Restless legs and periodic movements

Typical symptoms of the “restless legs” are unpleasant sensations in the feet or legs, and, more seldom, in the arms and in the whole body. The sensations are described as prickling, drawing or aching. The symptoms increase in the course of the day and are the worst in the evening in bed. Also, the patient will often wake in the night or experience the symptoms during the day when sitting quietly, e.g., in a cinema or waiting room.

The need to rub or massage the legs, and the compulsion to get up and walk around can be unbearably strong. The symptoms usually improve temporarily through such measures, but can also be relieved by cooling. Many affected persons can’t keep their feet under the blanket because of the warmth or they need to give their legs a cold shower.

In many cases the restless legs are connected with nightly periodical leg movement. Thereby, the muscles of the feet or legs tense up during certain sleep stages in intervals of 20 to 40 seconds for a few seconds at a time. The sleeper doesn’t notice because it happens in the sleep. In some cases, the muscle strain causes movements of the feet, legs or arms which can be very powerful and in isolated cases are then also noticed by the bed partner.

Triggers of restless legs affecting a small portion of patients:

• Iron deficiency can be a reason. This is often the case with blood loss after operations, with severe illnesses, chronic bleeding in the stomach bowel area or strong menstrual bleeding. 
• Severe kidney damage can also cause such problems. A large portion of dialysis patients suffers from it. 
• Pregnant women are also often tormented by restless legs.

If a treatable iron deficiency or kidney damage is not present, the restless legs as well as the nightly periodic leg movements can be treated with drugs. In some cases high doses magnesium is sufficient. However, most must be treated with special drugs. Most of them are drugs which were actually developed to the treat Parkinson disease. This is due to the fact that in both cases not enough Dopamine exists in the nervous system. With Parkinson disease, the deficiency exists in a certain part of the brain, and with the Restless Legs and with nightly periodic leg movements in the nerves in the legs.

A synthetic Dopamine, the L-Dopa, or substances which promote the emission of Dopamine in the body usually help quite well. Indeed, several treatments must often be carried out to find the suitable drug and the optimum dose. If these drugs fail, other ones are used which are otherwise administered on other neurological illnesses.

Sleep doctors have the most experience with the treatment. Also, neurologists can prescribe suitable drugs and rule out other illnesses, for example a polyneuropathy which can cause similar complaints.