RESTLESS LEGS SYNDROME - a patient's guide
Abstract
Restless Legs Syndrome (RLS) disorder varies in severity. In its milder form it is a feeling of discomfort in the legs, often the calves, coming on with rest, especially on going to bed and relieved by standing or walking about.
When severe, there is marked unpleasant discomfort in the legs (not usually pain) coming on soon after resting, so that watching television or going to the pictures or theatre may not be possible, and sleep is disrupted or prevented.
Moving about provides relief, so severely affected individuals may be up and down all night. Generally, the symptoms are better in the mornings and get worse as the day goes on.
Mostly, RLS starts in middle age and at its onset it may be present only intermittently (for example after strenuous exercise or caffeine) and gradually becomes more persistent and intense over a matter of years.
In a few people it starts in adolescence and often becomes worse in the third trimester of pregnancy. It affects about 10 percent of the population but is more common in the elderly.
Frequently it runs in families and may be inherited as a dominant trait, although the gene(s) responsible for the RLS has not been identified. In some patients RLS is a result of another disorder - peripheral neuropathy, Parkinson's disease or iron deficiency anaemia.
Treatment may not be necessary if the symptoms are mild and intermittent. If the severity of the symptoms is such that treatment is necessary, then a dopamine agonist of long duration (e.g. Pergolide or Permax) would be indicated, although nausea and other side effects may occur.
Alternatively, a slow release form of Madopar or Sinemet can be used; these may be very helpful for the night time symptoms but the day time symptoms may be exacerbated. Benzodiazepines (e.g. Clonazepam) are often helpful but there can be problems with the long-term use of this class of medication. Also, a few patients are helped by anti-epileptic medication (e.g. Tegretol or Epilim).