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Restless Legs Syndrome - Medical Malpractice
Restless legs syndrome is a disorder of the nervous system that has no known cure. A person with the condition experiences a throbbing or pulling sensation in the legs or other unpleasant leg sensations that are only relieved by moving the legs. The symptoms are most common at nighttime when the person is trying to rest or sleep. It interferes with decent rest and good sleep. The sensations a person feels can just be annoying or can be somewhat painful.
The symptoms are activated by trying to lie down and relax. Falling asleep can be difficult because of restlessness of the legs. This can lead to exhaustion and daytime tiredness. Activities of daily living are interfered with because of the sleep deprivation. Concentration and memory are impaired because the person hasn't had enough sleep. Patients with restless leg syndrome often become depressed and have a difficult time travelling because they cannot keep their legs still.
About ten percent of us have restless legs syndrome. It is moderate to severe in about 3 percent of people and about 5 percent have a milder form of the disease. It can affect adults and children alike. Many do not see a doctor about their symptoms because they don't feel as though the doctor will treat their symptoms seriously. Some feel there symptoms are too mild for treatment; however, this is not the case in most situations. Some doctors who do not understand RLS or restless legs syndrome believe it is just a case of nerves, sleep deprivation, stress, aging, muscle cramps or arthritis. The incidence is twice as high in women as in men. It is common in pregnancy. While it can occur at any age, most patients with the disease are in their middle ages or older. The symptoms get worse with age.
Restless leg syndrome is strongly related to periodic limb movement in sleep, which is more common than RLS. About 80 percent of RLS sufferers have both conditions. This involves leg twitching in sleep that occurs about every 15-40 seconds, sometimes all night long. The two diseases have similar treatments.
The key to identifying restless legs syndrome is noting the uncomfortable feelings within the legs that goes away by moving the legs. In some cases, there needs to be almost constant moving of the legs before a person achieves relief. This can be very tiring and can interfere with rest and sleep. It can occur on one side of the body or both sides (most common). There is often a symptom-free period in the early morning hours when the patient can nod off to sleep and get at least a couple of hours of sleep. If sleep is reduced for other reasons, such as stress and activity, there is worsening of the RLS symptoms. In milder forms of the disease, the symptoms can come only once or twice per week.
While the cause of restlessness legs syndrome is not known, it appears to have a hereditary or genetic component. It runs in families, especially when it occurs before the age of 40. There have been genetic variants noted with different types of RLS. Low levels of brain iron stores seem to be related to some cases of restless legs syndrome.
Others believe that an abnormality in the brain's basal ganglia is the cause behind some cases of RLS. These are the parts of the brain that release dopamine in the system. Disruption of dopamine pathways causes abnormal movements, including Parkinson's disease and restless legs syndrome. Certain RLS cases are associated with kidney failure, peripheral neuropathy, diabetes, some nausea medications, antipsychotic drugs, antidepressants and some cold and allergy medications. As mentioned, it is common in the third trimester of pregnancy. Drinking alcohol and not getting enough sleep can contribute to getting RLS.
There are no specific tests for restless legs syndrome. Instead the doctor must rely on a careful history and physical examination. The symptoms are usually the key to diagnosing the disease as they are very characteristic restless leg syndrome.
Restless legs syndrome can be treated with various medications and lifestyle changes. You must reduce your caffeine intake and alcohol intake in order to fight RLS. You shouldn't smoke either. You should take multivitamins that correct abnormal folate, iron and magnesium levels. Get a regular pattern of sleep and use a hot bath or a heating pad on the legs to keep them from feeling strange. Massage before sleep sometimes helps as well.
Medications to treat RLS include dopaminergic agents, similar to those used in the treatment of Parkinson's disease. Pramipexol and ropinarole have been approved by the US FDA to treat RLS. Other medications that help include benzodiazepines, opioid medications and anticonvulsants. Sometimes a medication works for a while and then quits working so you need to alternate medications or switch to a different one.LEGAL HELPLINE: ☎ 855 804 7125
The author of the substantive medical writing on this website is Dr. Christine Traxler MD whose biography can be read here