Restless Legs

Restless legs syndrome is a common nervous system disease that can be seen in men and women. Although it is generally not fully described by patients, it is a disease characterized by symptoms such as itching, chills, pain, burning and tingling in the feet and legs, and in some patients in the arms. Restless leg syndrome can be confused with cramps and numbness in the muscles in some cases. This delays the diagnosis of the disease and initiation of the treatment process. For this reason, it is of great importance to determine the source of the problem with a detailed examination in patients with symptoms of restless leg syndrome.

What are the symptoms of restless leg syndrome?

Symptoms seen in individuals with restless leg syndrome can be listed as follows:

Feeling of restlessness in the legs and feet

The need to move constantly due to the feeling of restlessness

Pain and discomfort that increase during night hours

The feeling that the pain and discomfort felt will decrease for a short time by moving the affected area.

Involuntary twitching in the legs

WHAT ARE THE COMPLAINTS AND FINDINGS REQUIRED TO DIAGNOSE RISE LEGS?

1- The need to move the legs due to or with uncomfortable or unpleasant sensations in the legs
2- The need to move or uncomfortable sensations begin or worsen at rest
3- Complaints decrease or pass when walking or legs are stretched.
4- Complaints occur in the evening and at night
5- There should be no other disease (myalgia, varicose veins, leg edema, venous insufficiency, leg cramps ...) that can explain the above complaints.
These complaints listed above should last at least 3 days a week and at least 3 months during this period so that the disease can be diagnosed.

What are the causes of restless leg syndrome?

Restless leg syndrome often occurs in an idiopathic way. In some cases, other factors in the individual play a role in the emergence of the disease. Some of these can be listed as follows:

Genetic predispositions

Dopamine balance disorder

Pregnancy (especially the last trimester)

Anemias caused by iron deficiency or other reasons

Neuropathy

Excessive alcohol use

Spinal cord or spinal block formation in the spinal cord

Use of antidepressants and antipsychotic drugs that increase serotonin levels

What are the types of restless leg syndrome?

Restless leg syndrome disease is basically divided into 2 subgroups:

Idiopathic Restless Leg Syndrome: In this type of restless leg syndrome, the exact cause of the disease is unknown. It can be divided into two as genetically derived idiopathic restless legs syndrome and non-familial restless legs syndrome.

Secondary Type (Secondary) Restless Leg Syndrome: In this type of disease, restless leg syndrome occurs due to any other ailment in the individual. This disease; There may be polyneuropathy, kidney disease, parkinson, anemia, pregnancy, vitamin or mineral deficiency, or some rheumatic diseases.

What are the restless leg syndrome treatment methods?

Determining the type of disease plays a very important role in the treatment of restless leg syndrome. In case of any underlying problem such as iron deficiency or anemia, a treatment plan should be applied primarily to eliminate this problem. In other cases, massage, hot and cold compress applications, exercise and medication can be used. In this disease, where nutrition is also of great importance, it is beneficial to keep the dietary intake of substances such as caffeine under control. Apart from these, patients with restless leg syndrome should avoid situations such as stress, smoking, and being inactive for a long time. If you also have restless leg syndrome, you can prevent the problems caused by the disease and increase your quality of life by complying with the treatment principles recommended by your physician and having regular checkups.

Iron Levels and RLS

Iron is known to help and treat restless leg syndrome. This is because iron is involved in the dopamine pathway. With the lack of iron in the body, dopamine levels also decrease and RLS worsens.

Low‐normal ferritin levels <50 ng/mL are known to coincide with severe symptoms of RLS.

A total of three studies have been conducted to evaluate whether oral iron therapy can improve RLS symptoms.In an open-label trial, O’Keeffe et al. An elderly patient population (n = 15) with a mean serum Ferritin (Ft) level of 32.5 ng / mL was administered 600 mg of oral ferrous sulfate daily. This resulted in an overall improvement in RLS symptoms as well as an average increase in Ft of 34 ng / mL, with the strongest effects observed in people with Ft levels <18 ng / mL. More recently, Wang et al. 11 people with RLS who received 650 mg of oral ferrous sulfate daily over a 12-week period showed a significant improvement in IRLSSG severity scores (10.3 vs 1.1 points; P = 0.01) compared to 7 people treated with placebo.

References:

1.Sun ER, Chen CA, Ho G, Earley CJ, Allen RP. Iron and the restless legs syndrome. Sleep1998;21:371–377. PubMed PMID: 9646381.

2.Wang J, O’Reilly B, Venkataraman R, Mysliwiec V, Mysliwiec A. Efficacy of oral iron in patients with restless legs syndrome and a low‐normal ferritin: a randomized, double‐blind, placebo‐controlled study. Sleep Med 2009;10:973–975. PubMed PMID: 19230757.