Cramp, characterized by a sudden, brief, intense, burst-like, involuntary contraction of muscle with
pain, is a very common phenomenon, and mostly happens as a form of benign conditions like nocturnal
leg cramps or exercise-associated muscle cramps in otherwise healthy people. Recent series of
electrophysiological studies suggest that hyperexcitability of motor neurons induced by muscle
afferent input is a main driving force of development of cramps. Detailed history taking and bedside
neurological evaluation are sufficient in most case not only for differentiation from other similar
complaints such as myalgia, paresthesia, but also for limiting the potential causes for the cramp. If
neither associated with neuromuscular or medical disorders, nor precipitated by a certain factor,
recurrent cramps should be managed with regular stretch exercise firstly as both preventive and
abortive measure. Cases with cramps refractory to stretch exercise then may be managed with various
agents like carbamazepine, gabapentin, and so on.

KEYWORDS : Cramp, Motor unit, Hyperexcitability