Restless Leg Syndrome
Restless legs syndrome refers to an irresistible urge to move the legs when awake and inactive, especially when lying in bed just prior to sleep. This interferes with the ability to fall asleep. Often there is a creeping or crawling sensation deep within the calves or thighs, or sometimes even in the upper limbs, that is only relieved briefly by movement, particularly walking. The severity of this chronic, idiopathic disorder may wax and wane with time and can be exacerbated by caffeine and pregnancy. Nearly all patients with restless legs also experience periodic limb movement disorder during sleep, although the reverse is not the case. Restless legs syndrome occurs most commonly in middle-aged women.
The restless sensation may be accompanied by myoclonic jerks of muscle. These myoclonic jerks are similar to the myoclonus observed in normal individuals entering REM sleep.
Symptoms may respond to treatment with dopaminergic medication (such as levodopa or bromocriptine), benzodiazepines (diazepam or clonazepam), or opiates (codeine, propoxyphene, or oxycodone).
Restless leg syndrome often has a familial basis, with evidence of autosomal dominant inheritance. Restless leg syndrome can be caused by iron or folic acid deficiency anemia and renal failure.
Certain conditions are characterized by a compulsion to move the extremities. Akathisia, or motor restlessness, occurs in Parkinson's disease and other disorders of the basal ganglia, including druginduced movement disorders. Restless leg syndrome is also associated with fibromyalgia.
Lab tests would include a complete blood count, tests for iron status (Iron or Ferritin; Iron or Transferrin Saturation; Total Iron Binding Capacity), folic acid levels, and kidney function tests (BUN, phosphorous, LDH, creatinine, creatinine clearance, uric acid, total protein, A/G ratio, albumin, globulins, calcium, glucose, and cholesterol).
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