Restless Legs Syndrome
What is it?
Restless legs syndrome is a neurological disorder whose primary feature is an irresistible urge to move the legs when the individual is at rest, referred to as focal akathisia. The sensation is worse at night. Relief from the sensation is almost immediate when the individual moves the legs or walks around. However, if the individual stops moving or walking, the sensation may return. The sensation will usually lead to insomnia. The bed partner may notice periodic or rhythmic movements of the legs when the individual is asleep. Restless legs syndrome affects between 2 and 5 percent of the general population. Although the syndrome can occur in all age groups, its incidence seems to increase with age. The condition, though unpleasant and annoying, is not a major health risk, nor is it an early warning sign of a more serious neurological disorder such as Parkinson's disease.
What Causes It?
- The exact cause of restless legs syndrome is unknown, but some studies suggest the symptoms are related to low levels of the neurotransmitter dopamine in the brain.
- Hereditary factors may play a role.
- Emotional stress or regular use of caffeine, antihistamines, or tobacco may trigger or worsen symptoms.
- It is associated with iron deficiency, pregnancy, dialysis, and peripheral neuropathy (see Anemia, Iron Deficiency and Peripheral Neuropathies for more information).
Prevention
- There is no way to prevent restless legs syndrome.
Diagnosis
- Diagnosis is based upon the symptoms.
- A polysomnagram may be conducted to study sleep behavior if symptoms occur only during sleep.
- Physical examination may be performed to rule out other disorders such as neuropathy, myopathy, or arthropathy.
- Blood tests (ferritin and percent iron saturation) to measure iron status should always be conducted.
How to Treat It
- Although some nondrug therapies are outlined below, the only consistently successful treatments are with medications.
- Walk around for 10 to 15 minutes prior to going to bed, to stretch the leg muscles and promote restful sleep. Contracting, massaging, or keeping the leg muscles warm before going to bed may relieve symptoms.
- Many medications appear to be effective: the dopamine-related medications (such as levodopa, pergolide, pramipexole, and ropinirole), analgesics (such as codeine, propoxyphene, and tramadol), clonazepam, and gabapentin.
- Antipsychotic medications (neuroleptics), antiemetics (nausea preventives), and antidepressants may aggravate the symptoms, as may long-term use of levodopa (see your doctor for an alternative).
- Some cases caused by iron deficiency may respond to iron supplements, but these should not be taken without your doctor's guidance.
When to Call a Doctor
- Make an appointment with a doctor if restless legs symptoms interfere with sleep.
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Copyright © 2008 Medletter Associates, LLC
Content excerpted from Johns Hopkins Symptoms and Remedies: The Complete Home Medical Reference.