restless legs syndrome
What is Restless Leg Syndrome? We can define restless legs syndrome as one of the least known and most common diseases because it is very common in society, it is not known to be a disease, and people live with this disease for years without treatment. Restless legs syndrome is a neurological disease that manifests itself with complaints such as numbness, burning, prickling, tingling, pain and a strong desire to move the legs, especially during the rest period. While complaints usually occur in the evening and in the legs, in later cases, they may occur during long periods of sitting and resting during the day. One of the most important features is that the complaints decrease with movement. Although it usually affects both legs, it should be kept in mind that it may be unilateral in a small percentage of patients. Rarely, it can spread to the arms, hands and other parts of the body. The findings frequently appear in the evening and night hours, causing serious sleep disorders in these patients. In addition, nearly 80% of patients with restless legs syndrome have involuntary movements that occur in the legs at certain intervals during sleep, which we call Periodic Leg Movements (PBH). These are another reason that affects sleep. In some patients, only PBH may occur without restless legs syndrome. Although restless legs syndrome is a disease that usually occurs in older ages, it can be seen at all ages. It is approximately twice as common in women as in men.
What is the incidence of Restless Leg Syndrome?
In studies conducted in different societies, the prevalence of restless legs syndrome varies between 1-15%. According to the results of studies conducted in our country, we can say that the average incidence in our society is between 3-5%. This is a very high rate. Many patients live with restless leg syndrome because it is not well known and undiagnosed.
How is Restless Leg Syndrome diagnosed?
There is no test specific to this disease to diagnose restless legs syndrome. Therefore, the criteria mentioned below should be questioned carefully.
• Severe desire to move with abnormal sensations in the legs
• Symptoms appear during resting situations such as sitting and lying down
• Complete or partial improvement of symptoms by moving
• The symptoms have a specific feature, usually worsening in the evening or at night
• Apart from these main diagnostic features, some blood tests and (POLYSOMNOGRAPHIC) (all-night sleep study) examinations of the patients are performed in the differential diagnosis.
What are the causes of Restless Leg Syndrome?
The exact cause of restless legs syndrome cannot be found in the majority of patients. This type of patients, whose cause is unknown, is called Primary Restless Leg Syndrome. However, it should be investigated whether these patients have similar patients in their families. Genetic transmission is at a higher rate, especially in people who start at an early age (before the age of 40). There may be a genetic transmission in approximately half of patients with restless legs syndrome, the cause of which cannot be determined.
According to the most accepted view today, restless legs syndrome develops as a result of the decrease in the substance called DOPAMINE in some specific regions of the brain.
Conditions that may cause Restless Leg Syndrome include:
• Iron deficiency (the most important indicator (FERRITIN) is low)
• Advanced stage renal failure (uremia)
• Diabetes
• Parkinson’s disease
• Nerves affected by various reasons (POLINOROPATHY)
• Pregnancy
• (RHEUMATOID ARTHRITIS)
Apart from these, some nausea, depression and psychosis medications, some epilepsy medications (containing phenytoin), cold medications (containing antihistamines), and blood pressure medications (containing nifedipine) may worsen the symptoms of restless legs syndrome. For this reason, patients with restless legs syndrome should not use this group of medications without consulting their doctor. It should also be remembered that caffeine, alcohol and cigarettes can worsen restless legs syndrome symptoms.
How is Restless Leg Syndrome treated?
Restless leg syndrome can be treated. There are some relaxing movements and precautions that can be taken before starting drug treatment. It is very important for patients to pay attention to these.
The first thing to do is for the patient to take some simple precautions and make arrangements in the bedroom.
It is necessary to stay away from substances such as alcohol, cigarettes and caffeine (such as chocolate, caffeine-containing tea and coffee), which we know can worsen the symptoms of restless legs syndrome, and pay attention to these, especially in the evening before going to bed. You should not take medications that may increase the symptoms of restless legs syndrome without consulting your doctor, and if it occurs due to another cause, this cause should be treated first.
Drugs that can be used in patients planned for drug treatment
Dopaminergic (increasing dopamine levels) drugs: These drugs are often used in the treatment of Parkinson’s disease. However, it should not be forgotten that the two are very different diseases. These are generally dopamine agonists and levodopa. When choosing dopaminergic drugs, it is important to choose especially long-acting ones. Apart from these, epilepsy drugs such as benzodiazepines, gabapentin and carbamazepine, and some drugs from the opioid and narcotic group are also among the next options.
