The restless legs syndrome (RLS) is a disease mainly affecting the lower limbs. It results in uncomfortable tingling and need irrepressible motion, evening and night, which may affect the quality of life and sleep. Sometimes without definite cause, restless legs syndrome may be genetic, related to another condition or a medication.
This syndrome is a disorder of the nervous system causing an urge to move the legs. This condition is also called “disease and Willis Ekbom” or “syndrome Restless wakefulness” (or simply “impatience”).
RLS is accompanied by unpleasant sensations in the lower limbs, namely:
- itches ;
- an impression of “electric shock”.
Often these symptoms increase the urge to move and are more pronounced for one of the two legs. In 20% of cases, they also affect the arms. Much more rarely, they can spread to other body parts. In the most pronounced forms of the syndrome, these events sometimes cause pain.
RLS signs say they usually at night to rest, once the person lying down. In all cases, the symptoms are relieved by the movement of the legs.
In addition, 80% of people with RLS have involuntary muscle jerks (or “periodic leg movements of sleep”) during their sleep. If these patients have not always aware of these tremors can interfere spouse.
In addition, the syndrome of restless legs:
- reached more often women;
- usually appears in adulthood (although in rare cases it can occur in children or adolescents).
Finally, know that we can present signs suggestive of RLS several times a year without developing the disease.
WHAT CAUSES THE SYNDROME OF RESTLESS LEGS?
While the exact mechanisms of the disease remain unknown, two factors seem to play an important role in triggering:
- iron deficiency in the body, with or without anemia ;
- the lack of dopamine (a substance allowing transmission of information between nerve cells) in some areas of the brain and spinal cord.
Doctors also distinguish three main forms of the disease, defined by context and / or specific contributing factors:
They have a genetic origin.
The forms called “secondary”
They are associated with other diseases, behaviors or situations that trigger or exacerbate symptoms such as:
- the chronic renal failure ;
- the diabetes ;
- the rheumatoid arthritis ;
- the multiple sclerosis ;
- the pregnancy (20 to 30% of pregnant women have RLS which disappears after delivery);
- taking certain medications (eg. neuroleptics, antidepressants,antihistamines );
- the consumption of alcohol , of tobacco , coffee, tea and / or chocolate;
- stress and fatigue.
The forms called ” idiopathic “
They have no identified cause (in particular, no other member of the patient’s family is not reached).
THE EVOLUTION AND THE POSSIBLE CONSEQUENCES OF RLS
The restless legs syndrome (RLS) is changing gradually. In addition, symptoms may worsen during certain periods (stress, fatigue) and / or regress temporarily.
This condition can have two main consequences on the quality of life for people with:
A deterioration of sleep
The patient has difficulty falling asleep. He happens to wake up several times at night to move the legs or getting up.Sometimes this causes insomnia and discomfort for the person sharing the bed, where applicable. Eventually, fatigue may appear in the day and generate:
- difficulty concentrating;
- mood disorders (irritability or depression).
Disruption of social and professional life
Sometimes RLS becomes troublesome in situations where one remains immobilized for some time (meetings, shows, family meals, long car rides or plane, etc.) Some affected people often avoid such events.
The syndrome of restless legs is essentially characterized by three events:
- An urge to move the legs, accompanied or caused by uncomfortable sensations in the legs.
- A trigger or an accentuation of signs during periods of rest, evening or night.
- The total or partial disappearance of the symptoms by movement of the legs.
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- Haba-Rubio J, R Heinzer, Tafti M, J. Krieger restless legs syndrome and periodic leg movements during sleep. EMC (Elsevier Masson SAS, Paris) – Neurology. 2012; 17-009-A-15.
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WHAT TO DO: RESTLESS LEGS SYNDROME: THE CASE MUST BE CONSULTED AND GOOD REFLEXES
In case of restless legs syndrome, you can reduce your symptoms by walking, you massaging or taking a hot bath. also prefer a healthy lifestyle. If the symptoms become more pronounced, see a doctor and try to follow his prescriptions.
You experience unpleasant sensations in the legs, causing an urge to move? If these events are episodic, know that they are commonplace and do not require medical attention.
However, take the advice of your doctor in the following cases:
- symptoms are repeated more and more often;
- they disrupt your sleep and concentration throughout the day, and / or sound on your mood.
HOW TO MITIGATE SELF SYMPTOMS OF THE DISEASE IN MILD FORMS?
