Restless Leg Syndrome

Causes, symptoms, and medications of Willis-Ekbom Disease

Causes, symptoms, and medications of restless leg syndrome

Restless legs syndrome (RLS) is a nervous system disorder that causes an overpowering urge to move your legs. In this article, we’ll cover everything related to it.

Willis-Ekbom Disease, generally known as restless leg syndrome (RLS), is a neurological illness that affects millions of individuals each year. RLS is a disorder in which there is an uncontrolled need to move the legs, usually responding to an unpleasant sensation. It usually occurs when sitting or lying down in the afternoon or at night. Moving temporarily helps relieve the feeling of discomfort. When lying down in bed or sitting, people with RLS frequently experience aches, pains, or sensations in their legs. With Restless Legs Syndrome, the rest of the body and mind feel ready for sleep, but the legs feel exercising [1].

The study found that restless legs syndrome is less common in people with Parkinson’s disease. However, people with Parkinson’s disease were almost three times more likely to have motor restlessness in their legs [2].

Causes

Most of the time, the cause of RLS is unknown. There might be a hereditary tendency as well as a trigger in the environment. More than 40% of those who have RLS have a family history of the disorder. RLS is linked to five different gene variations. Symptoms generally appear before the age of 40 when it runs in the family. Even if blood tests show that your iron level is average, there may be a link between RLS and low iron levels in the brain.

RLS might be caused by a breakdown in the brain’s dopamine pathways. Dopamine is also linked to Parkinson’s disease. That might explain why so many patients with Parkinson’s disease also suffer from RLS. Both illnesses are treated with some of the same drugs. These and other possibilities are still being researched. RLS without an underlying cause is known as primary RLS. On the other hand, RLS might be a symptom of another ailment, such as neuropathy, diabetes, or renal failure. If this is the case, addressing the underlying disease may be enough to alleviate RLS symptoms. Certain chemicals, such as coffee or alcohol, may provoke or exacerbate symptoms. Medications used to treat allergies, as well as naphthalene, are all possible causes.

RLS has been linked to several medical disorders. RLS has been associated with end-stage renal disease (ESRD) and nerve damage caused by diabetes. Anemia due to a lack of iron has also been linked to RLS [3].

Symptoms

The excessive need to stretch your legs, especially while you’re sitting motionless or resting in bed, is the most common symptom of RLS. You may also have odd feelings in your legs, such as tingling, crawling, or tugging. These feelings may be relieved by movement. If you have moderate RLS, you may not have symptoms every night. These motions might be attributed to restlessness, anxiousness, or stress. It’s difficult to overlook a more severe case of RLS. It may make even the most basic activities, such as going to the movies, more complex. Long airline travel may be exhausting.

Because symptoms are more muscular at night, people with RLS are more likely to have problems sleeping or staying asleep. Physical and mental health can be harmed by daytime drowsiness, weariness, and sleep deprivation.

Symptoms usually affect both sides of the body. However, they might affect only one person. Symptoms may come and go in mild instances. RLS can also affect other body regions, such as your limbs and head. The majority of patients with RLS experience worsening symptoms as they become older. RLS sufferers frequently employ movement to alleviate their symptoms [4]. 

Medications

The patients should take medicines recommended by the doctor.  It’s important to remember that drugs used to treat primary RLS don’t cure the disorder; they merely ease the pain. People with sporadic RLS symptoms may be offered treatment to use just when they experience symptoms.

Dopaminergic agents

Increased dopamine levels in the body assisting reducing leg motion. Mild lightheadedness and nausea are possible side effects. Over time, these drugs may become less effective. They can induce daytime drowsiness, impulse control difficulties, and a worsening of RLS symptoms in some persons. Among the drugs in this category are:

  • pramipexole (Mirapex)
  • ropinirole (Requip)
  • rotigotine (Neupro)

Benzodiazepines

Although sleep aids and muscle relaxants do not cure symptoms, they can help you relax and sleep better. Daytime tiredness is one of the side effects. Among the drugs in this category are:

  • clonazepam (Klonopin)
  • eszopiclone (Lunesta)
  • temazepam (Restoril)
  • zaleplon (Sonata)
  • zolpidem (Ambien)

Narcotics (opioids)

These drugs can help you relax and reduce discomfort and unusual sensations. Dizziness and nausea are two possible side effects. If you have sleep apnea, you should avoid using these medications. These drugs are highly potent and addictive. Drugs include:

  • codeine
  • oxycodone (Oxycontin)
  • combined hydrocodone and acetaminophen (Norco)
  • combined oxycodone and acetaminophen (Percocet, Roxicet)

Anticonvulsants

These drugs aid in the reduction of sensory disturbances. Dizziness and weariness are two possible side effects. The drugs included in this category are:

  • gabapentin (Neurontin)
  • gabapentin enacarbil (Horizant)
  • pregabalin (Lyrica) [5].

Laser therapy

According to recent research, after undergoing an endovenous laser ablation, the primary surgery used to treat varicose veins, some RLS patients have observed a significant reduction or removal of their symptoms [6].

Other conventional treatments are: 

  • RLS symptoms may be relieved by massaging your leg muscles.
  • Like other forms of exercise, yoga and stretching activities have been found to help persons with RLS [7].
  • Iron supplementation can help relieve RLS symptoms [8].
  • Exercise can ease the symptoms. TheNational Institutes of Health report states that moderate exercise can help relieve mild RLS symptoms [9].
  • The foot wrap applies pressure to specific places on your foot’s bottom. The pressure transmits signals to your brain, which tells the muscles affected by RLS to relax in response. This aids in the alleviation of RLS symptoms [10].

Risk factors

The risk factors include: 

  • RLS affects twice as many women as it does males.
  • Although RLS can strike anybody at any age, it is more prevalent and severe after middle age.
  • If someone in your family has RLS, you’re more likely to get it as well.
  • RLS can occur in some women during pregnancy, especially in the third trimester. This usually goes away after a few weeks.
  • RLS can be caused by chronic conditions such as peripheral neuropathy, diabetes, and kidney failure. RLS symptoms are frequently relieved by treating the disorder.
  • Antinausea, antipsychotic, antidepressant, and antihistamine medicines can cause or exacerbate RLS symptoms [11].

According to the National Institute of Neurological Disorders and Stroke, RLS is a lifelong illness. On the other hand, there is no treatment; current treatments can help regulate the problem, reduce symptoms, and raise the amount of time spent sleeping well. Symptoms may deteriorate with age. However, for those who also have a medical condition, the decrease may be more rapid. The onset of another neurological condition, such as Parkinson’s disease, is not indicated by RLS diagnosis [12].