23. November 
 
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Definition and causes of RLS

Restless Legs syndrome RLS is neurological sensory motor disorder defined as a strong and irresistible urge to move the legs, accompanied by discomfort in the legs. RLS is quite common with recent studies showing that between 5-15% of the population has RLS syndrome.

Hereditary factors appear to play a large role in the development of RLS. In 50-60% of cases RLS can be identified in near relatives rising in twins to more than 80%. The reason for this hereditary form of RLS is unknown.

RLS can also occur as a result of an underlying illness or medical condition, for example iron deficiency, chronic kidney failure, diabetes or nerve inflammation. It can also be seen in the context of normal pregnancy. RLS might be exacerbated by certain types of medicine.

RLS occurs in all ages, but severe symptoms are seen more frequently in middle-aged to older individuals. In children, RLS is often confused with growing pains.

Symptoms of RLS

Symptoms of RLS can be established by four criteria:

  • A strong and irresistible urge to move the legs, often accompanied or caused by an uncomfortable feeling in the legs.
  • The symptoms occur most often in connection with the rest, for example in sitting or lying position.
  • The symptoms disappear in connection with activities such as walking or the extension of the leg muscles.
  • The symptoms are worse in the evening or during the night than during the day, or appear only in the evening or night.
  • Many who suffer from RLS have sleep problems, and most have jerky, periodic leg movements during sleep.

Precautions and diagnosis

If there is suspicion of RLS syndrome the physician may take blood samples to exclude the aforementioned medication problem as the cause. A nerve cord study may also be made to exclude other nerve disorders in the legs. There is no diagnostic test that can detect RLS, and the diagnosis is made on the basis of the above symptoms.

Treatment of restlessness in the legs

In cases of RLS, where there is an underlying disease, such as diabetes or nerve inflammation, the symptoms of RLS often disappear when the underlying disease is treated.

In the hereditary form of RLS the treatment aims at relieving the symptoms rather than curing the problem. A number of lifestyle changes have shown good results by reducing the symptoms in some individuals. These changes are to avoid excessive consumption of coffee and alcohol, using a heat or an ice bag and to apply acupuncture or massage. A deliberate change of one's circadian rhythm can improve the quality of life for some, because symptoms are often reduced early in the morning and worse at night. Regular physical activity may improve the sleep and ease the daily symptoms but excessive exercise may worsen the symptoms.

For moderate and severe cases of RLS medical treatment can be relevant. Drugs normally used for Parkinson's disease have proven effective in some individuals with RLS.

Outlook and complications

Although RLS might mean a substantial reduction of the individual's quality of life, in the form of insomnia and marked fatigue during the day, it is important to keep in mind that the condition does not result in a reduction of lifespan.

For further information see Nordic Restless Legs Study Group's website: http://www.rlsstudygroup.org
 

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