Restless Legs Syndrome (Willis-Ekbom Disease)

Restless Legs Syndrome
Body Parts: Lower Limbs
Medical Subjects: Nervous System

What Is Restless Leg Syndrome?

Restless legs syndrome is a neurological syndrome characterized by a strong desire for physical activity.

It is usually accompanied by paresthesias in both lower limbs and occasionally involves upper limbs. There are many kinds of paresthesias, such as soreness, ants walking, acupuncture, and even indescribable discomfort. This discomfort is reduced after physical activity, aggravated during rest, reduced during the day, and aggravated at night.

In severe cases, it can greatly affect the life of patients, but this disease has good therapeutic effects and can reach the standard of cure. However, the disease may recur after being cured, so it is necessary to do a good job of prevention.

Are there many patients with restless legs syndrome?

The prevalence rate ranged from 0.1% to 11.5%, with a higher incidence among Caucasians and a lower incidence among Asians.


What Are The Causes Of Restless Legs Syndrome?

The specific pathogenesis remains unclear and may be related to the following factors:

  • Heredity. the patients often have nerve conduction abnormalities in their limbs, and spinal cord lesions. In terms of neurotransmitters, these patients show inadequate dopamine function.
  • It is often secondary to other diseases, and the common ones include uremia, peripheral neuropathy, anemia, and myofiber pain.

Are there different types of restless legs syndrome?

According to the cause of the disease, the ones caused by other diseases are called secondary restless legs syndrome, while the cause is not found are called primary restless legs syndrome.


Symptoms Of Restless Legs Syndrome

What are the consequences of restless legs syndrome?

The disease is not harmful to life, but it seriously affects the life of patients. The symptoms of most patients with restless legs syndrome are mostly disorderly movements of hands and feet after falling asleep (periodic limb movements during sleep).

  • Involuntary movements during sleep may disturb the patient's sleep and even cause insomnia. It may also affect the sleep of the person next to you, leading to tension in the relationship between husband and wife.
  • Patients often suffer from severe physical discomfort, which affects their daily life and is often accompanied by depression symptoms such as depression, low self-evaluation and pessimism about the future. There are also cases of extreme results such as suicide.

What is the rating of severity for patients with restless legs syndrome?

Restless leg syndrome can be divided into mild, moderate and severe degrees according to its severity.

  • Mild: Occasional periodic attacks slightly affect the patient's sleep, but do not cause obvious troubles.
  • Moderate: No more than 2 attacks in a week can obviously delay the time of falling asleep, interfere with sleep moderately, and slightly affect daily life.
  • Severe: it occurs more than 3 times in a week, which seriously interferes with night sleep and obviously affects daily life.

How To Diagnose Restless Legs Syndrome?

Diagnostic criteria include four aspects:

  • Strong desire to move legs, or accompanied by discomfort in legs.
  • The above experience appears or intensifies during rest.
  • The above experience was partially or completely relieved after moving legs.
  • The above experience is more serious at night than during the day, or only occurs at night.

What diseases should restless legs syndrome be distinguished from?

This disease needs to be differentiated from the following diseases:

  • Akathisia: It is an internal sensation of restlessness, usually caused by dopamine agonists, and is often accompanied by extravertebral reactions without circadian changes and without affecting sleep.
  • Multiple peripheral neuropathy: It also has various discomforts of limbs, but does not have a strong desire to move limbs.
  • Arterial insufficiency: It is a clinical symptom arising from the lesion of arterial wall of limbs that affects blood flow and has the characteristics of aggravation after exercise and alleviation after rest. Color Dopplar ultrasound and CT can assist in the identification.

What check does the diagnosis of restless leg syndrome need to do?

The diagnosis of this disease mainly depends on clinical manifestations.

  • Auxiliary examination: some secondary causes can be ruled out, mainly including serum ferritin, transferrin, serum iron binding force, renal function, blood glucose, etc..
  • Polysomnography: It can be used to determine whether patients have periodic limb movements during sleep and the severity.

How is polysomnography performed in patients with restless legs syndrome?

When the patient conducts polysomnography, it is preferred that various leads of the polysomnography be connected, and the patient sleeps one night in the monitoring room of the sleep center. The technician then evaluates the sleep condition based on the overnight monitoring data on the next day, and issues a corresponding report.


Is There A Way To Prevent Restless Legs Syndrome?

Prevention should start with various living habits, as follows:

  • Eliminate and reduce pathogenic factors, such as active treatment of primary diseases, less use of coffee and coffee drinks, smoking cessation, a reasonable diet, to prevent iron deficiency. Pregnant women should actively supplement folic acid, vitamins, etc.
  • Work and rest rules, pay attention to exercise, don't fatigue, excessive consumption.
  • Exercise moderately during the day and avoid excessive physical exercise or daytime too much sleep.

How To Treat Restless Legs Syndrome?

  • Non-drug therapy: Massage legs, hot bath before bedtime, moderate exercise, and avoid drinking alcohol at night.
  • Drug therapy: dopamine replacement agents, such as madopar, levodopa. Dopamine receptor agonists such as pramipexole and ropinirole. If the patient's serum ferritin is below 45 to 50 μg/L, oral iron supplementation, such as ferrous sulfate, should be administered.

Patients with mild and moderate syndromes are treated by non-drug therapy first, while patients with severe syndromes are better treated by drug therapy. Of course, patients with secondary restless legs syndrome need to be actively treated for primary diseases.

What are the common adverse reactions during drug treatment?

Pramipexole, a dopa receptor agonist, has been shown to be effective in 70%–90% of patients. Therefore, pramipexole is the first choice for treatment, but it may cause side effects such as nausea, lethargy, headache, dizziness, hypotension, and external edema. Some patients may also suffer from impulse control disorder symptoms such as pathological gambling, excessive shopping, and hypersexuality.

How to deal with adverse reactions of drug therapy?

If the above adverse reactions are encountered during medication, the drugs should be reduced. if the effect is unsatisfactory, other drugs can be used instead.

Can restless leg syndrome cure?

The disease has good effects on various treatments and can reach the standard of cure.

Does restless leg syndrome have a relapse after cure?

The disease may recur after being cured, so it is necessary to do a good job of prevention.


What Should Be Noticed In The Life Of Patients With Restless Legs Syndrome?

Will restless legs syndrome cause paralysis in the future?


What should be noticed on diet?

Need a healthy and balanced diet:

  • When cooking, pay attention to less salt, less oil, less spices with high salt content, and less pickled vegetables and bacon.
  • Reasonable collocation of meat and vegetable, meat preferred chicken, duck and fish, eat less fat. Eggs, milk are an important source of protein and other nutrients.
  • If you are a vegetarian, you can eat more beans and soy products to supplement protein.
  • Eat more fruits and vegetables.
  • Try not to drink.

For more life advice, please refer to "Prevention".

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