Restless legs syndrome, a neurological condition characterized by an intolerable urge to move the leg

Restless legs syndrome is a disease that causes sleep disturbances due to severe sensory symptoms in the legs before going to sleep and moving the legs. It mainly occurs at night rather than during the day, and it is characterized by worsening when the legs are not moved and returning to normal when moving.

Symptoms

Restless legs syndrome patients complain of unpleasant sensations that cannot be accurately expressed in the legs, feet, hands, and trunk. Unpleasant sensations begin when not moving and are relieved by movement. Symptoms usually worsen in the evening. About 4 out of 5 people experience periodic limb tremors while sleeping. A significant number of patients have sleep disturbances, such as trouble initiating sleep, and daytime fatigue and drowsiness.

Causes

In many cases, the cause is not clear. Researchers speculate that an imbalance in the brain’s dopamine system is involved.

In the case of early onset restless legs syndrome, about half show a genetic tendency.

Stress tends to exacerbate restless legs syndrome. Pregnancy or hormonal changes can also temporarily exacerbate restless legs syndrome.

In some cases, restless legs syndrome may be associated with other diseases, and iron deficiency may cause or worsen restless legs syndrome symptoms even if there are no symptoms of anemia. Renal failure and peripheral neuropathy can also cause restless legs syndrome symptoms.


Diagnosis

The following are four essential requirements for diagnosing restless legs syndrome.

  1. The urge to move the leg: Usually there is an uncomfortable and unpleasant sensation in the leg. Occasionally, the urge to move the legs appears without abnormal sensation, and it appears not only in the legs but also in the arms and other body parts.
  2. The urge to move or unpleasant sensations begin or intensify when lying down or sitting, i.e., resting or immobility.
  3. The urge to move or unpleasant sensations are partially or almost entirely relieved by exercise such as walking or stretching, at least as long as the exercise is continued
  4. The urge to move or unpleasant sensations are worse in the evening or at night than during the day, or appears only in the evening or at night. This tendency disappears when symptoms become very severe, but there must have been a tendency in the past.

Tests

Blood tests such as iron, folic acid, and kidney function may be performed to differentiate the related medical cause. Additional tests may be performed as necessary.

Treatments

If there is a related disease such as iron deficiency or peripheral neuropathy, treatment of the related disease can greatly improve the restless legs syndrome.

If there is no related disease, lifestyle changes and drug treatment are performed.

Lifestyle changes include:

  1. Bath and massage are helpful.
  2. Cold and hot packs are helpful.
  3. Stress exacerbates symptoms, so ailments such as yoga or meditation can help. It is especially effective before going to sleep.
  4. Proper exercise helps relieve symptoms.
  5. A regular sleeping habit is recommended.
  6. Avoid foods and beverages containing caffeine.
  7. Tobacco and alcohol can also worsen symptoms, so limit them.

Medication must be prescribed by a specialist. Representative drugs include drugs for treating Parkinson’s disease that act on the dopamine system and drugs related to sleep disorders such as benzodiazepines.

Restless legs syndrome is a disease that can significantly improve symptoms through treatment, but the problem is that many patients are still living with discomfort due to lack of awareness.


Progress and complications

Although restless legs syndrome does not develop into a serious disease, symptoms vary from somewhat uncomfortable to very severe. The severity of the symptoms is not constant and often changes, and in some cases the symptoms disappear within a certain period of time.

Restless legs syndrome can occur at any age and becomes more common with increasing age.

Prevention

Irregular meals or excessive diet are not allowed, and eat foods rich in protein and vitamins that help blood formation and iron absorption.

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