Willis-Ekbom Disease (Restless Leg Syndrome), A Simple Guide To The Condition, Diagnosis, Treatment And Related Conditions

This book describes Willis-Ekbom Disease or Restless Leg Syndrome, Diagnosis and Treatment and Related DiseasesRestless Legs Syndrome every one hates you. You rob people of the sleep and make them blueOut of the blue my legs started feeling funnyMy RLS leaves me with very little energyYou make me have the urge to move my legsI feel that ants are crawling on my skin and laying eggsI only feel comfortable when my legs are kickingThese sensations becomes worse when I am sleepingEven at rest the patient come and irritate meWhen can I ever stop suffering and be freeBecause of you I had to quit the job I lovedEvery day I watched for triggers that make my RLS worsePlease help me, doctor, be kindI think that I am going out of my mindPlease help me to stop my legs from fidgetingAnd allow me at least some hours of good sleeping-An original poem by Kenneth KeeThe other day I had one patient who could not sleep for a few nights before of jerking movements of his legs one leg after the other.
He felt that he just has to move his legs because of the funny sensations he felt in the legs. They occur only when he was lying still trying to sleep. PrimaryI found out that he was taking a high dose of antihistamine for his cold symptoms and asked him to stop them. I also gave him some clonazepam (a mild tranquillizer with anti convulsant effect) to be taken only if he still has the jerking movements.
Happily for him after stopping the antihistamine his jerking movements stopped and he did not have to take the clonazepam. Willis-Ekbom disease or Restless Legs Syndrome is a neurological movement disorder featured by a distressing need or urge to move the legs or arms (akathisia) normally followed by an uncomfortable deep-seated sensation in the legs that is activated by:1. Rest;2. Sitting or lying down, 3.
Worsening at night or in the evening. It is relieved by moving or walking. It most often affects the legs, but can affect the arms, body, head, and even phantom limbs. People who have RLS depict the unpleasant feelings as creeping, crawling, pulling, itching, tingling, burning, aching or electric shocks. There is sleep disturbance and a link with involuntary jerking movements of the legs during sleep called periodic leg movements of sleep.
There are 2 types of Restless Legs Syndrome:A. Primary or idiopathic central nervous system (CNS) disorder can be familial with a pattern of autosomal dominant or recessive inheritance happening at an earlier age of onset of 45 years and slower disease progression. Psychiatric factors, stress, and fatigue can make the symptoms of restless legs syndrome worse. B. Secondary Restless Legs Syndrome can happen due to some linked disorders such as:1.
Iron deficiency (especially); blood ferritin below 50 µg/L (seen in 20% of cases)2. Peripheral neuropathy3. Hypoglycemia4. Parkinson's Disease5. Folate or magnesium deficiency6. Vitamin B-12 deficiency7. Diabetes mellitus8. Frequent blood donation9. Rheumatic disease and Rheumatoid arthritis10. Uremia11. End-stage renal disease (seen 25-50% of patients with End stage renal disease may improve after kidney transplant)12.
Pregnancy (seen in 25-40% of pregnant women normally subsides within a few weeks after delivery). Restless legs syndrome is diagnosed on history taking and 4 diagnostic criteria:1. An urge to move the legs, normally accompanied by unpleasant sensations;2. Occurrence of symptoms during rest;3. Relief of symptoms by movement; and4. Worsening of symptoms in the evening or night. For primary Restless Leg Syndrome, drug therapy is mainly for symptomatic relief.
TABLE OF CONTENTIntroductionChapter 1 Willis-Ekbom Disease or Res...