As cãibras musculares idiopáticas nas pernas são comuns. As estimativas de prevalência e frequência dos ataques variam, mas a maioria dos adultos relata ter sentido cãibras nas pernas em algum momento.[3]American Academy of Sleep Medicine. International classification of sleep disorders - third edition, text revision (ICSD-3-TR). Jun 2023 [internet publication].[8]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.pdf
http://www.ncbi.nlm.nih.gov/pubmed/1659038?tool=bestpractice.com
[9]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
[10]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
[11]Grandner MA, Winkelman JW. Nocturnal leg cramps: Prevalence and associations with demographics, sleep disturbance symptoms, medical conditions, and cardiometabolic risk factors. PLoS One. 2017;12(6):e0178465.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5460850
http://www.ncbi.nlm.nih.gov/pubmed/28586374?tool=bestpractice.com
A prevalência e a frequência dos ataques são maiores nos idosos.[9]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]Grandner MA, Winkelman JW. Nocturnal leg cramps: Prevalence and associations with demographics, sleep disturbance symptoms, medical conditions, and cardiometabolic risk factors. PLoS One. 2017;12(6):e0178465.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5460850
http://www.ncbi.nlm.nih.gov/pubmed/28586374?tool=bestpractice.com
[12]Maisonneuve H, Chambe J, Delacour C, et al. Prevalence of cramps in patients over the age of 60 in primary care : a cross sectional study. BMC Fam Pract. 2016 Aug 12;17(1):111.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4983045
http://www.ncbi.nlm.nih.gov/pubmed/27520635?tool=bestpractice.com
[13]Hallegraeff J, de Greef M, Krijnen W, et al. Criteria in diagnosing nocturnal leg cramps: a systematic review. BMC Fam Pract. 2017 Feb 28;18(1):29.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5330021
http://www.ncbi.nlm.nih.gov/pubmed/28241802?tool=bestpractice.com
As mulheres relatam sentir cãibras com mais frequência que os homens.[10]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
[11]Grandner MA, Winkelman JW. Nocturnal leg cramps: Prevalence and associations with demographics, sleep disturbance symptoms, medical conditions, and cardiometabolic risk factors. PLoS One. 2017;12(6):e0178465.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5460850
http://www.ncbi.nlm.nih.gov/pubmed/28586374?tool=bestpractice.com
[14]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.pdf
http://www.ncbi.nlm.nih.gov/pubmed/1783937?tool=bestpractice.com
As cãibras idiopáticas são menos comuns nas crianças que nos adultos. Cãibras noturnas nas pernas foram relatadas em cerca de 7% dos participantes de um estudo de coorte com cerca de 2500 crianças saudáveis, começando apenas depois dos 8 anos e atingindo a intensidade máxima na prevalência aos 16 a 18 anos.[15]Leung AK, Wong BE, Chan PY, et al. Nocturnal leg cramps in children: incidence and clinical characteristics. J Natl Med Assoc. 1999;91:329-32.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2608508/pdf/jnma00351-0033.pdf
http://www.ncbi.nlm.nih.gov/pubmed/10388258?tool=bestpractice.com
A maioria das crianças afetadas não tem cãibras com frequência.[15]Leung AK, Wong BE, Chan PY, et al. Nocturnal leg cramps in children: incidence and clinical characteristics. J Natl Med Assoc. 1999;91:329-32.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2608508/pdf/jnma00351-0033.pdf
http://www.ncbi.nlm.nih.gov/pubmed/10388258?tool=bestpractice.com
Foi relatado que a duração média por episódio de cãibra é de 8 a 9 minutos em adultos e 2 minutos em crianças.[9]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
[10]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
[15]Leung AK, Wong BE, Chan PY, et al. Nocturnal leg cramps in children: incidence and clinical characteristics. J Natl Med Assoc. 1999;91:329-32.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2608508/pdf/jnma00351-0033.pdf
http://www.ncbi.nlm.nih.gov/pubmed/10388258?tool=bestpractice.com
Cerca de 75% dos episódios de cãibras em adultos e crianças ocorrem à noite.[9]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
[10]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
[15]Leung AK, Wong BE, Chan PY, et al. Nocturnal leg cramps in children: incidence and clinical characteristics. J Natl Med Assoc. 1999;91:329-32.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2608508/pdf/jnma00351-0033.pdf
http://www.ncbi.nlm.nih.gov/pubmed/10388258?tool=bestpractice.com
As cãibras idiopáticas geralmente envolvem músculos isolados ou parte de um músculo, particularmente o gastrocnêmio.[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.[16]Miller TM, Layzer RB. Muscle cramps. Muscle Nerve. 2005;32:431-42.