If it is impossible to prevent leg syndrome (RLS), we can reduce the number and intensity of its manifestations. For that, try some simple gestures (often enough to relieve mild symptoms):
- at the first sign, move, get up and walk a few minutes;
- massage the affected members;
- according to your preferences, use your legs on cold or hot compresses, or relax in a hot bath;
- focus all your attention on a sustained activity (intellectual, manual or playful).
Also make sure to adopt a healthy lifestyle:
- lie down and get up at set times, and get enough sleep;
- Avoid anything that can increase symptoms (eg. tea, coffee, alcohol , intense physical exercise late in the day);
- keep a supply balance;
- practice regularly a physical activity .
WHAT ARE THE RULES TO FOLLOW IN CASE OF RLS DIAGNOSED AND TREATED?
If your doctor has confirmed the diagnosis of restless legs syndrome:
- follow its recommendations and the prescribed treatment carefully;
- tell your doctor about any side effect or reduced effectiveness of medication taken;
- avoid any additional self-medication;
- if another healthcare professional should give you a prescription, tell him that you suffer from this disease. In fact, some medicines may increase your symptoms.
RESTLESS LEGS SYNDROME: DIAGNOSIS AND TREATMENT
A medical consultation is often enough to diagnose the syndrome restless legs. Sometimes additional tests are needed (eg. Blood tests). The prescribed treatment is based on simple gestures and a healthy lifestyle. In some cases, medications help treat the symptoms and / or their cause.
HOW IS THE MEDICAL CONSULTATION?
If you look for restless legs syndrome (RLS), the doctor first ask you about your symptoms (intensity, context, frequency, evolution, etc.) It also asks whether these signs affect your sleep, your daytime alertness and mood.
Then the practitioner asks you about:
- possible cases of RLS in your family;
- Your personal medical history (eg. diabetes , chronic renal failure );
- the treatments you are taking (some self-medication drugs can trigger or worsen symptoms).
Finally, the doctor examines you.
Generally, this first consultation is sufficient to confirm the diagnosis.However, your doctor may also prescribe:
- a blood test to check your levels of iron in your blood;
- a sleep recording, to better perceive the impact of RLS on your nights;
- a consultation with a neurologist (a specialist in diseases of the nervous system) or a specialist in sleep disorders. These can indeed provide medical care best suited to your case if necessary.
The diagnosis of restless legs syndrome is often late
On average, the disease is diagnosed ten years after the first signs. This delay can be explained by ignorance of RLS. In particular, its symptoms can be confused with those of certain neurological or vascular pathologies.
Once the diagnosis, your doctor will inform you about the disease and its possible evolution, fluctuating with periods of calm and potential increases which may require therapeutic adaptations.
WHAT ARE THE POSSIBLE TREATMENTS PRESCRIBED FOR RLS?
In order to choose the most appropriate care to you, the doctor measures the intensity of your RLS. It uses a specific rating scale (forms “light”, “moderate”, “severe” and “very severe”), based on:
- the nature of your symptoms;
- their impact on your mood and on your social life, family and work.
In mild forms, simple gestures and adopting a healthy lifestyle generally sufficient to reduce the signs.
If these first steps are insufficient, your doctor may prescribe medication to the family of dopamine agonists (eg. Pramipexole, ropinirole, rotigotine skin patch). These products compensate the lack of dopamine (a substance allowing the transmission of information in the nervous system), which promotes the development of RLS. Reproducing the action of this molecule in the body, dopaminergic are often very effective.
The doses prescribed by your doctor depending on your symptoms:
- In case of discontinuous events, the treatment is taken during episodes of RLS. It can also be indicated in preventive (in situations that routinely trigger signs).
- If symptoms are regular and frequent, drug are taken continuously.
In any case, to avoid side effects, dopamine prescribed in moderate doses, increased gradually.
Finally, note that this treatment is only symptomatic. Indeed, there is still no medicine to cure the syndrome restless legs.
THE TREATMENT OF THE CAUSE OR TRIGGERS
If your RLS is related to another disease ( anemia iron deficiency , diabetes , etc.), it will be treated to remove the cause of symptoms.
In addition, any drug potentially triggering or exacerbating will, if possible, deleted and replaced by the treating physician.
If you are treated with a dopamine medication, apply the following rules:
- observe well the prescribed dose, without increasing the (risk of side effects);
- take the product at the times indicated by your doctor;
- do not interrupt taken without medical advice;
- always specify the health professionals that you suffer from RLS and use dopamine;
- if unusual symptoms occur, report it immediately to the doctor who prescribed the treatment. It can thus adapt it to your situation.