Help for Restless Leg Syndrome
By Barry J. Cutler, MD
When I went into neurology some 31 years ago, there were relatively few neurological disorders that could be helped with medications Slowly but surely over the many years, research developed important therapies to such problems as Parkinson’s disease, migraines, stroke, and epilepsy. It is not often that a physician can be involved in treating a disorder that is affecting him personally, especially when it is one of the disorders that can be helped.
The condition I am talking about is restless legs syndrome (RLS). This is a common yet frequently under-diagnosed sensorimotor disorder. Restless Legs Syndrome has been described since 1945, but it has taken 50 years for a set of criteria to be developed to allow neurologists to be more confident when diagnosing this disorder.
The severity of the symptoms of RLS vary widely – ranging from occurring only occasionally during stress to occurring every night and severely disturbing sleep. The essential symptoms include an urge to move the legs usually accompanied or caused by uncomfortable and unpleasant sensations in the legs. The urge to move or the unpleasant sensation begins to worsen during periods of rest or inactivity such as lying or sitting. The urge to move can be partially or totally relieved by movement, such as walking or stretching, and seems to be worse in the evening and during the night. Some of the descriptive terms for RLS include creepy-crawly, ants crawling, jittery, pulling, worms moving, shock-like feelings, and heebie-jeebies. When the severity of RLS worsens, symptoms may involve other areas of the body including the arms and hips and trunk.
As far as inheritance is concerned, a study in the United States revealed that more than 60% of RLS patients had a positive family history of this disorder. As I was writing this article, I remember how my older son used to move his legs all over the bed when he was trying to go to sleep.
There are a few disorders that can be associated with RLS. These include low serum iron levels, end-stage renal disease, diabetes, and peripheral neuropathy. The good news is that most people with RLS have a positive response to therapy. The main forms of therapy include the same medications that are used for Parkinson’s disease and 90% of patients report some relief with these medications. It does not mean that patients with RLS have Parkinson’s – it just means that the same chemicals in the brain that are involved with Parkinson’s disease are involved with RLS.
In conclusion, although RLS has been affecting a good percentage of you who are reading this article, you can at least feel confident that neurologists and sleep specialists are very much experienced in its diagnosis and treatment.