RESTLESS LEG SYNDROME

Collected,Compiled,Edited and Presented by :-

DR.V.JAGANNATHAN

Restless legs syndrome (RLS) is a movement condition that causes a strong urge to move the legs during rest. Sensations like itching, pulling, crawling or throbbing may be present. There is no cure for RLS, but treatment to control is available.

Restless legs syndrome (RLS) is a brain, nerve and sleep disorder that causes a strong, nearly irresistible urge to move the legs  at least partially to relieve the symptoms by movement. Symptoms are more common during rest in the evening.. The urge to constantly move can interfere with the ability to relax or fall asleep.

Types of restless legs syndrome?

There are two types of RLS:

• Early onset: Diagnosed before age 45, it usually runs in family and the condition progresses slowly.
• Late onset: RLS progresses more quickly and diagnosed after age 45.

Symptoms of restless legs syndrome?

• Uncomfortable sensations in the legs that make us want to move them.
• Sensations get worse during resting.
• Relief of discomfort (at least temporarily) when you the legs.are moved
• Twitchy legs or leg jerks in the evening and during sleep.

Symptoms of restless legs syndrome can affect sleep causing                   1)Sleep disruptions, difficulty falling asleep or staying asleep.

2)The urge to get out of bed to stretch or move your legs.

3)Fatigue or daytime drowsiness

4)Behavior or mood changes.

5)Difficulty in paying attention, remembering things or concentrating.

6)Depression or anxiety.

RLS SENSATIONS

Restless legs syndrome causes sensations that make us want to move our legs. but they can also may affect the arms or the entire body. One may experience the following feelings:

• Crawling.
• Itching.
• Aching.
• Burning.
• Throbbing.
• Pulling.
• Tugging.

Sensations can happen on one side of the body, but more commonly affect both sides equally

Causes of restless legs syndrome?

The cause of restless legs syndrome isn’t well understood. It may relate to how the basal ganglia functions. The basal ganglia use dopamine to regulate body movements. If it doesn’t get enough dopamine, it isn’t able to regulate the movement as efficiently as it should leading to RLS symptoms.

CONTRIBUTING FACTORS

• Genetics: RLS can be inherited. This is an Autosomal Dominant genetic disorder
• Iron deficiency: Iron can be low in the brain despite normal blood levels.
• Underlying medical condition: Some conditions can cause secondary RLS,
• Medications: Certain medications, like antihistamines, antidepressants or antiemetics , can cause RLS or make symptoms worse.

Conditions causing RLS

1)Iron deficiency in the Brain

2)Anemia.

3)Pregnancy.

4)Diabetes.

5)Kidney disease.

6)Peripheral neuropathy.

7)Substance use disorder.

Triggers of restless legs syndrome

• Alcohol.
• Caffeine.
• Nicotine.
• Certain drugs.
• Stress.

DIAGNOSIS

A complete medical history and family medical history. and physical exam to review and assess the symptoms.

There is no  test to diagnose RLS,

A  neurological exam and blood tests may help to rule out other conditions or determine the cause of theyour symptoms.

To confirm a diagnosis of RLS, the following criteria must be looked for

• The urge to move the legs, usually occurring with uncomfortable sensations like aching or pulling.
• Symptoms begin or worsen during periods of rest or inactivity.
• There is partial or total relief when stretching, walking or exercising the affected muscles.
• Symptoms are worse or only occur in the evening or at night.
• Another medical condition didn’t cause symptoms.

Management and Treatment

Treatment for RLS may include taking drugs or changing the routine at home to help relieve the symptoms. Some people may get their symptoms relieved if they work with their Physician to manage other underlying health conditions.

Drugs for Restless legs syndrome

Certain drugs can help relieve the symptoms of RLS.

1)Iron supplements, taken with vitamin C.

2)Antiseizure medications (gabapentin, pregabalin).

3)Dopamine agonists (pramipexole, ropinirole).

4)Dopamine precursors or medications that turn into dopamine (levodopa).

5)Certain medications like benzodiazepines (clonazepam), hypnotics (zolpidem) or opioids (methadone, buprenorphine) may help with severe cases if all other forms of treatment are ineffective.

Domicillary Measures

• Getting regular exercise, such as aerobics, riding a bike/stationary bike or walking. Avoid heavy or intense exercise within a few hours of bedtime.
• Following good sleep habits like avoiding reading, watching television or being on a computer or phone while lying in bed. Not getting enough sleep can make RLS symptoms worse.
• Soaking your legs in a warm tub, and applying a heating pad or cold compress to your legs. These may provide temporary relief for your discomfort.
• Reducing your overall stress. A mental health professional can help you with this.
• Avoiding caffeine, like drinking coffee, before bedtime.

Prevention

There’s no known way to prevent restless legs syndrome. You can reduce your risk of experiencing worsening symptoms by treating any underlying health conditions or avoiding triggers like caffeine and alcohol.

Prognosis

Restless legs syndrome doesn’t affect your life expectancy, but it can affect your overall wellness. Symptoms may be mild to severe. Even mild symptoms can have a major impact on your life.

DR.V.JAGANNATHAN

Thursday,october  17th  2024