Restless legs syndrome: Difference between revisions
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#redirect [[bullshit]] |
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{{Infobox_Disease | |
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Name = Restless legs syndrome | |
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Image = RLS-Schlafmuster.png | |
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Caption = Sleep pattern of a Restless Legs Syndrome patient (red) vs. a healthy sleep pattern (blue). | |
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DiseasesDB = 29476 | |
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ICD10 = {{ICD10|G|25|8|g|20}} | |
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ICD9 = {{ICD9|333.94}} | |
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ICDO = | |
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OMIM = 102300 | |
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OMIM_mult = {{OMIM2|608831}} | |
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MedlinePlus = | |
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eMedicineSubj = neuro | |
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eMedicineTopic = 509 | |
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MeshID = D012148 | |
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}} |
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'''Restless legs syndrome''' (RLS, '''Wittmaack-Ekbom's syndrome''', or sometimes, but inaccurately, referred to as [[Nocturnal myoclonus]]) is a condition that is characterized by an irresistible urge to move one's legs (occasionally arms or torso). It is described as uncontrollable urges to move the limbs to stop uncomfortable or odd sensations in the body, most commonly in the legs, but can also be in the arms and torso. Moving the affected body part modulates the sensations, providing temporary relief. |
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Many doctors express the view that the incidence of restless leg syndrome is exaggerated by manufacturers of drugs used to treat it.<ref>{{cite journal |author=Woloshin S, Schwartz L |title=Giving legs to restless legs: a case study of how the media helps make people sick |journal=PLoS Med. |volume=3 |issue=4 |pages=e170 |year=2006 |pmid=16597175 |url=http://dx.doi.org/10.1371/journal.pmed.0030170}}</ref> Other physicians consider it a real entity that has specific diagnostic criteria.<ref>{{cite journal |author=Montplaisir J; Boucher S; Nicolas A; Lesperance P; Gosselin A; Rompré P; Lavigne G |journal=Movement disorders |volume=13 |issue=2 |pages=324-9 |year=1998|pmid=9539348|url=http://www.ncbi.nlm.nih.gov/sites/entrez?db=PubMed&cmd=retrieve&dopt=AbstractPlus&list_uids=9539348}}</ref> |
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Many people tap their feet or shake their legs resulting from a [[nervous tic]], consumption of stimulants, drug side-effects or other factors; this is usually innocuous, unnoticed, and does not interfere with daily life. Restless leg syndrome is very different. A nervous tic is often unnoticed while in RLS it is very noticeable. RLS causes a sensation in the legs or arms that can most closely be compared to a burning, itching, or tickling sensation in the muscles. |
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== Signs and symptoms == |
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The sensations—and the need to move—may return immediately after ceasing movement, or at a later time. RLS may start at any age, including early childhood, and is a progressive disease for a certain portion of those afflicted, although the symptoms have disappeared permanently in some sufferers. |
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Some experts believe RLS and periodic limb movement disorder are strongly associated with [[ADHD]] in some children. Both conditions are hereditary and [[dopamine]] is believed to be involved. Many types of medication for the treatment of both conditions affect dopamine levels in the brain.<ref>[http://www.umm.edu/patiented/articles/other_disorders_associated_with_attention-deficit_disorder_000030_5.htm Attention deficit hyperactivity disorder—Other Disorders Associated with ADHD], University of Maryland Medical Center.</ref> |
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*"An urge to move, usually due to uncomfortable sensations that occur primarily in the legs." |
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The sensations are unusual and unlike other common sensations, and those with RLS have a hard time describing them. People use words such as: uncomfortable, antsy, electrical, creeping, painful, itching, pins and needles, pulling, creepy-crawly, ants inside the legs, and many others. The sensation and the urge can occur in any body part; the most cited location is legs, followed by arms. Some people have little or no sensation, yet still have a strong urge to move. |
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*"Motor restlessness, expressed as activity, that relieves the urge to move." |
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Movement will usually bring immediate relief, however, often only temporary and partial. Walking is most common; however, doing stretches, yoga, biking, or other physical activity may relieve the symptoms. Constant and fast up-and-down movement of the leg, coined "sewing machine legs" by at least one RLS sufferer, is often done to keep the sensations at bay without having to walk. Sometimes a specific type of movement will help a person more than another. |
