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Restless Leg Syndrome

by Ling Li, MD PhD, Neurologist at Deuk Spine Institute

January 5th, 2012; Melbourne FL - Montaigne, the great French essayist, wrote about restless of the legs, sometimes aroused by sermons in church “so that though I was seated, I was never settled”.  The first medical description of restless leg syndrome (RLS) may have been from Willis in 17th century .  In 1954, restless leg syndrome was first named by the Swedish neurologist Ekbom.

melbourne fl restless leg syndrome can cause the sensation of crawling or tingling in the legsRLS was under recognized for centuries. Mid 1990’s was when RLS was more recognized and studied. Recent study revealed that the prevalence of RLS in North American and European populations is about 10%. By the early 2000’s, several companies had begun trials to see if medication would be effective for RLS. In 2005, Ropinirole was 1st approved by FDA in US for treatment or RLS.

The most prominent symptom of the restless leg syndrome (RLS) is an unpleasant sensation in the legs, and occasionally in the arms, that the patients describe as crawling, creeping, extremely unpleasant, and  sometimes painful.  In addition, involuntary leg movement during sleep and wakefulness are present in some patients.

RLS was diagnosed clinically. There are 4 clinical criteria:

1. An urge to move the legs, usually accompanied or caused by uncomfortable and unpleasant sensations in the legs.

2. The urge to move or unpleasant sensations begin or worsen during periods of rest or inactivity.

3. The urge to move or unpleasant sensation is partially or totally relieved by movement, such as walking or stretching, at least as long as the activity continues.

4. The urge to move or unpleasant sensation are worse in evening or night than during the day, or only occur in the evening or night.

The exact cause of RLS is unknown. Risk factors of restless leg syndrome include iron deficiency, peripheral neuropathy, pregnancy and end stage renal disease.

Although RLS does not increase the risk of mortality nor does it have other serious health consequence aside from that associated with sleep loss, it impact quality of life. Studies showed that moderate to severe RLS patient suffer a disruption of their life as great as other serious chronic medical disorders. It affects a wide assortment of individuals in a wide assortment of ways. Each story is unique and individualized; however, the frustrations are always very similar: lack of sleep, not being able to share a bed with your spouse, the inability to travel or attend concerts or movies, ect.

Treatment of RLS is aimed at symptomatic relief. There is no “cure” for the condition. Several categories of medications were found to be effective in this condition. They are dopamine agonist, for example, Requip and Mirapex, Levadopa and Opioids.  Other agents, including Benzodiazepam, antiepileptic medications, Baclofen, Tramadol, Magnesium have been reported to help RLS as well.

Call 321-751-3389 or 1-800-349-6922 to make an appointment with neurologist, Dr. Ling Li for Restless Leg Syndrome.

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