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Muscle cramps are common in liver disease, especially in patients with cirrhosis, among whom the prevalence ranges from 22% to 88% based on varying definitions of cramps. A new review summarizes the state of knowledge on biological mechanisms and treatment options.
The underlying mechanism of muscle cramps in cirrhosis is still not fully elucidated, but possibilities include alterations in three overlapping categories: nerve function, energy metabolism, and electrolytes and plasma volume.
Nerve dysfunction in cirrhosis may be due to structural alterations and oxidative stress leading to increased excitability of motor neurons. Treatments such as vitamin E (300 mg three times daily), quinine sulfate (200 mg twice daily), and eperisone hydrochl…