Restless Leg Syndrome
(RLS) is a neurological disorder that is fairly common but often unrecognized
or misdiagnosed and is characterized by uncomfortable sensations in
the legs, which are worse during periods of inactivity, resting or
whilst sitting or lying down. The condition is not dangerous or life-threatening
and does not indicate a serious disorder however, it is uncomfortable
and can disrupt sleep. The diagnosis of RLS is based on the patient’s
description and personal history of their affliction. The condition
most commonly occurs among older people and pregnant women. Because
it presents no external secondary symptoms, RLS can be difficult to
identify but its main characteristics are:
Difficulty Sleeping.
Persistent leg movements during sleep hours. Symptoms occur most frequently
during the evening or early part of the night.
Irresistible urge to move the legs.
Abnormal sensation in the legs, occasionally, feet, thighs, arms,
which entail creeping, burning, tingling, cramping, aching, pulling
or crawling sensations within the affected extremities.
Sensations or discomfort (not pain, not cramps) are relieved by movement
of the legs
May occur during the day.
Worse when lying down and may be temporarily diminished by voluntary
movements of the affected limb.
The disturbance is not due to the direct physiological effects of
a substance (e.g., a drug of abuse, a medication) or a general medical
condition.
Associated
Features:
Some of the conditions
associated with RLS are:
Chronic Renal
Failure
Peripheral Neuropathies
Amyloidosis (metabolic disorder of organs and tissues)
Diabetes Mellitus
Anemia and related hemoglobin deficiencies
Iron deficiency
Vitamin B12 deficiency
Uremia (kidney-related toxicity)
Leukemia
Rheumatoid Arthritis
Fibromyalgia
Isaac’s Syndrome
Huntington’s Chorea
Differential
Diagnosis:
Some disorders have similar symptoms. The clinician, therefore, in
his diagnostic attempt, has to differentiate against the following
disorders which need to be ruled out to establish a precise diagnosis.
Periodic Limb
Movement Disorder - The condition is characterized by behavior ranging
from shallow, continual movement of the ankle or toes, to wild and
strenuous kicking and flailing of the legs and arms. Periodic limb
movement disorder affects people only during sleep.
Nocturnal Seizures.
Generalized Anxiety Disorder.
Drug
Usage or Abuse.
Schizophrenia.
Cause:
Restless leg syndrome
(RLS) occurs most often in middle-aged and older adults. It is worsened
by stress. The cause is not known
Treatment:
There is no known cure for restless
leg syndrome The main treatment is to relieve the symptoms and make
the sufferer more comfortable. Warm baths, gentle stretching exercises,
massage or similar techniques may promote muscle relaxation.
Recent research has found that although there are no unique
pathological changes in the brains of patients with RLS, it appears
that cells in a portion of the mid-brain are not getting enough iron.
(Penn State College of Medicine and Johns Hopkins University)
Counseling
and Psychotherapy [ See
Therapy Section ]:
Minimizing stress
and promoting muscle relaxation are often helpful in reducing episodes
of restless leg syndrome through appropriate counselling or therapy.
Pharmacotherapy
[ See Psychopharmacology
Section ] :
The
following list of medications are used in the treatment of RLS however,
many of these do have have side effects.
Clonazepam
Parkinson drugs - levodopa/carbidopa
Codeine
Oxycodone
Methadone
Propoxyphene
Current
research suggests correction of iron deficiency may improve symptoms
for some patients.
