Have you seen people moving or shaking their legs while resting, especially while sleeping, lying down or sitting? This involuntary movement is called Restless Leg Syndrome (RLS). Though not dangerous or fatal, RLS can be highly uncomfortable for the patient and interfere with sleep and quality of life.
Around two to three percent of the adult population in India suffers from RLS, which is, however, less than the Western world. It is also seen more in females than males, especially in pregnant women. The condition is almost unheard of in children.
Explaining the syndrome, its probable causes and treatment, Dr G V Subbaiah Chowdhary, senior neurologist at Yashoda Hospital, says “RLS is an underestimated problem that can be associated with sleeprelated movement disorder. The affected person undergoes the unpleasant, uncomfortable urge to move their legs and sometimes arms, especially during sleep or while taking rest. They may also feel pain in their legs, which may not actually be present. Usually, the lower part of the leg (below the knees) is affected. The patients get relief when they get up and start walking.”
The doctor adds that RLS is different from the Periodic Limb Movement Disorder (PLMD), which happens only during sleep, usually without the patient being aware of it. “The leg discomfort due to RLS is different from normal leg pain, which can happen because of various reasons like poor blood circulation and peripheral neuropathy, positional discomfort, leg cramps from sports and exercise-related exhaustion etc,” he says. RLS can be temporary or it may continue throughout life.
PROBABLE CAUSES
“The causes of RLS have not been completely established but research points to either low iron level in the body or dopaminergic reasons — that is, alteration in neurotransmitters or brain chemicals in the dopamine pathway. Studies are on to establish the exact correlation between neuro-transmitters like GABA, glutamate and RLS. Some abnormality in the cellular level or micro level in the thalamus of the brain can also be a cause. The peripheral nervous system can get involved, causing an increased sensitivity to touch or pain and producing RLS. It is not proven if the condition is genetic, though in 40 per cent to 60 per cent of cases, there seems to be a family history. Certain medications like antihistamines and anti-nausea medicines and some psychiatric drugs including anti-depressants can also cause RLS as side effects in some people. The condition could improve if these drugs are stopped,” Dr Subbaiah shares.
THE VULNERABLE SECTION
People with existing comorbidities such as diabetes, kidney failure, Parkinson’s Disease, spinal cord ailments, multiple sclerosis, peripheral neuropathy (tingling sensation of the limbs), and pregnant women are more prone to RLS.
TREATMENT OPTIONS
“We take the patients’ history, lifestyle, comorbidities etc. and then suggest treatment. Patients usually respond well to treatment. Since iron deficiency and dopamine disruptions are associated with RLS, giving supplements that increase the level of iron in the body and heighten the dopamine level can improve the condition. Discontinuing certain drugs that may trigger RLS can also help. RLS can fluctuate, and the symptoms can eventually disappear in 30 per cent to 60 per cent of patients,” the neurologist says. “Patients will do better if they stop smoking and consuming alcohol, reduce their caffeine intake, exercise regularly, massage their legs and divert their minds from the syndrome,” he stresses.
