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Nocturnal leg cramps are involuntary muscle contractions that occur in the calves, soles of the feet, or other muscles in the body during the night or (less commonly) while resting. The duration of nocturnal leg cramps is variable, with cramps lasting anywhere from a few seconds to several minutes.
Typical early symptoms are "tingling" (sort of electrified vibration or paresthesia) or numbness in the extremities, frequent (night) leg cramps, loss of reflexes (in knees), muscle fasciculations, "vibration" feelings, loss of balance, general muscle cramping and nerve pain.
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Charley horses have many possible causes directly resulting from high or low pH or substrate concentrations in the blood, including hormonal imbalances, dehydration, low levels of magnesium, potassium, or calcium (evidence has been mixed), [5] [6] [7] side effects of medication, or, more seriously, diseases such as amyotrophic lateral sclerosis and neuropathy. [8]
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These movements can lead the patient to wake up, and if so, sleep interruption can be the origin of excessive daytime sleepiness. [2] PLMD is characterized by increased periodic limb movements during sleep, which must coexist with a sleep disturbance or other functional impairment, in an explicit cause-effect relationship.
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Muscle stiffness may also be present; if muscle weakness is not also present, and cramps are more severe, the stiffness may be categorized instead as cramp fasciculation syndrome. [3] Cramp fasciculation is a variant of BFS which presents with muscle pain and exercise intolerance. [2] [4]
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