What causes extreme "Charlie Horse Spasms" in chins, calves and thighs of people with MS despite using Baclofen and Lyrica?
Spasms in the legs often do not respond to the same dose of medication used to treat overall spasticity even though they are related phenomenon. If the spasms do not respond to higher doses of Baclofen, tizanidine, gabapentin, Lyrica or a more standard muscle relaxer or if these doses cause too many side effects, we often add a benzodiazepine like diazepam or clonazepam at bedtime. This usually does the job for most people since cramps and spasms are more common at night while lying supine.
Cramps are a slightly different phenomenon causes by muscle irritability and will sometimes respond to magnesium oxide supplements (250 to 500 mg). But beware, higher doses of magnesium oxide can cause loose stools.
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