stroke
Label
Restless Legs Syndrome (RLS)
Definition &CausesSymptomsInvestigations & TreatmentsRisk Factors & PreventionOutcome
Definition and Causes:

An irresistible urge to move lower extremities that is often triggered by lying down and/or relaxation and associated with sensory symptoms including prickling, throbbing and pulling sensations, and temporarily relieved by physical activity (walking). RLS may lead to sleep disturbance, daytime fatigue and exhaustion.

 

Causes:

Underlying cause is unknown but may have a genetic component.

RLS has also been reported with:

  • Pregnancy/obesity
  • Iron deficiency
  • Chronic illnesses (e.g. diabetes, renal failure)
  • Caffeine and alcohol over consumption
  • Some medications (e.g. cimetidine, certain antidepressants)

 

Back to Top
Symptoms:

Uncomfortable sensation in legs, especially when sitting or lying down, accompanied by an urge to move the affected limb. These sensations do not affect the arms, trunk, or head. Usually affects both limbs; sometimes may it occur in one limb.

Symptoms include the following:

  • Discomfort in legs at rest
  • Deep irresistible urge to move legs (tossing, leg jerking/flexing, walking/bicycling movements, or turning in bed)
  • Sensation of pins and pricks as well as insects crawling on legs, or itchiness
  • Symptoms relieved by rubbing legs, sitting up and stepping onto the floor
  • Symptoms often begin in the evening/night and finishes by the next morning. However, may occur during the day time in some individuals

RLS can occur more than twice a week, resulting in interruption of sleep and impairment of daytime activities.

 

Back to Top
Investigations and Treatment:

There are no specific investigations for RLS.

Diagnosis is usually made on the basis of characteristic symptoms, and normal physical /neurological examination.

Four key criteria are considered in the diagnosis:

  • Symptoms that are worse at night and are absent or negligible in the morning
  • A strong need or urge to move the affected limb(s), often associated with numbness and other abnormal sensations
  • Symptoms triggered by rest, relaxation, or sleep
  • Relieved with movement

Note: Diagnosing RLS in children is difficult, since it may be hard for a child to describe what the actual problem is, and how frequently it occurs, and sometimes may lead to misdiagnosis.

 

History:

Doctors will inquire about:

  • Whether the patient has other medical conditions (e.g. diabetes)
  • Current medications (if any)
  • Family medical history, including RLS
  • Severity and intensity of symptoms
  • Location /frequency/duration
  • Pattern of the symptoms; in relation to day and night
  • Tendency to fall asleep during the day

Physical exam might include:

  • Blood pressure, heart rate, temperature and a neurological examination

Investigations:

Laboratory tests may be performed to rule out other conditions

Labs:

  • Complete blood count
  • Vitamin B12
  • Folic acid

CT scan (brain): Often not required as this test is usually normal in RLS. However, it may be requested if the treating physician wants to exclude other causes of abnormal movements.

Sleep study (polysomnography): Records brain waves, heart rate, breathing, and leg movements during sleep. It is useful to identify the presence of other causes of sleep disruption (e.g., sleep apnea)

 

Treatment:

The treatment is directed towards relieving the symptoms. Sometimes it is controlled by treating an associated condition (e.g. diabetes).

Mild to moderate symptoms can be controlled without use of medications and include:

Lifestyle changes:

  • Decrease use of alcohol, tobacco and caffeine
  • Proper dietary intake of vitamins and iron to avoid deficiency
  • Hot baths prior to going to bed
  • Mild to moderate exercises
  • Using hot packs and/or ice packs
  • Maintaining proper sleep routine

 

Medications are usually helpful but no single medication effectively manages RLS in all patients. Trials of different drugs may be necessary. In addition, medications taken regularly may lose their effect over time, making it necessary to change medications periodically.

1-Image-Pt-RLS-Common Drugs

 

Back to Top
Risk Factors and Prevention:
  • There are no known risk factors
  • A persistent problem; adoption of certain strategies, may control the symptoms, but nothing to prevents it

 

Back to Top
Outcome:
  • Near-complete relief of symptoms is achieved with medication
  • May progress with the age, but there are always periods of remission in which symptoms disappear for days to months

 

Back to Top
 
Copyright © 2011-2017 Innovate R&D
stroke

educate Are you a Healthcare professional or patient?

Healthcare Professionals would include: Physicians (MD,OD), Physician assistants, Nurses, Pharmacists,Allied Health Workers (PT, OT, SLP, etc), Chiropractors, Paramedics, Optometrists, Dentists, Podiatrists etc, and students within these disciplines.

educate ** You are required to register **

eDucate is committed to optimizing the delivery of health information across the Healthcare continuum. To this end eDucate uses a wide array of learning tools, including Webinars, Quick Review Charts, Graphs, Brochures, Videos and Slide Presentations.

Professional Membership Benefits include free access to all archived and upcoming Webinars:

educate DISCLAIMER: This website is owned and operated by The Innovate Research and Development LP (Innovate R&D). All references herein to Innovate R&D shall be deemed to include any subsidiary, affiliate, associate or successor corporation of Innovate R&D. By entering and using this site, you agree to the "Terms of Use"for this website. If you do not agree to these terms and conditions then exit from this site immediately. Although Innovate R&D updates this website regularly with material believed to be accurate at the time of posting, Innovate R&D does not guarantee the accuracy, completeness, timeliness or currency of the material and consequently Innovate R&D expressly disclaims any liability for errors or omissions in the material contained in the website. The Innovate R&D website and all contents are provided as-is, and all representations and warranties, express or implied, relating to the website or the content are disclaimed, including any implied warranty of merchantability, fitness for a particular purpose or non-infringement, as well as any warranty of quality, functionality, accuracy, currency, completeness, reliability, operability, use performance or absence of viruses. In no way or event will Innovate R&D or any party that has been involved in the creation, production, promotion and marketing be liable to you or any other party for perceived direct or indirect damages. You assume all responsibility and risk of loss resulting from the use of our website.