Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2016 Apr;53(4):513-7.
doi: 10.1002/mus.24892. Epub 2015 Sep 28.

Natural history of muscle cramps in amyotrophic lateral sclerosis

James B Caress  1 , Stephanie L Ciarlone  2 , Elizabeth A Sullivan  3 , Leah P Griffin  4 , Michael S Cartwright  1
Affiliations

Natural history of muscle cramps in amyotrophic lateral sclerosis

James B Caress et al. Muscle Nerve. 2016 Apr.

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.

PubMed Disclaimer

Conflict of interest statement

The remaining authors have nothing to disclose and there are no conflicts of interest.

Figures

Figure
Figure
The mean number of cramps per month with standard deviation (whisker lines) reported during progression of ALS. The mean number of cramps declined over time, but this trend did not reach statistical significance (P = 0.26).
See this image and copyright information in PMC

References

    1. Chio A, Canosa A, et al. Pain in amyotrophic lateral sclerosis: a population-based controlled study. Eur J Neurol. 2012;19:551–55. - PubMed
    1. Ganzini L, Johnston WS, Hoffman WF. Correlates of suffering in amyotrophic lateral sclerosis. Neurology. 1999;52:1434–1440. - PubMed
    1. Heiman-Patterson TD, Rampal N, Brannagan TH, Acosta T, Forshew D, Bromberg MB. The spectrum of patient symptoms in ALS and symptom management. Neurology. 2001;56:A199.
    1. Ringel SP, Murphy JR, Alderson MK, Bryan W, England JD, Miller RG, et al. The natural history of amyotrophic lateral sclerosis. Neurology. 1993;43:1316–1322. - PubMed
    1. Caress JB, Paudyal B. Muscle Cramps and Fasciculations. In: Katirji B, et al., editors. Neuromuscular Disorders in Clinical Practice. 2. New York: Springer Science+Business Media; 2014. pp. 1455–1464.

Publication types