If you believe that you may be suffering from Restless Leg Syndrome, your smart move is to consult your physician who can help pinpoint the cause and prescribe proper treatment. This article is for your additional information only. Restless Leg Syndrome is an all too common neurologic movement disorder that is somewhat treatable and often under diagnosed and can ruin many nights sleep. This medical problem is defined by extremely uncomfortable feelings and sensations in the legs, especially when resting or sleeping, resulting in the necessity to move the legs. This need to keep re-positioning the legs results in sleep interference, insomnia and difficulty resting or even sitting at a computer or watching television. This problem can result in insomnia or loss of sleep, serious stress, the inability to take a good rest and general discomfort and lessening of quality of life. It has been estimated that as many as up to 15% of the population has this problem. RLS frequency generally increases with age but may also occur in children. People with severe RLS had problems prior to twenty years of age. Someone who has this medical problem generally will have symptoms in their legs, although arms and other places can be affected. Generally the problems are worse in the night, when trying to rest. The degree of problems range from light to severe. Restless Leg Syndrome has been described as feeling like the skin is creeping or crawling, burning or itching legs, aching, restless legs that can not get comfortable and just plain painful legs. Generally, RLS is caused by a central nervous system disorder. This disorder often runs in families which suggests a genetic cause. Symptoms can be aggravated by stress and psychiatric problems and of course the loss of sleep that this problem causes can increase stress and psychological problems. Possible secondary causes of this medical problem are iron deficiency, neurological lesions, end stage kidney failure, certain drugs and pregnancy. Decreased iron stores in a patient can help cause or worsen RLS. Generally, a person should have serum ferritin levels above 50 mcg/L. Reading below this can cause or worsen conditions. Neurological lesions associated with the spinal cord and peripheral nerve lesions have been known to cause this problem, as well as people with vertebral disc disease. Up to 19% of pregnant women can exhibit this medical condition of the legs but it usually disappears within several weeks postpartum. Up to 50% of end stage kidney failure or dialysis patients can experience this leg problem. Additionally, kidney transplant patients may also experience these symptoms. Certain drugs such as caffeine, tricyclic antidepressants, lithium, dopamine antagonists and selective serotonin reuptake inhibitors can worsen this leg problem. Restless Leg Syndrome can be treated with drugs but there is no silver bullet. No medication works well with all patients so each sufferer has to be individually treated. Dopaminergic agents are usually the first line of treatment for many cases. Pregnant women may not be administered any drugs, depending upon the physician. Other drugs that may or may not be used to treat Restless Leg Syndrome are Dopaminergic Agents such as carbidopa-levodopa for a one time use or as need requires. Dopamine agonists such as Pergolide, Pramipexole and Ropiniole, may be used in moderate to severe cases. Opioids such as Codeine, Tramadol, Propoxyphene, Oxycodone and Hydrocodone may be prescribed. These are often used occasionally. Benzodiazepines such as Temazepam and Clonazepam can be helpful when certain other medications cannot be tolerated. Anticonvulsants such as Carbamazepine and Gabapentin can be used when dopamine agonists have failed. Iron or ferrous sulfate can be used in iron deficient patients. Finally, Clonidine may be used with patients with high blood pressure. In general, most patients with Restless Leg Syndrome can be effectively treated by the primary care physician. If insomnia still results after treatment, a referral to a movement disorders specialist or sleep specialist may be in order. |
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