特发性腿痛性痉挛较为常见,约 33% 到 95% 的成人患病。[6]Wilder J. Crampus disease and localized muscle cramps. Med Rec. 1940;152:442-446.[7]Norris FH Jr, Gasteiger EL, Chatfield PO. An electromyographic study of induced and spontaneous muscle cramps. Electroencephalogr Clin Neurophysiol. 1957;9:139-147.http://www.ncbi.nlm.nih.gov/pubmed/13404940?tool=bestpractice.com[8]Hall AJ. Cramp and salt balance in ordinary life. Lancet. 1947;2:231-233.[9]Oboler SK, Prochazka AV, Meyer TJ. Leg symptoms in outpatient veterans. West J Med. 1991;155:256-259.http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1002979/pdf/westjmed00097-0046.pdfhttp://www.ncbi.nlm.nih.gov/pubmed/1659038?tool=bestpractice.com[10]Naylor JR, Young JB. A general population survey of rest cramps. Age Ageing. 1994;23:418-420.http://www.ncbi.nlm.nih.gov/pubmed/7825490?tool=bestpractice.com[11]Abdulla AJ, Jones PW, Pearce VR. Leg cramps in the elderly: prevalence, drug and disease associations. Int J Clin Pract. 1999;53:494-496.http://www.ncbi.nlm.nih.gov/pubmed/10692732?tool=bestpractice.com 与成人相比,这种痛性痉挛在儿童中发生率较低。 约 7% 的健康儿童存在夜间腿痛性痉挛,仅在 8 岁以后才开始出现相关症状,发病高峰为16 到 18 岁。[12]Leung AK, Wong BE, Chan PY, et al. Nocturnal leg cramps in children: incidence and clinical characteristics. J Natl Med Assoc. 1999;91:329-332.http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2608508/pdf/jnma00351-0033.pdfhttp://www.ncbi.nlm.nih.gov/pubmed/10388258?tool=bestpractice.com 痛性痉挛在女性(32% 到 56%)中比男性(26% 到 40%)中更常见。[11]Abdulla AJ, Jones PW, Pearce VR. Leg cramps in the elderly: prevalence, drug and disease associations. Int J Clin Pract. 1999;53:494-496.http://www.ncbi.nlm.nih.gov/pubmed/10692732?tool=bestpractice.com[13]Jansen PH, Joosten EM, van Dijck J, et al. The incidence of muscle cramp. J Neurol Neurosurg Psychiatry. 1991;54:1124-1125.http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1014704/pdf/jnnpsyc00510-0088.pdfhttp://www.ncbi.nlm.nih.gov/pubmed/1783937?tool=bestpractice.com 大约 75% 的成人与儿童痛性痉挛在夜间发生。[12]Leung AK, Wong BE, Chan PY, et al. Nocturnal leg cramps in children: incidence and clinical characteristics. J Natl Med Assoc. 1999;91:329-332.http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2608508/pdf/jnma00351-0033.pdfhttp://www.ncbi.nlm.nih.gov/pubmed/10388258?tool=bestpractice.com[10]Naylor JR, Young JB. A general population survey of rest cramps. Age Ageing. 1994;23:418-420.http://www.ncbi.nlm.nih.gov/pubmed/7825490?tool=bestpractice.com[11]Abdulla AJ, Jones PW, Pearce VR. Leg cramps in the elderly: prevalence, drug and disease associations. Int J Clin Pract. 1999;53:494-496.http://www.ncbi.nlm.nih.gov/pubmed/10692732?tool=bestpractice.com 特发性痛性痉挛通常累及单块肌肉或一块肌肉的某些部分,腓肠肌受累尤为常见。[14]Miller TM, Layzer RB. Muscle cramps. Muscle Nerve. 2005;32:431-442.http://www.ncbi.nlm.nih.gov/pubmed/15902691?tool=bestpractice.com 大多数发作累及腓肠肌 (83%),其次为足部肌肉 (40%)。[10]Naylor JR, Young JB. A general population survey of rest cramps. Age Ageing. 1994;23:418-420.http://www.ncbi.nlm.nih.gov/pubmed/7825490?tool=bestpractice.com[13]Jansen PH, Joosten EM, van Dijck J, et al. The incidence of muscle cramp. J Neurol Neurosurg Psychiatry. 