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Welcome, medical contents search April 25, 2013
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Restless leg syndrome, Periodic Limb Movement Disorder, PLMD, Nocturnal Myoclonus

  • Restless Leg Syndrome (RLS) is a common condition in which there may be a restless feeling in the legs, with muscle twitching, pins-and-needles, pulling, ants-crawling-under-the-skin sensation, or cramps and muscle aches.  This occurs when the patient is lying in bed or sleeping and makes it impossible for the patient, or his bed partner, to get a good night's sleep.
  • This condition is related to PLMD in which one or both legs or arms may undergo a variety of jerky movements -- from twitching to kicking or hitting the partner in bed.

  • May be at rest or during sleep
  • May affect the arms
  • Need for rubbing or stretching or walking to relieve the discomfort
  • Muscle twitching
  • Burning sensation
  • Pins-and-needle feeling under the skin
  • Ants crawling under the skin
  • Depression
  • Insomnia -- difficulty sleeping
  • Day time sleepiness or fatigue
  • Marital problems

  • Unknown
  • Cerebellum and the thalamus of the brain may be involved
  • 60% of the people with RLS may have a positive family history of this disease.

  • History includes symptoms, medications, habits, family history, illnesses, surgeries
  • Medical exam may be normal or may show the evidence of underlying disease
  • Blood test may be needed to rule out electrolyte imbalances and anemia (e.g., iron, B 12, folate deficiencies).
  • Blood glucose may help in diagnosis
  • Nocturnal polysomnography and video recording -- patient may be sent to a sleep disorder laboratory where the movements of the leg can be documented and videotaped during sleep.  The tapes and recordings of the abnormal leg movements may then be analyzed by a sleep specialist.

  • Family history
  • Diseases:
    1. Peripheral Neuropathy
    2. Parkinson's
    3. Multiple Sclerosis
    4. Kidney (renal) failure
    5. Pinched nerves in the back, i.e., Sciatica
    6. Anemia due to low levels of iron
    7. Electrolyte deficiencies, such as Potassium, Calcium, or Magnesium
  • Drugs:
    1. Caffeine
    2. Withdrawal from drugs such as heroin or Valium
    3. Some antidepressants
    4. Calcium channel blockers
    5. Theophylline
  • Increases with age may occur beginning in the 20s
  • Stress
  • Diet
  • Hormonal imbalances
  • During pregnancy symptoms may be aggravated.

  • Avoid caffeine and other triggers for RLS
  • Supplement Electrolytes if low
  • Correct anemia
  • Change medications if necessary and be aware that some medications may alter the levels of Potassium and other Electrolytes.
  • Stretching before exercise is recommended.
  • Sleep a minimum of 8 hours per day.
  • Medications such as sedatives (e.g., Benzodiazepines), opiates (e.g., Codeine, Dopamine), and brain chemical enhancers (e.g., Sinemet, etc.) can help in severe cases.

  • Avoid trigger factors and contact your physician for an evaluation.

  • Leg Cramps
  • Leg jerks from fatigue, lack of sleep, or over activity in sports.
  • Cramps due to medications
  • Radiculopathy or nerve compression or damage

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