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Muscle Nerve. 2016 Apr;53(4):513-7. doi: 10.1002/mus.24892. Epub 2015 Sep 28.

Natural history of muscle cramps in amyotrophic lateral sclerosis.

Author information

1
Department of Neurology, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA.
2
Department of Molecular Pharmacology and Physiology, Morsani College of Medicine, University of South Florida, Tampa, Florida, USA.
3
Neurology Associates, Hattiesburg, Mississippi, USA.
4
Department of Biostatistical Sciences, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA.

Abstract

INTRODUCTION:

Muscle cramping is a common symptom in amyotrophic lateral sclerosis (ALS) that lacks efficacious treatment. The natural history of this symptom is unknown, which hampers efforts to design optimal clinical trials.

METHODS:

We surveyed early stage ALS patients about their experience with cramps each month by phone for up to 21 months.

RESULTS:

Cramps developed in 95% of patients over the course of their disease. The number of cramps experienced by an individual varied widely from month-to-month and trended lower after the first year of illness (P = 0.26). Those with limb-onset and age >60 years had more cramps than bulbar-onset (P < 0.0001) and younger patients (P < 0.0001).

CONCLUSIONS:

The high variability of the number of cramps experienced suggests that clinical trials will need to use crossover designs or large numbers of participants, even when the treatment effect is substantial.

KEYWORDS:

amyotrophic lateral sclerosis; cramps; muscle spasms; natural history; pain

PMID:
26332705
PMCID:
PMC4775451
DOI:
10.1002/mus.24892
[Indexed for MEDLINE]
Free PMC Article

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