Restless legs syndrome - Diagnosis. There's no single test for diagnosing restless legs syndrome. A diagnosis will be based on your symptoms, your medical and family history, a physical examination, and your test results. Your GP should be able to diagnose restless legs syndrome, but they may refer you to a neurologist if there's any uncertainty. There are four main criteria your GP or specialist will look for to confirm a diagnosis. These are: an overwhelming urge to move your legs, usually with an uncomfortable sensation such as itching or tingling your symptoms occur or get worse when you're resting or inactive your symptoms are relieved by moving your legs or rubbing them your symptoms are worse during the evening or at night Assessing your symptoms.
Your GP or specialist will ask you about the pattern of your symptoms to help assess their severity. For example, they may ask you: how often you have symptoms how unpleasant you find your symptoms whether your symptoms cause significant distress whether your sleep is disrupted, making you tired during the day Keeping a sleep diary may help your doctor assess your symptoms. You can use the diary to record your daily sleeping habits, such as the time you go to bed, how long it takes you to fall asleep, how often you wake during the night, and episodes of tiredness during the day. Mild symptoms of restless legs syndrome can usually be treated by making lifestyle changes – for example, establishing a regular sleeping pattern and avoiding stimulants, such as caffeine, alcohol or tobacco, in the evening. If your symptoms are more severe, you may need medication to bring them under control.
Read more about treating restless leg syndrome. Blood tests. Your GP may refer you for blood tests to confirm or rule out possible underlying causes of restless legs syndrome. For example, you may have blood tests to rule out conditions such as anaemia, diabetes and kidney function problems. It's particularly important to find out the levels of iron in your blood because low iron levels can sometimes cause secondary restless legs syndrome. Low iron levels can be treated with iron tablets. Sleep tests. If you have restless legs syndrome and your sleep is being severely disrupted, sleep tests – such as a suggested immobilisation test – may be recommended. The test involves lying on a bed for a set period of time without moving your legs while any involuntary leg movements are monitored.
Occasionally, polysomnography may be recommended. This is a test that measures your breathing rate, brain waves and heartbeat throughout the course of a night. The results will confirm whether you have periodic limb movements in sleep (PLMS).
WebMD Restless Legs Center: Find in-depth information about symptoms and explore treatment options for restless legs syndrome (RLS). There are many reasons a person might have restless legs syndrome, including genetics, peripheral neuropathies, dialysis, iron deficiency, and many more. The Restless Legs Syndrome Foundation describes this neurological condition as one in which people have an overwhelming urge to move their legs.
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Restless leg syndrome (RLS) can cause unpleasant sensations in the legs and an intense urge to move them. Learn why this happens and how to manage it. Restless legs syndrome and related disorders Description. An in-depth report on the causes, diagnosis, treatment, and prevention of RLS. The Restless Leg Syndrome News & Perspectives is a collection of the latest medical news and clinical information about RLS diagnosis and treatment.
Restless legs syndrome and related disorders. Description. An in- depth report on the causes, diagnosis, treatment, and prevention of RLS. It can develop from several medical conditions and genetic risk factors. The condition involves a feeling of . This. causes an irresistible urge to move the legs.
These sensations can sometimesaffect the thighs, feet, and sometimes even the arms. Treatment often includes. Iron supplements may be. Prescription. medications can provide good relief of symptoms.
Restless legs syndrome — Comprehensive overview covers symptoms, treatment of disorder that can cause insomnia. Restless Legs Syndrome. Multimedia health information for patients, caregivers and providers supplied by Harvard Medical School. Debbie Nippert reveals her journey with restless legs syndrome, including diagnosis, treatment and everyday management of her symptoms. Read on for her real-life. Restless legs syndrome (RLS) is a disorder of the part of the nervous system that causes an urge to move the legs. Because it usually interferes with sleep, it also.
RLS and PLMD: Periodic limb movement disorder (PLMD) is a condition where. These. movements may last less than 1 second, or as long as 1. Unlike RLS, contractions in PLMD usually do not wake patients. Four out of five people who have of RLS sufferers also report having PLMD, but only about a third of people with PLMD also have RLS.
