Muscle Cramps and Spasms: Or something else? Differential Diagnosis

Differential diagnoses for Cramps (Crampi/Krampi)

Respiratory System (J00-J99)

  • Hyperventilation

Endocrine, nutritional, and metabolic diseases (E00-E90).

  • Carnitine Deficiency – Carnitine is a vitaminoid, 98% of which is stored in heart and skeletal muscle.
  • Hypocalcemia (calcium deficiency).
  • Hypomagnesemia (magnesium deficiency)
  • Hyponatremia (sodium deficiency)
  • Hypoparathyroidism (parathyroid insufficiency).
  • Hypothyroidism (hypothyroidism)
  • Hypovolemia, hypotonic dehydration (hyponatremia / sodium deficiency) – lack of water, dehydration of the body.
  • Addison’s disease – primary adrenocortical insufficiency (adrenal insufficiency).
  • Phosphofructokinase deficiency (glycogenosis type VII, Tarui disease) – deficiency of an enzyme of carbohydrate metabolism.
  • Thyroid dysfunction, unspecified.

Cardiovascular system (I00-I99)

Infectious and parasitic diseases (A00-B99).

  • Tetanus

Liver, gallbladder and bile ducts – Pancreas (pancreas) (K70-K77; K80-K87).

  • Liver cirrhosis – irreversible damage to the liver leading to gradual connective tissue remodeling of the liver with impairment of liver function.

Musculoskeletal system and connective tissue (M00-M99).

  • Contracture, unspecified – involuntary permanent muscle shortening leading to joint constraint.
  • Metabolic myopathies – muscle changes caused by metabolic disorders.
  • Muscle pain, ischemic related

Psyche – nervous system (F00-F99; G00-G99)

  • Amyotrophic lateral sclerosis (ALS) – progressive, irreversible degeneration of the motor nervous system; in this case, fasciculations as a symptom of the demise of α-motoneurons.
  • Brody syndrome – pseudomyotonic dysfunction of skeletal muscles; muscles are stiff after marked activity and take several minutes to fully relax; creatine kinase (CK) normal or slightly elevated; autosomal recessive inheritance is present in most cases
  • Dystonia – disorder of the state of tension of the muscles, unspecified.
  • Neuromyotonia – disorder leading to sudden and episodic muscle activity with permanent tension of the muscles.
  • Polyneuropathy, unspecified – generic term for diseases of the peripheral nervous system associated with chronic disorders of peripheral nerves or parts of nerves.
  • Spastic tonus elevation
  • Stiff-man syndrome (SMS; synonyms: Stiff-person syndrome, SPS; Moersch-Woltman syndrome); neurological disorder characterized by generalized tone elevation of the muscles; in addition, spasms occur spontaneously or triggered in the affected muscles; usually the back and hip muscles are symmetrically affected; Gait becomes stiff-legged and bizarre; many have insulin-requiring diabetes mellitus (30%), autoimmune thyroiditis (autoimmune disease leading to chronic thyroiditis; 10%), atrophic gastritis (gastritis) with pernicious anemia (vitamin B12 deficiency anemia (anemia of the blood); 5%)

Pregnancy, childbirth, and puerperium (O00-O99).

  • Pregnancy

Symptoms and abnormal clinical and laboratory findings not elsewhere classified (R00-R99)

  • Edema (water retention), unspecified.
  • Tetany – neuromuscular hyperexcitability with painful muscle spasms.
  • Uremia (occurrence of urinary substances in the blood above normal levels).

Medication

Environmental exposures – intoxications (poisonings).

  • Strychnine poisoning

Further

  • Behavioral causes
    • Alcohol consumption (possible trigger) – People (aged 60 to 86 years) with nocturnal calf cramps consumed a median of 94 g of alcohol weekly, controls without such complaints 66 g; patients who consumed at least one alcoholic beverage per week were 6.5 times more likely to have nocturnal calf cramps than those who consumed less.
    • Caffeine consumption
    • Physical work or sports stress, especially heat stress (heavy sweating, salt loss).
  • Pregnancy
  • Hemodialysis

Differential diagnoses for spasticity

Cardiovascular (I00-I99).

  • Apoplexy (stroke)

Psyche – nervous system (F00-F99; G00-G99)

  • Hereditary spastic spinal paralysis (HSP; paraplegia) – genetic disease with autosomal dominant, autosomal recessive, as well as X-linked recessive inheritance, leading to increasing spasticity and paralysis of the legs; disease can start in early childhood, but even 70-year-olds can still suffer from it. Men suffer from it twice as often as women.
  • Hypoxic brain injury – brain damage that is due to a lack of oxygen to the brain.
  • Multiple sclerosis (MS)
  • Spinal cord lesion, unspecified

Injuries, poisoning, and other sequelae of external causes (S00-T98).