Red flags The following findings are of particular concern: Upper extremity or truncal involvement Hyperreflexia or hyporeflexia Muscle weakness Fasciculations Signs of alcoholism Hypovolemia Pain or loss of sensation in a peripheral nerve, plexus, or root distribution Interpretation of findings Focal cramps suggest benign idiopathic leg cramps, exercise-associated muscle cramping, musculoskeletal abnormalities, peripheral nervous system causes, or an early degenerative disorder that can be asymmetric, such as a motor neuron disorder.