Restless Leg Syndrome Overview

Restless Leg Syndrome

Restless leg syndrome, also referred to as Willis-Ekbom disease, is characterized by an uncontrollable urge to move the legs. 

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What Causes Restless Leg Syndrome?

Evidence suggests that restless leg syndrome occurs due to a problem in the basal ganglia. This is a region located in the brain that utilizes dopamine in order to adequately control movement and muscle activity. If the cells within this region become damaged, dopamine levels in the brain drop, leading to muscle spasms and uncontrollable movements of the extremities. At the end of the day, dopamine levels naturally fall, which may account for the fact that the symptoms of this condition worsen during the evening and at nighttime.

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Triggers

The following are factors that can aggravate symptoms of restless leg syndrome:

1. Medication: certain antidepressants, antipsychotics, lithium, antihistamines, metoclopramide. If you believe that your medication is aggravating your symptoms, speak with your physician
2. Excessive intake of alcohol and caffeine
3. Vein disease, including chronic venous insufficiency
4. Excessive smoking
5. Obesity or being overweight
6. A sedentary lifestyle
7. Stress

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Signs & Symptoms Of Restless Leg Syndrome:

• Uncontrollable urge to move the legs
• Uncomfortable sensations in the legs, such as: tingling, itching, burning or throbbing
• Painful cramps in the legs, especially in the calves

The sensations can also affect the chest, arms, and face. They can be mild or severe, and are usually worse during the night and in the evening. Often times, these symptoms can be relieved by rubbing or moving the legs. Some people experience them daily, others occasionally. The condition can affect any person, although it is more common in women. The majority of cases are diagnosed in during midlife, but it can begin as early as childhood. Restless leg syndrome is also associated with involuntary jerking of the arms and legs during sleep.

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Establishing a diagnosis of restless leg syndrome requires careful analysis of your symptoms, family and medical history, a full physical examination and additional tests. The 4 main diagnostic criteria include:

1. The presence of an overwhelming need to move the legs, accompanied by uncomfortable sensations such as tingling, crawling or itching
2. Symptoms occur or worsen when inactive or resting
3. Symptoms lessen when rubbing or moving the affected leg
4. Symptoms worsen at night or in the evening

In order to rule out or confirm a possible underlying cause of restless leg syndrome some of the following tests might be required:

• Blood tests (blood count, hemoglobin levels, iron levels, liver and kidney function studies, blood glucose, electrolytes et.)
• Ultrasound to examine various organs, tissues and blood vessels (to rule out chronic venous insufficiency)
• Electrocardiogram – those suffering from restless leg syndrome are more inclined to develop a cardiovascular condition
• Sleep tests – recommended for those that have trouble sleeping in order to diagnose the presence of periodic limb movements in sleep

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Treatment

If restless leg syndrome is caused by an underlying disease, treating that condition may also resolve the restless leg syndrome. In mild cases of restless leg syndrome that is not linked to any other medical condition, a few lifestyle changes such as weight loss, exercise and wearing compression garments or compression stockings can help manage the syndrome.

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