines) are not recommended. The majority has no proven efficacy. In some studies, quinine, although effective, but it is not recommended because of occasional severe side effects normally (eg. As arrhythmias, thrombocytopenia, thrombotic thrombocytopenic purpura [TTP] and hemolytic uremic syndrome [HUS], severe allergic reactions) , Mexiletine sometimes helps, but it is unclear whether this justifies the risk of adverse effects. The effects are nausea, vomiting, heartburn, dizziness and tremors. Important Points leg cramps are common. The common causes are benign idiopathic leg cramps and training-associated muscle spasms. Cramps are indistinguishable from the claudication and of dystonia; a clinical evaluation is usually displayed. Stretching can relieve cramps and help prevent. Drug therapy is not usually recommended.