1991;54:1124-1125.http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1014704/pdf/jnnpsyc00510-0088.pdfhttp://www.ncbi.nlm.nih.gov/pubmed/1783937?tool=bestpractice.com 其他肌肉的局灶性痛性痉挛较少见, 但常在神经肌病患者中发现。[1]Bradley WG, Daroff RB, Fenichel GM, et al. Neurology in clinical practice. 5th ed. Volumes 1 and 2. Philadelphia, PA: Butterworth-Heinemann-Elsevier; 2008. 成人平均每次发作持续约 8 到 9 分钟,儿童约 2 分钟。[10]Naylor JR, Young JB. A general population survey of rest cramps. Age Ageing. 1994;23:418-420.http://www.ncbi.nlm.nih.gov/pubmed/7825490?tool=bestpractice.com[11]Abdulla AJ, Jones PW, Pearce VR. Leg cramps in the elderly: prevalence, drug and disease associations. Int J Clin Pract. 1999;53:494-496.http://www.ncbi.nlm.nih.gov/pubmed/10692732?tool=bestpractice.com[12]Leung AK, Wong BE, Chan PY, et al. Nocturnal leg cramps in children: incidence and clinical characteristics. J Natl Med Assoc. 1999;91:329-332.http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2608508/pdf/jnma00351-0033.pdfhttp://www.ncbi.nlm.nih.gov/pubmed/10388258?tool=bestpractice.com 多数受累患儿并不经常发生痛性痉挛(82% 每年有 1 到 4 次发作)。[12]Leung AK, Wong BE, Chan PY, et al. Nocturnal leg cramps in children: incidence and clinical characteristics. J Natl Med Assoc. 1999;91:329-332.http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2608508/pdf/jnma00351-0033.pdfhttp://www.ncbi.nlm.nih.gov/pubmed/10388258?tool=bestpractice.com
大约 5% 到 75% 的妊娠妇女会发生肌肉痉挛,尤其在孕期的最后三个月,[15]Hertz G, Fast A, Feinsilver SH, et al. Sleep in normal late pregnancy. Sleep. 1992;15:246-251.http://www.ncbi.nlm.nih.gov/pubmed/1621025?tool=bestpractice.com 分娩后会显著缓解。[15]Hertz G, Fast A, Feinsilver SH, et al. Sleep in normal late pregnancy. Sleep. 1992;15:246-251.http://www.ncbi.nlm.nih.gov/pubmed/1621025?tool=bestpractice.com 血液透析期间痛性痉挛的发病率为 15% 到 87% 不等。[16]Neal CR, Resnikoff E, Unger AM. Treatment of dialysis-related muscle cramps with hypertonic dextrose. Arch Intern Med. 1981;141:171-173.http://www.ncbi.nlm.nih.gov/pubmed/7006544?tool=bestpractice.com[17]Donauer J, Kolblin D, Bek M, et al. Ultrafiltration profiling and measurement of relative blood volume as strategies to reduce hemodialysis-related side effects. Am J Kid Dis. 2000;36:115-123.http://www.ncbi.nlm.nih.gov/pubmed/10873880?tool=bestpractice.com[18]Noordzij M, Boeschoten EW, Bos WJ, et al. Disturbed mineral metabolism is associated with muscle and skin complaints in a prospective cohort of dialysis patients. Nephrol Dial Transplant. 2007;22:2944-2949.http://ndt.oxfordjournals.org/content/22/10/2944.fullhttp://www.ncbi.nlm.nih.gov/pubmed/17597087?tool=bestpractice.com[19]Brass EP, Adler S, Sietsema KE, et al. Peripheral arterial disease is not associated with an increased prevalence of intradialytic cramps in patients on maintenance hemodialysis. Am J Nephrol. 2002;22:491-496.http://www.ncbi.nlm.nih.gov/pubmed/12381949?tool=bestpractice.com[20]Ahmad S, Robertson HT, Golper TA, et al. Multicenter trial of L-carnitine in maintenance hemodialysis patients. II. Clinical and biochemical effects. Kidney Int. 1990;38:912-918.http://www.nature.com/ki/journal/v38/n5/pdf/ki1990290a.pdfhttp://www.ncbi.nlm.nih.gov/pubmed/2266675?tool=bestpractice.com 血液透析和腹膜透析期间发生痛性痉挛的风险接近。