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Medical history, physical examination, and a limited laboratory screen help to determine the various causes of muscle cramps. Despite the \u201cbenign\u201d nature of cramps, many patients find the symptom very uncomfortable. Treatment options are guided both by experience and by a limited number of therapeutic trials. Quinine sulfate is an effective medication, but the side\u2010effect profile is worrisome, and other membrane\u2010stabilizing drugs are probably just as effective. Patients will benefit from further studies to better define the pathophysiology of muscle cramps and to find more effective medications with fewer side\u2010effects. 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