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.
