Nocturnal myoclonus

Definition

Restless leg syndrome is a sleep disorder characterized by leg discomfort during sleep, which is only relieved by frequent movements of the legs.

Alternative Names

Causes

Restless leg syndrome (RLS) occurs most often in middle-aged and older adults. It is worsened by stress. The cause is not known.

The disorder consists of sensations in the lower legs that make the person uncomfortable unless the legs are moved. The sensations usually occur shortly after going to bed but may also occur during the daytime.

The abnormal sensations occasionally occur in the upper leg, the feet or the arms in addition to the lower leg. In some cases, no other medical or neurological condition is identified. However, restless leg syndrome may occur in patients with peripheral neuropathy or other neurological disorders.

There is an irresistible urge to walk or move the legs to relieve the discomfort, resulting in periodic episodes of leg movements during early sleep stages. The symptoms may last for 1 hour or longer.

Restless leg syndrome can result in a decreased quality of sleep (insomnia) with subsequent daytime sleepiness, anxiety or depression, and confusion or slowed thought processes from lack of sleep.

Symptoms

• Sleeping difficulty
• Persistent leg movements during sleep hours
• Irresistible urge to move the legs
• Abnormal sensation in the legs (occasionally, feet, thighs, arms)
  • Creeping sensations or discomfort (not pain, not cramps) relieved by movement of the legs
  • May occur during the day
  • Worse when lying down

Exams and Tests

There is no specific examination for restless leg syndrome. No structural or other abnormalities are usually discovered unless peripheral nerve disease is also present. A blood test may be done to rule out anemia, which rarely has been associated with restless leg syndrome.

Examination and testing may be used to rule out other disorders that may cause similar symptoms, especially disorders associated with claudication of the legs.

Treatment

There is no known cure for restless leg syndrome.

Treatment is aimed at reducing stress and helping the muscles relax. Warm baths, gentle stretching exercises, massage or similar techniques may help.

If sleep is severely disrupted, medications such as Sinemet (an anti-Parkinson's medication) or tranquilizers such as clonazepam may be prescribed, but they may cause daytime sleepiness. Low doses of pramipexole or ropinirole (Requip) have been found to be very effective in controlling symptoms in some people.

Low doses of narcotics may sometimes relieve symptoms of restless leg syndrome.

Outlook (Prognosis)

Restless leg syndrome is not dangerous or life-threatening and does not indicate a serious disorder. It can be uncomfortable and can disrupt sleep.

Possible Complications

Insomnia may occur.

When to Contact a Medical Professional

Call for an appointment with your health care provider if symptoms of restless leg syndrome are present and sleep is disrupted.

Prevention

Techniques to promote muscle relaxation and stress reduction may reduce the incidence of restless leg syndrome in people prone to the condition.