What do als cramps feel like

Then she had difficulty in walking, button-up her clothes and bradykinesia. There was no numbness and muscle atrophy of her tongue, face, hands and limbs. She had no complaints of dysphagia, dysarthria or dyspnea and history of alcohol drinking or cigarette smoking, no family history of neurological diseases.

Physical examination revealed a normal body figure, well-oriented in place, time and person, with no unconsciousness. Cranial nerve examination revealed no abnormalities. There was no atrophy of the limbs, trunk and lingual muscles. Sensations and cerebellar examinations were unremarkable. Deep tendon reflexes in the 4 limbs were asymmetrical that left limbs were hyperactive and right limbs brisk.

Left ankle clonus was positive. For laboratory examinations, blood cell count, urine analyses, liver function, renal function, muscle enzymes creatine kinase, creatine kinase-MB, aspartate aminotransferase, lactate dehydrogenase, hydroxybutyrate dehydrogenase , serum vitamin B12, autoantibodies and tumor biomarkers were normal. Intracranial pressure and cerebral spinal fluid analysis were normal. Brain and spine magnetic resonance imaging MRI suggest Arnold-Chiari malformation type I [Figure 1A] , which was not explainable for the symptoms and abnormalities of physical examinations.

Spine MRI revealed slight prominence of intervertebral disks and no abnormality was observed in the whole spinal cord [Figure 1A]. Electromyography EMG showed neurogenic changes in the left biceps brachii, the left thenar muscles and bilateral gastrocnemius [Figure 1B-D]. Evoked potentials examination showed prolonged latency period in the left side of the visual evoked potential and event-related potential-P Motor evoked potential, somatosensoroy evoked potential and brainstem auditory evoked potential, nerve conduction, ambulatory electroencephalogram and electrocardiogram were normal.

Figure 1. Brain and spine image and electromyography of the ALS case. B-D Electromyography showed denervation potentials in the left biceps brachii B , the left thenar muscle C and right gastrocnemius D.

According to the revised 2, criteria, [ 12 ] the patient was diagnosed with clinically probable ALS, which was confirmed by other hospitals in Beijing. The oral administration of diazepam and baclofen was initiated; muscle cramps were relieved a bit. The patient did periodic follow-ups in our outpatient clinics, but her symptoms did not improve with the use of the muscle-relaxants prescribed.

ALS has many varied manifestations as first symptoms, which are vital to help for early diagnosis, and understand the natural course the disease progression. Besides MNDs, other etiology of muscle cramps includes metabolic disorders, electrolyte disturbances, medications, etc. As to pathophysiology, the muscle cramps may arise from spontaneous discharges of the motor nerves, this may origin at neuronal level and then transferred through the nerve trunks to the muscular fibers or it may begin at nerve trunks level by activation of abnormal cholinergic receptors that function as trigger points.

Hitherto, there is no disease-modifying therapeutics for ALS. The main managements for patients with ALS are the symptomatic treatments, including muscle relaxants, anticonvulsants for cramps, fasciculations and spasticity, physiotherapy for weakness or disability, and ventilator support for dyspnea, [ 2 , 14 ] These treatments can alleviate symptoms, improve the quality of life and increase the life expectancy.

In conclusion, our case presents a rare initial manifestation of progressive painful muscle cramps in the absence of muscle weakness. It helps to improve our early recognition of the atypical initial presentations of ALS, and formulate effective symptomatic therapies to improve the life quality and survival of the patients.

Incidence of amyotrophic lateral sclerosis in Europe. J Neurol Neurosurg Psychiatry ; A comprehensive review of amyotrophic lateral sclerosis. Surg Neurol Int ; Genetic heterogeneity of amyotrophic lateral sclerosis: implications for clinical practice and research. Muscle Nerve ; Global epidemiology of amyotrophic lateral sclerosis: a systematic review of the published literature. Neuroepidemiology ; Natural history and clinical features of sporadic amyotrophic lateral sclerosis in China.

Huynh W, Kiernan MC. A unique account of ALS in China: exploring ethnic heterogeneity. Robberecht W, Philips T. This article discusses muscle cramps in more detail, including their causes, treatment, and prevention. It also explains when to see a doctor about this issue. Muscle cramps are sudden contractions in one or more muscles. These contractions are involuntary, meaning that a person cannot control them.

These cramps can cause uncomfortable symptoms, but, for the most part, they are temporary. The duration of symptoms typically ranges from seconds to minutes. When muscle cramps occur, the person may feel a sudden tightening in the muscle or muscles in the area. It may feel as though they have flexed their muscle, even if they are otherwise relaxed.

This tightening often does not stop and leads to pain in the area as the muscle overcontracts. In some cases, such as with muscles close to the skin, the person may be able to see the contraction in the muscle. A hard knot or lump of tissue may form in the affected muscle. Much of the time, it is difficult to identify the exact cause of a muscle cramp. Although there are many possible causes of a cramp, in many cases, the underlying cause is unknown.

Some muscles may simply start cramping for a short time and then go back to normal. Cramps may occur anywhere in the body, but they most commonly affect the legs — specifically, the calves. The reason for this may be that people use the calves throughout the day. However, the exact cause may vary in each case. The authors of an article in Sports Medicine also note that cramps are hard to study because they are largely unpredictable. General muscle loss from aging, called sarcopenia , may play a role as well.

Aging muscles do not work as hard or as quickly, and they may be more susceptible to overuse that could cause cramping. Muscle cramps may occur at night as people sleep, typically in the legs.

Muscle cramps at night may be due to a person keeping the muscles in one position for a long period while sleeping, holding an awkward position in bed, or overusing the muscles throughout the day. People who menstruate often get period cramps before and during menstruation each month. The feeling may vary from heaviness in the abdomen to severe cramping in the abdomen and pelvic area.

Pain from period cramps occurs as the uterus contracts. In a period , the uterus contracts to help shed the uterine lining, which the body then expels through the vagina. Many cramps are temporary and will simply come and go. Some home treatments may ease the symptoms or help the cramp pass. Some with ALS experience painful muscle cramps, which can sometimes be alleviated with medication.

Some people with ALS undergo alterations in their thinking or may exhibit uncharacteristic behavior changes , often referred to as frontotemporal dementia , or FTD. However, memory loss, a hallmark of Alzheimer's-type dementia, is generally not a feature of ALS. Instead, the person with ALS might be irritable, inconsiderate, apathetic, or impulsive or might otherwise act in uncharacteristic ways. Another potential ALS symptom — not experienced by all — is a temporary lapse of control over emotional expressions such as laughing or crying, a phenomenon called pseudobulbar affect.

Laughing or crying bouts, often triggered by the smallest of things, are more related to the disease process rather than to actual feelings of happiness or sadness.

Medications such as Nuedexta and various other strategies can help manage this symptom. Skip to main content. Search MDA. Search Donate. References Thakore, N. Laughter, crying and sadness in ALS. Psychiatry Sudomotor dysfunction in amyotrophic lateral sclerosis. Pain in amyotrophic lateral sclerosis.