Common side effects included mild sleepiness and dizziness. The drug rotigotine (Neupro) was withdrawn from the US in 2. The issue has since been corrected and the drug was approved in April 2. RLS. The problem can occur in both children and adults. Although effective treatments are available, RLS often goes undiagnosed.
Symptoms of RLS. The core symptom of RLS is an irresistible urge to move the legs (medically known as akathisia). Some people describe this symptom as a sense of unease and weariness in the lower leg. The sensations are aggravated by rest and relieved by movement. Specific characteristics of RLS include. These sensations can occur mostly in the lower legs, but they can sometimes affect the thighs, feet, and even the upper body. RLS- type symptoms may also occur in the arms.
These may be the first symptoms of RLS in some people. About 4 out of 5 patients with RLS also have semi- rhythmic movements during sleep, a condition called periodic limb movement disorder (PLMD). Symptoms usually occur at night when lying down. In more severe cases,symptoms also occur during the day while sitting. Episodes of RLS usually develop between 1. Symptoms are often worse shortly after midnight and disappear by morning.
If the condition becomes more severe, people may begin to have symptoms during the day, but the problem is always worse at night. The unpleasant sensations and uncontrollable urge to move the legs often disturbs nighttime sleep. When the person tries to ignore the urge to move the legs, tension builds up until the legs jerk uncontrollably. Individuals who experience daytime symptoms may find it difficult to sit during air or car travel, or through classes or meetings. Late- onset and Early- onset Forms.
There appear to be two forms of RL - - early- onset and late- onset. Each form may have different characteristics: People with early- onset RLS (occurring in the teenage years or earlier) tend to have a family history of the disorder. They usually have RLS without accompanying pain. People with late- onset RLS usually do not have a family history of RLS. The condition is more likely to result from a problem with the nervous system. Symptoms may also include pain in the lower legs. Periodic Limb Movement Disorder.
Periodic limb movement disorder (PLMD) is also known as nocturnal myoclonus. PLMD symptoms include: Nighttime episodes that usually peak near midnight (similar to the pattern in restless legs syndrome). Contractions and jerking of the leg muscles every 2. These movements may last less than 1 second, or as long as 1. PLMD usually does not wake patients. This condition is distinct from the brief and sudden movements that occur just as people are falling asleep; these brief jerking movements may interrupt sleep.
Four out of five people who have RLS also report having PLMD, but only a third of people with PLMD report having RLS. While treatments for the two conditions are similar, PLMD is a separate syndrome.
PLMD is also very common in narcolepsy, a sleep disorder that causes people to fall asleep suddenly and uncontrollably. Causes. The main cause of RLS is unknown. Scientists are researching nervous system problems that may arise in either the spinal cord or the brain. One theory suggests that low levels of the brain chemical dopamine causes restless legs syndrome. RLS may often have a genetic basis, particularly in those who develop it before age 4. Restless legs syndrome in older adults is less likely to be inherited.
The peripheral nervous system includes all peripheral nerves. Researchers have detected at least six genetic factors that may play a part. Two of the genes are linked to spinal cord development. Several studies support the theory that an imbalance in neurotransmitters (chemical messengers in the brain), notably dopamine, may play a part in RLS. Dopamine triggers numerous nerve impulses that affect muscle movement.
The effect is similar to that seen in Parkinson's disease. In addition, drugs that increase dopamine levels treat both disorders. However, Parkinson's disease itself does not seem to increase the risk for RLS and RLS early in life does not increase the risk of Parkinson's later on. Neurologic Abnormalities in the Spine. Other research suggests that restless legs syndrome may be due to nerve impairment in the spinal cord. Researchers had thought that such abnormalities began in nerve pathways in the lower spine.
However, some patients with RLS have symptoms in the arms, which indicates that the upper spine may also be involved. Neuropathy. Some experts suggest that RLS, particularly if it occurs in older adults, may be a form of neuropathy, which is an abnormality in the nervous system outside the spine and brain. So far, there is no evidence to support a cause and effect relationship between neuropathy and RLS. Abnormalities of Iron Metabolism.