[18]Noordzij M, Boeschoten EW, Bos WJ, et al. Disturbed mineral metabolism is associated with muscle and skin complaints in a prospective cohort of dialysis patients. Nephrol Dial Transplant. 2007;22:2944-2949.http://ndt.oxfordjournals.org/content/22/10/2944.fullhttp://www.ncbi.nlm.nih.gov/pubmed/17597087?tool=bestpractice.com 肝硬化患者中痛性痉挛的发病率为 22% 到 88%。[21]Marotta PJ, Graziadei IW, Ghent CN. Muscle cramps: a 'complication' of cirrhosis. Can J Gastroenterol. 2000;14(suppl D):21D-25D.http://www.ncbi.nlm.nih.gov/pubmed/11110608?tool=bestpractice.com[22]Konikoff F, Theodor E. Painful muscle cramps. A symptom of liver cirrhosis? J Clin Gastroenterol. 1986;8:669-672.http://www.ncbi.nlm.nih.gov/pubmed/3805668?tool=bestpractice.com[23]Kobayashi Y, Kawasaki T, Yoshimi T, et al. Muscle cramps in chronic liver diseases and treatment with antispastic agent (eperisone hydrochloride). Dig Dis Sci. 1992;37:1145-1146.http://www.ncbi.nlm.nih.gov/pubmed/1618065?tool=bestpractice.com[24]Angeli P, Albino G, Carraro P, et al. Cirrhosis and muscle cramps: evidence of a causal relationship. Hepatology. 1996;23:264-273.http://onlinelibrary.wiley.com/doi/10.1002/hep.510230211/pdfhttp://www.ncbi.nlm.nih.gov/pubmed/8591851?tool=bestpractice.com[25]Abrams GA, Concato J, Fallon MB. Muscle cramps in patients with cirrhosis. Am J Gastroenterol. 1996;91:1363-1366.http://www.ncbi.nlm.nih.gov/pubmed/8677996?tool=bestpractice.com 这些患者中有 12% 到 42% 为临床相关的痛性痉挛(至少每周发作一次,对患者的生活质量产生负面影响,并且需要镇痛)。[21]Marotta PJ, Graziadei IW, Ghent CN. Muscle cramps: a 'complication' of cirrhosis. Can J Gastroenterol. 2000;14(suppl D):21D-25D.http://www.ncbi.nlm.nih.gov/pubmed/11110608?tool=bestpractice.com 与对照组或慢性非硬化肝病患者相比,肝硬化患者的痛性痉挛患病率显著更高。 与其他人群不同的是,肝硬化患者多在静息间 (79%) 而非睡眠间 (10%) 发生痛性痉挛,更多累及手指 (25%) 与大腿 (19%)。[22]Konikoff F, Theodor E. Painful muscle cramps. A symptom of liver cirrhosis? J Clin Gastroenterol. 1986;8:669-672.http://www.ncbi.nlm.nih.gov/pubmed/3805668?tool=bestpractice.com[23]Kobayashi Y, Kawasaki T, Yoshimi T, et al. Muscle cramps in chronic liver diseases and treatment with antispastic agent (eperisone hydrochloride). Dig Dis Sci. 1992;37:1145-1146.http://www.ncbi.nlm.nih.gov/pubmed/1618065?tool=bestpractice.com
进行剧烈运动,尤其是铁人三项 (68%)、马拉松 (39%) 和超级马拉松 (100%) 等耐力项目的人易发生运动相关性肌肉痉挛 (EAMC)。[26]Schwellnus MP, Drew N, Collins M. Muscle cramping in athletes - risk factors, clinical assessment, and management. Clin Sports Med. 2008;27:183-194.http://www.ncbi.nlm.nih.gov/pubmed/18206574?tool=bestpractice.com[27]Fallon KE. Musculoskeletal injuries in the ultramarathon: the 1990 Westfield Sydney to Melbourne run. Br J Sports Med. 1996;30:319-323.http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1332416/pdf/brjsmed00008-0048.pdfhttp://www.ncbi.nlm.nih.gov/pubmed/9015594?tool=bestpractice.com 参与团队运动的人也易于发生 EAMC(例如:橄榄球:52%;自行车:60%)。[26]Schwellnus MP, Drew N, Collins M. Muscle cramping in athletes - risk factors, clinical assessment, and management. Clin Sports Med. 2008;27:183-194.http://www.ncbi.nlm.nih.gov/pubmed/18206574?tool=bestpractice.com