Case reports  CLINICAL MEDICINE 

The Journal of Sports Medicine and Physical Fitness 2002 March;42(1):92-4

Copyright © 2009 EDIZIONI MINERVA MEDICA

language: English

Exercise-induced, persistent and generalized muscle cramps. A case report

Dickhuth H. H., Röcker K., Niess A., Horstmann T., Mayer F., Striegel H.

From the Medical Clinic and Polyclinic, Department of Sports Medicine, University of Tübingen, Tübingen, Germany

We are ­reporting on a 46-­year-old man who has suf­fered of ­muscle ­cramps for 4 ­years, occur­ring imme­di­ately ­after jog­ging and ­playing ­tennis and ­lasting for 7-8 ­hours. ­Repeated neu­ro­log­ical, ortho­pedic, ­internal med­ical and endo­crin­o­log­ical exam­ina­tions ­showed no path­o­log­ical find­ings. Phys­io­therapy, sup­ple­men­ta­tion of ­fluids and elec­tro­lytes had no ­effect, nor did med­i­ca­tion ­therapy ­with ­muscle relax­ants. ­During spi­roer­gom­etry ­without med­i­ca­tion, ­there was an over­pro­por­tional ­increase of ­heart ­rate and res­pir­a­tory ­rate ­with ­delayed pCO2 ­increase ­after exer­cise ­with oth­er­wise ­normal ­blood gas ­levels. ­This reac­tion was con­sid­er­ably ­reduced ­during spi­roer­gom­etry ­under β-­blockade (metop­rolol 100 mg); at the ­same ­time, the ­muscle ­cramps ­could no ­longer be ­induced. ­Both exces­sive res­pir­a­tory reg­u­la­tion and ­direct hyper­ad­re­nergic stim­u­la­tion ­should be dis­cussed as the pri­mary ­cause of the ­muscle ­cramps. ­According to ­recent find­ings, β-­blockers ­with ­intrinsic sym­path­o­com­i­metic ­activity ­should be ­avoided in ­therapy.