Restless legs syndrome (RLS) is an uncomfortable, aching sensation that is relieved if you constantly move your legs. RLS occurs in the evening or at night when you're resting. The sensations are described as an irresistible urge to move as twitching, burning, stabbing, creeping and crawling, aching, heaviness, and tension felt deep in the calf muscles or even the bones. Occasionally, the sensation spreads to the feet or the thighs, but rarely to the arms or hands. The only relief is to get up and walk, which for someone with PD can be difficult. Insomnia often follows, leading to more problems with a lack of sleep, anxiety, or depression.
Restless legs syndrome an uncomfortable, aching sensation that is relieved if you constantly move your legs; usually occurs during sleep or while resting.
RLS affects approximately 5% of the U.S. population and is often unrecognized and misdiagnosed. Although it affects up to 5% of the population, in only 10% is RLS sufficiently bothersome for people to seek treatment. Although RLS may begin at any age, but most people affected are 50 and older. Approximately 80% of people with RLS may have periodic limb movements (called myoclonus) during sleep. Myoclonus occurs rhythmically and is not harmful but can be frightening—especially to your bed partner.
Diabetes, iron deficiency anemia, kidney disease, peripheral neuropathy, and poor circulation may cause RLS. Most of the time the cause is unknown. RLS is related, in part, to abnormalities in dopamine. Dopamine agonists help RLS, and dopamine antagonists worsen RLS. Although there is link with dopamine and although restless legs are common in people with PD, a debate exists about whether restless legs are part of PD.
The dopamine agonists Mirapex and Requip are effective in the treatment of PD and restless legs (secondary to PD or unrelated to PD). Mirapex is started at 0.125 mg at bedtime and is gradually increased to a maximum of 1.5 mg three times daily for PD or restless legs. Requip is started at 0.25 mg and is increased to 3 to 8 mg three times daily for PD or restless legs.
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