• Restless Legs Syndrome

    (RLS)

    Definition

    Restless legs syndrome (RLS) is a neurologic disorder. It is characterized by:
    • Unpleasant sensations in the legs
    • An irresistible urge to move your legs

    Causes

    The cause of primary RLS is unknown. In some cases, RLS may be genetic. Or, it may be caused by other conditions or certain drugs. This is called secondary RLS.
    Many people with RLS also have periodic limb movement disorder (PLMD). This is a related motor disorder characterized by:
    • Involuntary, repetitive, jerking movements
    • Interrupted sleep because of periodic leg movements

    Risk Factors

    These factors increase your chance of developing RLS:

    Symptoms

    Symptoms may include:
    • Feelings of tingling, creeping, pulling, prickling, pins and needles, or pain in the legs during periods of rest or inactivity—may also occur in the arms
    • Symptoms typically get worse at night
    • A strong urge to relieve uncomfortable sensations with movement
    • Restlessness, including floor pacing, tossing and turning in bed, and rubbing the legs
    • Difficulty falling asleep and staying asleep
    • Hypersomnia—recurrent episodes of excessive daytime sleepiness or prolonged nighttime sleep
    Symptoms may begin at any age. But, they are most common in people older than 60 years old. Symptoms usually increase in the evening and during times of rest, relaxation, or inactivity. For this reason, people with RLS generally have insomnia , which may be severe.

    Diagnosis

    The doctor will ask about your symptoms and medical history. A physical and neurologic exam will be done. The diagnosis is based mainly on your symptoms. There is no specific test for RLS.
    Nerves of the Leg
    Leg Nerves
    Copyright © Nucleus Medical Media, Inc.

    Treatment

    There is no cure for RLS. Treatments are aimed at relieving or reducing symptoms.

    Treatment for Mild Cases of RLS

    Self-care
    • Massage your legs.
    • Use a heating pad or ice pack.
    • Take a hot bath.
    • Avoid using tobacco, alcohol, or caffeine.
    • Follow a sleep routine.
    • Begin a safe exercise program with the advice of your doctor.
    • Avoid the use of medicines that may worsen RLS.

    Treatment for Conditions That May Trigger RLS

    Effective treatment of conditions that may trigger RLS can ease or resolve your symptoms:

    Treatment for Severe Cases of RLS

    Medication
    Dopamine agonists are the only drugs that are FDA approved to treat restless leg syndrome. They are often considered the most effective type of medicine for this condition.
    Other medications may be used to help control symptoms of restless leg syndrome. Some medication options include clonidine, anticonvulsants, and opioids. Your doctor will select the medication based on your symptoms and medical history.

    Prevention

    There are no guidelines for preventing RLS.

    RESOURCES

    National Sleep Foundation http://www.sleepfoundation.org

    Willis-Ekbom Disease Foundation http://www.rls.org

    CANADIAN RESOURCES

    Canadian Sleep Society http://www.css.to

    Health Canada http://www.hc-sc.gc.ca/index-eng.php

    References

    Bradley WG, Daroff RB. Neurology in Clinical Practice . Philadelphia, PA: Butterworth Heiemann; 2004.

    Cui Y, Wang Y, Liu Z. Acupuncture for restless legs syndrome. Cochrane Database of Systematic Reviews . 2008;CD006457.

    Current Medical Diagnosis and Treatment . 45th ed. McGraw-Hill; 2006.

    Restless legs syndrome. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/what.php . Updated December 19, 2012. Accessed February 19, 2013.

    Salas RE, Gamaldo CE, Allen RP. Update in restless legs syndrome. Curr Opin Neurol . 2010;23(4):401-6.

    What is restless legs syndrome? National Heart, Lung, and Blood Institute website. Available at: http://www.nhlbi.nih.gov/health/health-topics/topics/rls/. Updated November 1, 2010. Accessed February 19, 2013.

    What is Willis-Ekbom disease (WED)/RLS? Willis-Ekbom Disease Foundation website. Available at: http://www.rls.org/page.aspx?pid=477. Accessed February 19, 2013.

    11/26/2012 DynaMed Systematic Literature Surveillance DynaMed's Systematic Literature Surveillance : Aurora R, Kristo D, Bista S, et al. The Treatment of Restless Legs Syndrome and Periodic Limb Movement Disorder in Adults—An Update for 2012: Practice Parameters with an Evidence- Based Systematic Review and Meta-Analyses. Sleep. 2012;35(8):1039-1062.

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