Деякі препарати, захворювання та інші стани, пов’язані з м’язовими судомами

Drugs

Contributory drugs: Angiotensin II receptor blockers, cisplatin, clofibrate, diuretics, donepezil, drugs with beta-adrenergic agonist effects (including bronchodilators and some beta-blockers), lovastatin, oral contraceptives, pyrazinamide, raloxifene, stimulants (eg, amphetamines, caffeine, cocaine, ephedrine, nicotine, pseudoephedrine), teriparatide, tolcapone, vincristine

Withdrawal syndromes: Alcohol, barbiturates, benzodiazepines, sedative-hypnotics

In patients taking a causative drug

History and physical examination alone, including sometimes trying withdrawal of suspected drug

Disorders and other conditions

Benign idiopathic leg cramps

Unprovoked and unexplained cramps, typically in calf muscles and at night

Usually tight calf muscles

History and physical examination alone

Exercise-associated muscle cramping

Cramping of involved muscles during exercise or in the few hours after exercise

History and physical examination alone

Extracellular fluid volume depletion and/or electrolyte abnormalities (eg, ionized hypocalcemia, low body potassium or magnesium)

Sometimes excessive sweating, vomiting, diarrhea, use of a diuretic, signs of dehydration

Sometimes occurring during or after hemodialysis or during late pregnancy (probably related to low body magnesium)

Sometimes serum potassium, magnesium, and/or ionized calcium

Metabolic disorders (eg, alcohol use disorder, hypothyroidism)

Alcohol use disorder: History of overuse; sometimes ascites, gynecomastia, spider angiomas, testicular atrophy

Hypothyroidism: Cold intolerance, constipation, fatigue, sluggish reflexes

Alcohol use disorder: History and physical examination alone

Hypothyroidism: Thyroid function testing

Musculoskeletal abnormalities

Tight calf muscles, a history of prolonged sitting

In patients with structural disorders (eg, flat feet, genu recurvatum)

History and physical examination alone

Motor neuron disease

Myopathies

Peripheral neuropathies

Plexopathies

Radiculopathies

Weakness, sensory loss, pain, and/or hyporeflexia in a peripheral nerve, plexus, or nerve root distribution

Fasciculations

In motor neuron disease, weakness that begins in one hand or foot

Usually EMG, nerve conduction studies, and/or spinal cord MRI