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Restless Leg Syndrome
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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.

 


DSM Code

None

G25.81 Restless Leg Syndrome

Disorder Sheets

RLS:UK/ESA
42 Nursery Road, Rainham,
Gillingham,
Kent
ME8 0BE
Tel: +441634260483
Email: None Indicated
Website: Click Here

Recommended Book

Sleep Thief, Restless Legs Syndrome - Click Here to View

 

Restless Leg Syndrome

Misc Information

RLS Foundation Chatroom

Sleep Disorders