Abstract Details

Title The Natural History of Muscle Cramps in ALS

Topic Anterior Horn

Presentation(s) P06 - (-)

Poster/Presentation
Number 139

Objective

Background BACKGROUND: ALS is a progressive motor neuron disease that affects 2 patients per 100,000 worldwide. Muscle cramps are a common source of pain in ALS, and there are no widely accepted effective treatments. This study examines the frequency and severity of muscle cramps in ALS patients over time as well as the pattern of fasciculations over time.

Design/Methods DESIGN/METHODS: ALS patients with onset of weakness < 18 months were enrolled, regardless of history of cramps. Patients were surveyed monthly determining the frequency, severity, and location of muscle cramps, the pattern of fasciculations, and their use of medications for cramps. Participants were examined approximately every 3 months and provided information for the ALS-FRS score.

Results RESULTS: Prospective data were collected from 41 participants (mean age = 64, 23 men). Mean duration of ALS at enrollment was 11 months with a mean ALS-FRS of 38. At baseline, the mean number of cramps per month was 47 (range 0-600) and 9 patients had no cramps at all. Those that had zero cramps remained nearly cramp-free throughout the observed period. Five individuals reported extremely frequent and severe cramps. The greatest number and severity of cramps was seen between 12-24 months from disease onset followed by a gradual decline in the number of cramps reported.

Conclusions CONCLUSIONS: Muscle cramps in the ALS population appear to develop within the first year of symptoms, with approximately 75% of study patients complaining of cramps. While individual patients demonstrate significant variability, frequency of muscle cramps appears most prominent in months 12-24 from onset of disease, suggesting this is an optimal period for clinical trials aimed at ameliorating cramps.

Authors/Disclosures
Elizabeth Sullivan, MD PRESENTER	No disclosure on file
	No disclosure on file
	No disclosure on file
Mozhdeh Marandi	No disclosure on file
	No disclosure on file
Hans-Peter Hartung, MD, FAAN (Heinrich Heine University Medical Faculty)	Dr. Hartung has received personal compensation in the range of $500-$4,999 for serving as a Consultant for BMS Celgene. Dr. Hartung has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Geneuro. Dr. Hartung has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Novartis. Dr. Hartung has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Novartis. Dr. Hartung has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Merck. Dr. Hartung has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Bayer. Dr. Hartung has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for TG Therapeutics. Dr. Hartung has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Roche. Dr. Hartung has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Frontiers Neurology.
Michael Cartwright, MD (Wake Forest School of Medicine)	Dr. Cartwright has received publishing royalties from a publication relating to health care.
James B. Caress, MD, FAAN (Wake Forest School of Medicine)	Dr. Caress has received personal compensation in the range of $5,000-$9,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Wiley Publishing Inc.. Dr. Caress has received personal compensation in the range of $0-$499 for serving as a Grant Reviewer with US Department of Defense.

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