Diagnosis and differential diagnosis of muscle cramps: a clinical approach

Abstract

Muscle cramps are one of the most frequently occurring neuromuscular features. They occur normally in healthy persons, can be the manifestation of one of several cramp syndromes, but can also be the expression of various underlying neuromuscular disorders. We review the various types and boundaries of cramps, ranging from true muscle cramps to electromyographic silent muscle contractures (for example, Brody's disease) and cramps associated with dystrophinopathies. In addition, we delineate true muscle cramp from muscle stiffness and muscle twitching. Finally, we propose a workup in a patient suspected of having muscle cramps.