CLINICAL EPIDEMIOLOGY OF NOCTURNAL LEG CRAMPS IN MALE VETERANS

This article describes patients with nocturnal leg cramps concerning t heir age, medical problems, and medications, and reviews any medical e valuation performed for the complaint of nocturnal leg cramps. Provide d is a retrospective chart review of 50 patients who took quinine sulf ate for nocturnal leg cramps. These patients were identified through c omputerized pharmacy records. A control group was chosen from age-matc hed patients who took medications other than quinine during the study period. In a university-affiliated Veterans Administration hospital, p atients with nocturnal leg cramps had a significantly higher median nu mber of medical problems than controls. Cardiovascular diseases and ne urological diseases were significantly more common in patients with no cturnal leg cramps (cases) than in those without (controls) (82% versu s 64% and 36% versus 18%, respectively). The most striking differences between patients with cramps and controls were peripheral vascular di sease (34% versus 12%, P = 0.09) and peripheral neurological deficit ( 12% versus 0%, P = 0.012). Patients with nocturnal leg cramps were pre scribed significantly more medications than were controls, but no spec ific medication or type of medication was prescribed more frequently t o patients with cramps (other than quinine). Results suggested that me n with nocturnal leg cramps have greater medical comorbidity and are p rescribed more medications than age-matched control patients. Unlike i n previous studies, no evidence was found that specific medications, s uch as diuretics, betaagonists, or calcium-channel antagonists are ass ociated with nighttime cramps. The significantly increased frequency o f peripheral vascular disease and peripheral neurologic deficits in pa tients with nocturnal leg cramps raised the possibility that these pro blems contribute to the occurrence of cramps, Although the size of the study and its methodologic limitations preclude definitive conclusion s, areas for research to clarify the clinical epidemiology of nocturna l leg cramps are suggested.