Restless legs syndrome

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Rest leg syndrome is a disorder that presents primarily as creepy, crawly, achy sensation in the legs, but can affect any other part of the body.

Symptoms of restless leg syndrome

The symptoms of restless leg syndrome include creepy, crawly sensation, that is worse in the evenings, better with movement, happens at least 3 times per week, can affect both legs and other parts of the body, relieved with movement.

Types of restless leg syndrome

Primary

When there is no identifiable cause, it is called primary restless leg syndrome.

Secondary

Where there is an identifiable cause for restless leg syndrome, it is called secondary.

Clinical presentation

legs syndrome (RLS) is a neurological disorder that can affect any part of the body although most people present with symptoms in the legs. It commonly presents with a feeling of discomfort our sensation of creepy, crawly, achy feeling, creeping, achy feelings. This is often uncontrollable, and occasionally overwhelming, with an urge to move or stretch the legs. These symptoms often are worse in the evening or at night.

The symptoms can get worse as the night progresses. The symptoms are often relieved with movement or stretching.

Sleep problems related to Restless legs syndrome

Most people with restless leg syndrome can have difficulty initiating and maintaining sleep. They're often very tired and sleepy during the day. Since the restless legs syndrome can continue doing tonight significant leg movements throughout the night, the spouses people with restless legs syndrome can also have difficulty falling asleep and staying asleep. Restless leg syndrome at nighttime might present as periodic limb movement disorder. Often people might notice that the sheets on the bed are all over and the person might have a tendency to rock the bed.

Incidence of Restless legs syndrome

  • As many as 10 per hundred of the U.S. population may have Restless legs syndrome.
  • RLS occurs in both men and women, whereas the incidence is about two times as high in women. It may start at any age. .
  • RLS is classified as a movement disorder, as persons are forced to move their legs in order to gain relief from symptoms.
  • Childhood RLS is approximated to affect nearly 1 million school-age young kids, with one-third having moderate to critical symptoms.

Periodic limb movements and restless legs syndrome

  • More than 80 percent of persons with RLS also know-how a more common condition called periodic limb movement of sleep (PLMS) as can be seen as leg movements that occur at regular intervals in a diagnostic polysomnogram or sleep study. PLMS is distinuished by involuntary leg twitching or jerking movements that normally happen every 15 to 40 seconds at night, occasionally all through the evening.
  • Up to 80% of those with RLS have PLMS, but most people with PLMS do not know-how RLS.
  • People who have PLMS and do not have RLS or another origin for the PLMS may be diagnosed with periodic limb movement disorder (PLMD).
  • PLMD may be a variant of RLS and therefore reply to alike treatments.

Diagnosis of RLS

A sleep specialist or a physician trained in sleep disorders should be consulted for proper evaluation and treatment of RLS. The physician, after a history and physical examination, might consider additional testing including iron studies, other blood work to rule out secondary causes of RLS and also may order a sleep study.

Causes of Restless legs syndrome

In most situations, the cause of RLS is unidentified. Genetic predisposition is also know.

Pathophysiology of Restless legs syndrome

RLS is associated with a dysfunction in the brain’s basal ganglia circuits in the brain that use the neurotransmitter dopamine, which is required to produce smooth, purposeful muscle action. disturbance of these pathways often results in involuntary movements. persons with Parkinson’s, another disorder of the basal ganglia’s dopamine pathways, often have RLS as well.

Checklist for Restless legs syndrome symptoms

  • Symptoms that are worse at night and are missing or negligible in the morning;
  • A powerful urge need to move or stretch limb(s), often affiliated with paresthesias or dysesthesias;
  • Sensory symptoms that are triggered by rest, relaxation, or doze; and
  • Sensory symptoms that are improved or relieved with movement and the relief persists as long as the movement extends.

Treatment options for restless leg syndrome

Treatment options for primary restless leg syndrome should address the underlying cause such as iron deficiency.

Medications for restless leg syndrome

Treatment options for secondly restless legs syndrome include the following: The primary medication group that is used to treat restless legs syndrome include A group of medications called dopamine agonists.

One of the newer treatment options for restless leg syndrome is a patch called Neupro or Rotigozone, which is a member of the [dopamin agonist]] family of medications. Other medications for restless legs syndrome, which are also in the dopamine agonist family of drugs include: Ropinorole, marked as Requip, and Pramipexol, marketed as Requip.

These medications are also used at higher concentrations in people with Parkinson's disease.

Common side effects of dopamine agonists

The commonly seen side effects may include nausea, dizziness, or other side consequences.

Augmentation of RLS symptoms

Whereas dopamine-related medications are productive in managing RLS, long-term use can lead to worsening of the symptoms in some people. This clear-cut progressive worsening is referred to as “augmentation.”

With chronic use, a individual may start to experience symptoms earlier in the night than in the after noon until eventually the symptoms are present throughout the day and night.

Gabapentin or Neurontin and RLS

The FDA has approved gabapentin enacarbil, which metabolizes in the body to become gabapentin, for the treatment of moderate to critical RLS.

Other medications for RLS

Other medications may be prescribed “off-label” (not specifically conceived to heal RLS) to ease some of the symptoms of RLS.

Benzodiazepines can help persons who have gentle or intermittent symptoms obtain a more restful sleep. However, even if taken only at bedtime they can sometimes origin daytime sleepiness. Benzodiazepines such as clonazepam and diazepam are usually prescribed to heal anxiety, sinew spasms, and insomnia. Because these pharmaceuticals furthermore may induce or aggravate doze apnea in some cases, they should not be utilised in persons with this status.

Opioids such as codeine, propoxyphene, or oxycodone may be prescribed at evening to diminish agony and help to relax persons with more severe symptoms. Side consequences include dizziness, nausea, exacerbation of doze apnea, and the risk of addiction.

Anticonvulsants such as gabapentin and pregabalin can decline the sensory disturbances such as creeping and crawling feelings and nerve agony. Dizziness, fatigue, and sleepiness are amidst the likely edge consequences.

Prognosis of RLS

RLS is usually a lifelong condition for which there is no cure. The goals of therapy is to relieve the symptoms, slow the progression when possible, reduce pain, and suffering both the patient and the bed partner.

Also see other sleep disorders that may go together with RLS such as sleep apnea and consult with a physician familiar with the management of sleep disorders

Also see Sleep disorders


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