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October 2005

HEALTH MATTERS

Restless Leg Syndrome

This miserable condition affects 5 - 10% of people, it is a neurological disorder first described in 1672 by Thomas Willis, the physician of Charles 11. The term ‘Restless Leg Syndrome’ (RLS) was coined by Professor Ekbom in 1944. The syndrome may begin at any age, even in infancy. Most people who are severely affected are middle-aged or older; severity seems to increase with age. Most people with RLS also experience a more common condition known as periodic limb movement disorder. This is involuntary leg twitching or jerking movements during sleep at 10 - 60 second intervals during the night, often causing disrupted sleep.

What are the symptoms?

Uncomfortable, sometimes very painful sensations in the legs, described as burning, or tugging feelings, as though insects are crawling inside the legs, especially when sitting or lying down, more often in the evening than in the day. Triggering situations are periods of inactivity such as long journeys or sitting in the cinema. Lying down in bed at night often sets it off.

- An irresistible urge to move the legs about, in the hope of relieving the unpleasant sensations. People often pace the floor or kick about in bed, constantly moving their legs while sitting. My father was a sufferer and he would often spend entire evenings writhing about on the floor like a dying fly, much to my mother’s annoyance.

What is the cause?

In most cases the cause is unknown; half of all sufferers have a relative with the condition. In Familial RDS sufferers tend to be younger when symptoms start. In other cases, RLS appears to be related to the following factors or conditions, it is not known if these factors actually cause RLS.

- Low iron levels or anaemia, when the levels are corrected patients may see a reduction in symptoms.

- Chronic disease such as kidney failure, diabetes, Parkinson’s disease, and peripheral neuropathy are associated with RLS. Treatment of the underlying condition often improves RLS.

- Some pregnant women experience RLS, especially in the later stages, for most women the condition resolves within 4 weeks of delivery.

- Certain medication - anti nausea, anti seizure and anti psychotic drugs may aggravate symptoms.

How is RLS diagnosed?

There is no specific test for this, diagnosis is made by evaluating the history and symptoms of the condition.

How is RLS treated?

As any sufferer will know, moving the legs only gives temporary relief. However, RLS can be controlled by finding and, if possible treating, any underlying disorder. For those with no cause, treatment is focused on relieving the symptoms.

Prevention is the key for those with mild to moderate symptoms, cut down on caffeine, alcohol and tobacco (the usual suspects!!) Doctors may recommend the use of supplements to correct deficiencies in iron, folate and magnesium.

Studies have shown that maintaining a regular sleep pattern can reduce symptoms. Some measures can give temporary relief, e.g., plunging feet into a bowl of cold or warm water, ice packs or hot packs on the legs. Go and talk to your doctor as underlying disease or deficiency may be causing your symptoms. Some drug treatments can help in severe cases, research is ongoing and new drugs are being tried which relieve symptoms. As yet there is no magic cure.


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