RLS is a disorder of neurological origin, which manifests as uncomfortable sensations in the extremities (mainly the legs) at rest, for example when sitting or lying down. These sensations cause the need to stand up, walk, and move. With movement, the unpleasant sensations are relieved or disappear.
The disorder appears in 2-3% of the population with some severity and affects both men and women. It can begin at any age, most frequently starting after the fourth decade of life.
The terms used by patients to describe RLS symptoms include: “unease”, “tingling”, “cramps”, “pricking”, “nervousness”, “pain”, “deep strange sensations”, “burning”, “crazy legs”, etc. The main characteristics are:
Diagnosis should also take into account the existence of family members with the same disorder (familiar predisposition exists), history of response to dopaminergic pharmaceuticals (treatment used for the disease), and the presence of periodic leg movements during sleep and sometimes during wakefulness (appears in more than 80% of patients).
The evolution of RLS tends to be chronic and slowly progressive (increasing in intensity with time), altering sleep in the majority of subjects. Physical examination and routine medical tests tend to be normal.
In approximately 20% of cases, there are other medical situations that explain the emergence of symptoms of RLS: anemia, kidney failure, polyneuropathy, pregnancy, pharmaceuticals, etc.
RLS can sometimes be diagnosed in a consultation with a doctor by conducting a clinical history of the patient. This means that the diagnosis is clinical. However, along with the clinical history, some tests may be very useful:
Most research findings suggest a disorder in the functioning of dopamine, a substance present in the nervous system that is responsible for the regulation of movement. Dopamine needs iron to function properly, and a malfunction of iron and/or decreases of deposits (ferritin levels) have been noted in patients suffering from RLS. Very often, there are close family members that are affected.
The following measures should be taken into account:
Antiepileptic: these drugs are used to treat epilepsy and neuropathic pain, and have also been found to be useful in the treatment of RLS. The main ones are: gabapentin and pregabalin.
Opioids: in some cases codeine or extended-release oxycodone/naloxone can be indicated.
It is recommended in all cases to go to a specialized sleep center to be evaluated correctly. The doctor will determine the intensity of the symptoms that you have, and will evaluate the possibility of a treatment to control your disease.
Links of interest:
Spanish Association of Restless Legs Syndrome