Restless Leg Syndrome Part 2 of 8

What are common signs and symptoms of restless legs?

As described above, people with RLS feel uncomfortable sensations in their legs, especially when sitting or lying down, accompanied by an irresistible urge to move about.  These sensations usually occur deep inside the leg, between the knee and ankle; more rarely, they occur in the feet, thighs, arms, and hands.  Although the sensations can occur on just one side of the body, they most often affect both sides. 

Because moving the legs (or other affected parts of the body) relieves the discomfort, people with RLS often keep their legs in motion to minimize or prevent the sensations.  They may pace the floor, constantly move their legs while sitting, and toss and turn in bed. 

Most people find the symptoms to be less noticeable during the day and more pronounced in the evening or at night, especially during the onset of sleep.  For many people, the symptoms disappear by early morning, allowing for more refreshing sleep at that time.  Other triggering situations are periods of inactivity such as long car trips, sitting in a movie theater, long-distance flights, immobilization in a cast, or relaxation exercises. 

The symptoms of RLS vary in severity and duration from person to person.  Mild RLS occurs episodically, with only mild disruption of sleep onset, and causes little distress.  In moderately severe cases, symptoms occur only once or twice a week but result in significant delay of sleep onset, with some disruption of daytime function.  In severe cases of RLS, the symptoms occur more than twice a week and result in burdensome interruption of sleep and impairment of daytime function. 

Symptoms may begin at any stage of life, although the disorder is more common with increasing age.  Sometimes people will experience spontaneous improvement over a period of weeks or months.  Although rare, spontaneous improvement over a period of years also can occur.  If these improvements occur, it is usually during the early stages of the disorder.  In general, however, symptoms become more severe over time. 

People who have both RLS and an associated condition tend to develop more severe symptoms rapidly.  In contrast, those whose RLS is not related to any other medical condition and whose onset is at an early age show a very slow progression of the disorder and many years may pass before symptoms occur regularly. 

What causes restless legs syndrome?

In most cases, the cause of RLS is unknown (referred to as idiopathic).  A family history of the condition is seen in approximately 50 percent of such cases, suggesting a genetic form of the disorder.  People with familial RLS tend to be younger when symptoms start and have a slower progression of the condition.

In other cases, RLS appears to be related to the following factors or conditions, although researchers do not yet know if these factors actually cause RLS. 

People with low iron levels or anemia may be prone to developing RLS.  Once iron levels or anemia is corrected, patients may see a reduction in symptoms. 

Chronic diseases such as kidney failure, diabetes, Parkinson's disease, Multiple Sclerosis, and peripheral neuropathy are associated with RLS.  Treating the underlying condition often provides relief from RLS symptoms. 

Some pregnant women experience RLS, especially in their last trimester.  For most of these women, symptoms usually disappear within 4 weeks after delivery. 

Certain medications-such as:

·    antinausea drugs (prochlorperazine or metoclopramide),

·    antiseizure drugs (phenytoin or droperidol),

·    antipsychotic drugs (haloperidol or phenothiazine derivatives), and

·    some cold and allergy medications-

may aggravate symptoms.  Patients can talk with their physicians about the possibility of changing medications.

Researchers also have found that caffeine, alcohol, and tobacco may aggravate or trigger symptoms in patients who are predisposed to develop RLS.  Some studies have shown that a reduction or complete elimination of such substances may relieve symptoms, although it remains unclear whether elimination of such substances can prevent RLS symptoms from occurring at all.