A scoping review on muscle cramps and spasms in upper motor neuron disorder–two sides of the same coin?

Frontiers in Neurology, 2024 · DOI: 10.3389/fneur.2024.1360521 · Published: March 1, 2024

Simple Explanation

This review explores the similarities and differences between muscle cramps and spasms, particularly in patients with upper motor neuron disorders (UMND). It questions whether what is often identified as a spasm might sometimes be a cramp. The study points out that muscle cramps are usually considered benign and common in healthy people, while spasms are linked to spasticity from central motor lesions. However, the clinical presentation can be very similar. The findings suggest that muscle cramps and spasms might be related symptoms with overlapping causes. Therefore, current treatment strategies should consider that some spasms reported by patients might actually be cramps.

Study Duration

Not specified

Participants

Patients with Upper Motor Neuron Disorder (spinal cord injury, cerebral palsy, traumatic brain injury, and stroke)

Evidence Level

Review

Key Findings

1
Most studies lacked explicit definitions for either 'spasm' or 'cramp', and when descriptions were present, the clinical resemblance between the two was significant.
2
Various methods were used to quantify cramp/spasm frequency, with self-reports being the most common approach, but these often lacked clear definitions, potentially leading to misinterpretations.
3
The review found a lack of scientific documentation on muscle cramps in individuals with UMND, suggesting these cramps may be misclassified as spasms.

Research Summary

This scoping review aimed to explore the definition, prevalence, characterization, and measurement of cramps and spasms in the literature on UMND to evaluate if current clinical measures can distinguish muscle cramps from spasms, considering shared pathophysiological mechanisms. The systematic search confirmed the initial hypothesis that 'cramping' is confined to specific patient groups other than UMND. Less than 10% of the studies defined either cramps or spasms, and among those covering both terms, only two differentiated between them, revealing a lack of consensus. The review concludes that muscle cramps and spasms probably represent related symptoms with a shared pathophysiological component. Recognizing that part of the patient’s spasticity may be attributed to muscle cramps necessitates a critical reconsideration of current treatment strategies.

Practical Implications

Reconsideration of treatment strategies

Clinicians should consider that some symptoms reported as spasms in neurological patients may actually be muscle cramps, requiring a different therapeutic approach.

Improved Diagnostic Clarity

There is a need for clearer definitions and diagnostic criteria to differentiate between muscle cramps and spasms in patients with UMND, leading to more accurate diagnoses.

Development of Objective Measures

The development and implementation of objective measurement tools are needed to quantify spasms and cramps to reduce reliance on subjective self-reports.

Study Limitations

1
The review is constrained by its focus on how the scientific literature describes muscle cramps and spasms in UMND.
2
Clinical practice may have a more nuanced understanding of these phenomena than is reflected in the literature.
3
The variability in patient interpretations of ‘cramps’ and ‘spasms’ across surveys could influence the results.

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