Progressive muscle cramps with pain as atypical initial presentations of amyotrophic lateral sclerosis: a case report

Abstract

Amyotrophic lateral sclerosis (ALS) is the most common form of motor neuron disease and is a progressive and devastating neurodegenerative disease that affects both lower and upper motor neurons. Muscle cramps, which are characterized by a sudden, painful, involuntary contraction of muscles, are not rare in ALS patients. However, muscle cramps do not normally present early in ALS and therefore not used for the initial diagnosis of ALS. In this paper the authors present a case of ALS with initial manifestation of progressive painful muscle cramps in the absence of muscle weakness. This case might help people to recognize atypical foremost presentations of ALS and therefore formulate effective therapies.