Iron deficiency, even at a level too mild to cause anemia, has been linked to RLS in some people. Some research suggest that RLS in some people may be due to a problem with getting iron into cells that regulate dopamine in the brain. Some studies have reported RLS in a quarter to a third of people with low iron levels. Deficiencies in Cortisol. Other research suggests that low levels of the hormone cortisol in the evening and early night hours may be related to restless leg symptoms. Causes of Periodic Limb Movement Disorder. The causes of PLMD are not clear.
Some research suggests that it may be due to abnormalities in the autonomic nervous system, which regulates the involuntary actions of the smooth muscles, heart, and glands. Risk Factors. RLS may affect 3 - 1. It is more common in women than in men, and its frequency increases with age. The disorder affects an estimated 1. RLS as teenagers. An international study showed that 2% of children ages 8 - 1. RLS symptoms. RLS may be more common than epilepsy and diabetes in children and teens.
Family History. As many as two- thirds of people with restless legs syndrome (RLS) have a family history of the disorder. In people with a family history of the condition, RLS is more likely to occur before they turn 4. People who develop the condition at a later age are less likely to have a family history of RLS. RLS is also more common in people from northern and western Europe, adding support for the theory that some cases have a genetic basis. Attention Deficit Hyperactivity Disorder. RLS and PLMD in children are strongly associated with inattention and hyperactivity.
Up to a quarter of children diagnosed with attention- deficit hyperactivity disorder (ADHD) may also have RLS, sleep apnea, and PLMD. These conditions may actually contribute to inattentiveness and hyperactivity.
The disorders have much in common, including poor sleep habits, twitching, and the need to get up suddenly and walk about frequently. Some evidence suggests that the link between the diseases may be a deficiency in the brain chemical dopamine.
Pregnancy. About 1 in 5 pregnant women report having RLS. The condition usually goes away within a month of delivery. RLS in pregnancy has been linked to deficiencies in iron and the B vitamin folate. Dialysis. Restless legs syndrome is relatively common in people undergoing kidney dialysis. Up to two- thirds of patients report this problem. Symptoms often disappear after a kidney transplant. Anxiety Disorders.
Anxiety can cause restlessness and agitation at night. These symptoms can cause restless legs syndrome or strongly resemble the condition. Other Conditions Associated with Restless Legs Syndrome.
The following medical conditions are also associated with restless legs syndrome, although the relationships are not clear. In some cases, these conditions may contribute to RLS.
Others may have a common cause. In some cases, they may coexist due to other risk factors: Osteoarthritis (degenerative joint disease). About three- quarters of patients with RLS also have osteoarthritis, a common condition affecting older adults. Varicose veins. Varicose veins occur in about 1 in 7 patients with RLS. Obesity. Diabetes.
People with type 2 diabetes may have higher rates of secondary RLS. Nerve pain (neuropathy) related to their diabetes cannot fully explain the higher rate of RLS. Hypertension. Hypothyroidism (a condition in which the thyroid gland does not make enough hormones)Fibromyalgia (chronic pain of unknown cause)Rheumatoid arthritis. Emphysema (a lung disease usually caused by smoking)Chronic alcoholism. Sleep apnea (pauses in breathing during sleep) and snoring.
Chronic headaches. Brain or spinal injuries. Many muscle and nerve disorders. Of particular interest is hereditary ataxia, a group of genetic diseases that affects the central nervous system and causes loss of motor control. Researchers believe that hereditary ataxia may supply clues to the genetic causes of RLS. Osteoarthritis is a chronic disease of the joint cartilage and bone, once thought to result from .
Joints appear swollen, are stiff and painful, and usually feel worse the more they are used throughout the day. People who are deficient in iron are at risk for restless legs syndrome, even if they do not have anemia. Folic acid or magnesium deficiencies. Smoking. Alcohol abuse.