Restless Legs Syndrome (RLS) is a complaint that occurs in the lower extremities shortly after going to bed and is usually expressed as tension, numbness, stinging, burning, pricking or a strange feeling of discomfort that cannot be fully described. To relieve these complaints, the patient moves his legs or gets up and walks, but this time moving the legs delays falling asleep.
How common is Restless Leg Syndrome?
Restless legs syndrome is one of the most common neurological disorders, but it is diagnosed in only a fraction of people who suffer from it. According to studies, restless legs syndrome symptoms are seen in 10% of the population in European countries. Women suffer from restless legs syndrome twice as often as men, and older people more often than younger people.
Restless legs syndrome can occur in two different ways: primary “idiopathic” No concrete underlying cause has been found so far for RLS. Others are secondary “symptomatic” types of RLS and can occur in certain diseases (e.g. kidney failure) or during pregnancy.
What is idiopathic RLS?
Idiopathic The cause of RLS has not yet been fully explained. However, most likely, one of the causes is a disorder in the metabolism of dopamine neurotransmitter, which plays an important role in the brain. Most likely, a disorder in iron metabolism also plays a role. This also explains why treatment with an L-Dopa (a precursor of dopamine) or drugs that mimic the action of dopamine (dopamine agonists) relieves RLS complaints. More than half of idiopathic RLS patients have a family member with the same disease.
Why does secondary RLS occur?
Some diseases can also cause restless leg syndrome; In this case, a secondary RLS is mentioned. Kidney failure, iron deficiency or iron metabolism disorder, as well as neurological diseases, can also lead to restless legs syndrome. RLS symptoms are also relatively common during pregnancy: It affects up to 30% of pregnant women, but usually disappears shortly before birth. Finally, psychological drugs, especially Some medications can also trigger restless legs syndrome.
What symptoms are seen in RLS?
RLS symptoms are often difficult to understand. At the beginning of the disease, they are often only mild and can occasionally disappear completely, which in many cases causes RLS to continue undiagnosed for a long time. Typical symptoms are restlessness and uncomfortable sensations in the extremities, especially the legs, which occur at rest and decrease with movement.
Symptoms are almost always more severe in the evening and at night. HBSha patients describe their symptoms very differently; for example, a burning, pulling or tingling sensation in the legs, a feeling of heat or cold, and even pain or cramps. Symptoms are usually felt deeply inside, less are felt as superficial pain. The legs are almost always affected. Sometimes the arms or other parts of the body may also be affected. The majority of RLS patients have a strong desire to move their legs. Besides evening and night rest situations, there are other situations in which RLS symptoms may occur or worsen. These are, in the first place, situations where you sit still for long periods of time, e.g. on a car ride or plane, at the cinema or while watching television. Being bedridden or having an arm or leg in a cast can also intensify RLS complaints.
How does RLS affect daily life?
In most RLS patients, the strong feeling of restlessness in the legs in the evening and at night significantly affects the quality of sleep: These people cannot sleep well or wake up many times at night. In such a situation, many patients get out of bed and some walk around for hours in order to alleviate their complaints with movement and activity. Even if they could achieve this, it would still not be possible to sleep soundly. Sleep duration and sleep quality deteriorate significantly in more than 90% of patients. Constant sleep deprivation also has its own consequences: Chronic fatigue, exhaustion, concentration difficulties and headaches during the day, the quality of life of people with RLS has a strong impact on daily private and business life.
How is restless legs syndrome diagnosed?
Restless legs syndrome is diagnosed based on its typical symptoms. If RLS is suspected, the diagnosis is confirmed by testing called L-Dopa. Further tests are performed to rule out or confirm other diseases as the cause of secondary RLS. These include, for example, laboratory tests on kidney function and iron metabolism or additional neurological tests. Hormone disorders and vitamin deficiencies are also possible causes of secondary RLS. If RLS is suspected, measurements of thyroid hormones and also vitamin B12 may be required.
What are the diagnostic criteria?
The basic criteria for diagnosing Restless Leg Syndrome include the following:
• The desire to move the legs; It is often accompanied by or caused by uncomfortable sensations in the legs. Sometimes the urge to move occurs without uncomfortable sensations, and the urge to move occurs in the arms or other parts of the body in addition to the legs.
• Complaints begin or worsen during rest or inactive periods such as sitting or lying down.
• The desire to move and uncomfortable feelings are felt by movement or intense mental activities (e.g. computer games) can be partially or completely improved. Healing continues at least as long as this activity is continued.
• Complaints are worse in the evening or at night than during the day, or occur only in the evening or at night. When symptoms are very severe, worsening in the evening or at night may not become more noticeable after a while, even if it used to be present.
• The stated complaints cannot be attributed to another disease or certain behaviors alone.
How can RLS be treated?
Changes that most patients make in their lifestyle or personal habits help ease RLS symptoms and better cope with the disease. For example, it may help to better plan and avoid as much as possible certain daily situations or “stimulants” that may worsen the disease. It will be ci. In the case of secondary RLS, treatment of the underlying disease (e.g. iron deficiency, renal failure) may lead to a regression of symptoms. With the help of medications, the severity, frequency and/or duration of RLS complaints can be reduced. But the disease itself does not heal this way. Active substances that specifically affect the dopaminergic system in the brain are the preferred treatment. These include L-Dopa (Levodopa), a dopamine precursor that reaches the brain across the blood-brain barrier and is converted into active dopamine there, and dopamine agonists, which mimic the action of dopamine in the brain.
Complaints of restless legs syndrome are often caused by exercises. becomes lighter. Avoiding certain foods, alcohol and cigarettes may also have a positive effect; Because substances such as caffeine, alcohol, nicotine and chocolate act as stimulants and can trigger or intensify RLS symptoms. The same applies to food additives, certain preservatives or sweeteners (e.g. saccharin).
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