Guest Author - Wollie Woehler

Ekbom wrote in several articles published between 1944 through 1960 about a syndrome he described as “Restless Legs Syndrome.” This ill-defined condition was described as unpleasant sensations in the legs that urged the patient to almost continuously move his legs. Thomas Willis, a 17th century neurologist is generally credited as the first to describe this condition.

Symptoms

Patients experiencing the restless legs syndrome have different descriptions of the uncomfortable pattern of restless legs, arms or whole body. People define this unpleasant experience as an irresistible urge to move the legs, aching, prickling, tingling and pulling irritation located in the lower legs. The thighs and even the upper extremities of the body can be affected.

Although RLS has been known for centuries, even today, the restless legs syndrome frequently goes unrecognized or misinterpreted by primary care physicians, the very people who are most likely to encounter it.

Restless Legs are often experienced at night when it interferes with sleep or it can occur any time a patient must sit still for a long period or is not particularly stimulated. For example when the person sit still reading a boring book, or watching television he feels the strong urge to stand up and walk about until the irritating symptoms disappear.

Daytime symptoms are merely mildly annoying; it is at bedtime that the condition often reaches its most distressing proportions. Commonly, the discomforts commence or worsen shortly after going to bed and interfere with falling asleep. Some patients report initially falling asleep normally, only to be awakened within hours by the discomfort. Patients may stretch or massage their legs, thrash them about in bed or get up and walk around almost the whole night. Insomnia is often the predominant complaint people have who suffer from the restless legs syndrome.

The syndrome is not relative to age or gender; it has allegedly been identified in persons ranging from one to 82 years old. Ekbom was unable to detect any age-or sex-related occurrences of the syndrome; a recent survey of 174 patients, however, found about 70% of those affected to be women, with a higher prevalence among middle-aged people.

Restless leg syndrome occurs in isolation as well as in families where a history of the syndrome has been found in association with a number of other conditions.

Is there any treatment?

Many physicians suggest certain lifestyle changes and activities to reduce or eliminate symptoms. In take of caffeine, alcohol, and tobacco may increase occurrences of the condition. Physicians may suggest that patients take supplements to correct deficiencies in iron, foliate, and magnesium. Taking a hot bath, massaging the legs, or using a heating pad or ice pack can help relieve symptoms in some patients. Your doctor may prescribe certain medications to treat RLS, including dopaminergics, benzodiazepines (central nervous system depressants), opioids, and anticonvulsants. Be sure to first consult the doctor before taking any medication to reduce the occurrence of restless legs from keeping you awake.

What is the prognosis?

RLS is generally a life-long condition for which there is no cure. Symptoms may gradually worsen with age. Current therapies can control the disorder, minimizing symptoms and increasing periods of restful sleep. In addition, some patients have remissions, periods in which symptoms decrease or disappear for days, weeks, or months, although symptoms usually eventually reappear.

Who are most likely to experience Restless Legs Syndrome?

Certain physicians thought that Emotional factors could be important in producing restless legs. They were impressed with the high incidence of depression and anxiety in patients with the condition, which they felt were not simply due to chronic discomfort. Ekbom found most of his patients to be well-balanced persons without mental disturbances.

Various other conditions have been reported in association with or hypothesized to cause the restless legs syndrome, including cancer, prostatitis, polio, myokymia, barbiturate withdrawal, diabetes, prolonged exposure to cold, a itaminsis, cholesterol-crystal embolization, acute porphyria and following therapy with prochlorperazine or promethazine hydrochloride.' The significance of these relationships is dubious at best.

People who live with neuromuscular diseases often experience restless legs syndrome. Married couples often do not sleep together on one bed as the almost constant movements of the spouse keep the partner awake too. In dealing with questions asked in support groups, it seems as though the temperature in bed also plays a role. If the person is either too cold or too warm, the whole body suffers restlessness until the temperature becomes acceptable and sleep takes over.

Read more about this syndrome
Restless Legs Syndrome: Coping with Your Sleepless Nights (American Academy of Neurology)