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Cramps

Muscle cramps are more common early in the disease course. There is insufficient data to support or refute any specific intervention for the treatment of cramps in ALS (Miller 2009b).

Baldinger and others 2012

  • There is no evidence to support the use of any intervention for muscle cramps in ALS/MND. More and larger randomised controlled trials evaluating treatments for muscle cramps in ALS/MND are needed.

Miller and others 2009b

  • Studies of gabapentin, vitamin E, and riluzole for treating cramps were all negative (Class III). There are safety concerns about quinine.
  • There is insufficient data to support or refute any specific intervention for the treatment of cramps in ALS (Level U).

MND Australia 2014

  • Drinking tonic water may ease symptoms - it contains a small amount of quinine

Drug treatment

  • Start with very small doses e.g. baclofen 5-10mg bd or diazepam 1-2mg bd - only bedtime doses may be required

Note: observe for respiratory depression associated with sedatives/opiods/diazepam

Referral Pathways

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