http://www.ncbi.nlm.nih.gov/pubmed/15902691?tool=bestpractice.com
A maioria dos episódios envolve os músculos da panturrilha, seguidos pelos músculos dos pés; relatou-se que as cãibras nos pés são mais comuns nas mulheres que nos homens.[3]American Academy of Sleep Medicine. International classification of sleep disorders - third edition, text revision (ICSD-3-TR). Jun 2023 [internet publication].[9]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
[14]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.pdf
http://www.ncbi.nlm.nih.gov/pubmed/1783937?tool=bestpractice.com
As cãibras locais em outros músculos são menos comuns. Entretanto, são frequentemente observadas no contexto de doença neuromuscular.[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.
As cãibras musculares são comumente sentidas por gestantes, principalmente durante o último trimestre.[17]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
Isso diminui significativamente após o parto.[17]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
As estimativas da prevalência das cãibras durante a hemodiálise variam de 15% a 87%.[18]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
[19]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
[20]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.full
http://www.ncbi.nlm.nih.gov/pubmed/17597087?tool=bestpractice.com
[21]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
[22]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.
https://www.kidney-international.org/article/S0085-2538(15)57035-X/pdf
http://www.ncbi.nlm.nih.gov/pubmed/2266675?tool=bestpractice.com
O risco de cãibras pode ser semelhante durante a hemodiálise e a diálise peritoneal.[20]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.full
http://www.ncbi.nlm.nih.gov/pubmed/17597087?tool=bestpractice.com
As estimativas da prevalência das cãibras em pacientes com cirrose variam de 22% a 88%.[23]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
[24]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
[25]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
[26]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/pdf
http://www.ncbi.nlm.nih.gov/pubmed/8591851?tool=bestpractice.com
[27]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
As cãibras clinicamente relevantes (definidas como cãibras que ocorrem pelo menos uma vez por semana, que afetam negativamente a qualidade de vida do paciente e requerem analgesia) foram relatadas em 12% a 42% desses pacientes.[23]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
A prevalência das cãibras é significativamente maior nos pacientes com cirrose que em controles ou em pacientes com doença hepática crônica não cirrótica. Em contraste com outras populações, os pacientes com cirrose apresentam cãibras com mais frequência durante o repouso que durante o sono, e uma maior proporção dos episódios envolve os dedos e as coxas.[24]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
[25]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
Várias outras afecções clínicas crônicas estão associadas a cãibras noturnas nas pernas. Isso inclui depressão, artrite, doença cardiovascular e doença respiratória.[11]Grandner MA, Winkelman JW. Nocturnal leg cramps: Prevalence and associations with demographics, sleep disturbance symptoms, medical conditions, and cardiometabolic risk factors. PLoS One. 2017;12(6):e0178465.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5460850
http://www.ncbi.nlm.nih.gov/pubmed/28586374?tool=bestpractice.com
As pessoas que realizam exercícios extenuantes, principalmente em provas de resistência, como triatlos, maratonas e ultramaratonas, estão predispostas a cãibras musculares associadas ao exercício (CMAE).[28]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
[29]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.pdf
http://www.ncbi.nlm.nih.gov/pubmed/9015594?tool=bestpractice.com
[30]Maughan RJ, Shirreffs SM. Muscle cramping during exercise: causes, solutions, and questions remaining. Sports Med. 2019 Dec;49(suppl 2):115-24.
http://www.ncbi.nlm.nih.gov/pubmed/31696455?tool=bestpractice.com
Pessoas que participam de esportes em equipe (por exemplo, rúgbi) também relatam altos níveis de CMAE.[28]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
[30]Maughan RJ, Shirreffs SM. Muscle cramping during exercise: causes, solutions, and questions remaining. Sports Med. 2019 Dec;49(suppl 2):115-24.
http://www.ncbi.nlm.nih.gov/pubmed/31696455?tool=bestpractice.com