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*"Worsening of symptoms by relaxation." |
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Any type of inactivity involving sitting or lying—reading a book, a plane ride, watching TV or a movie, taking a nap—can trigger the sensations and urge to move. This depends on several factors: the severity of the person’s RLS, the degree of restfulness, the duration of the inactivity, etc. |
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*"Variability over the course of the day-night cycle, with symptoms worse in the evening and early in the night." |
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While some only experience RLS at bedtime and others experience it throughout the day and night, most sufferers experience the worst symptoms in the evening and the least in the morning. |
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===NIH criteria=== |
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In 2003, a National Institutes of Health (NIH) consensus panel modified their criteria to include the following: |
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# an urge to move the limbs with or without sensations |
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# worsening at rest |
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# improvement with activity |
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# worsening in the evening or night.<ref>{{cite journal | author = Allen R, Picchietti D, Hening W, Trenkwalder C, Walters A, Montplaisi J | title = Restless legs syndrome: diagnostic criteria, special considerations, and epidemiology. A report from the restless legs syndrome diagnosis and epidemiology workshop at the National Institutes of Health. | journal = Sleep Med | volume = 4 | issue = 2 | pages = 101-19 | year = 2003 | id = PMID 14592341}}</ref> |
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RLS is either primary or secondary. |
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* Primary RLS is considered [[idiopathic]], or with no known cause. Primary RLS usually begins before approximately 40 to 45 years of age, and can even occur as early as the first year of life. In primary RLS, the onset is often slow. The RLS may disappear for months, or even years. It is often progressive and gets worse as the person ages. RLS in children is often misdiagnosed as [[growing pains]]. |
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* Secondary RLS often has a sudden onset and may be daily from the very beginning. It often occurs after the age of 40, however it can occur earlier. It is most associated with specific medical conditions or the use of certain drugs. The most commonly associated medical condition is [[iron deficiency (medicine)|iron deficiency]], which accounts for just over 20% of all cases of RLS. The conditions include: pregnancy, [[varicose vein]] or venous reflux, [[folate deficiency]], [[sleep apnea]], [[uremia]], [[diabetes mellitus|diabetes]], thyroid problems, peripheral neuropathy, [[Parkinson's disease]] and certain auto-immune disorders such as [[Sjögren's syndrome]], [[Celiac Disease]], and [[rheumatoid arthritis]]. Treatment of the underlying condition, or cessation of use of the offending drug, often eliminates the RLS. |
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== Causes == |
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Certain medications may worsen RLS in those who already have it, or cause it secondarily. These include: [[anti-nausea drugs]], certain [[antihistamines]] (often in [[Over-the-counter drug|over-the-counter]] cold medications), [[antidepressants|drugs used to treat depression]] (both older [[tricyclics]] and newer [[SSRI]]s), [[antipsychotic]] drugs, and certain medications used to control [[seizures]]. |
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[[Hypoglycemia]] has also been found to worsen RLS symptoms.<ref name="pmid9613772">{{cite journal |author=Kurlan R |title=Postprandial (reactive) hypoglycemia and restless leg syndrome: related neurologic disorders? |journal=Mov. Disord. |volume=13 |issue=3 |pages=619-20 |year=1998 |pmid=9613772 |doi=10.1002/mds.870130349}}</ref> Opioid detoxification has also recently been associated with provocation of RLS-like symptoms during withdrawal{{Fact|date=March 2008}}. For those affected, a reduction or elimination in the consumption of simple and refined [[carbohydrates]] or [[starches]] (for example, sugar, white flour, white rice and white potatoes) or some hard [[fats]], such as those found in beef or biscuits, is recommended. Some doctors believe it is caused by irregular electrical impulses from the brain. |
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Both primary and secondary RLS can be worsened by surgery of any kind, however [[back surgery]] or injury can be associated with causing RLS.<ref name="pmid15830971">{{cite journal |author=Crotti FM, Carai A, Carai M, Sgaramella E, Sias W |title=Entrapment of crural branches of the common peroneal nerve |journal=Acta Neurochir. Suppl. |volume=92 |issue= |pages=69-70 |year=2005 |pmid=15830971 |doi=}}</ref> RLS can worsen in [[pregnancy]].<ref name="pmid3147073">{{cite journal |author=McParland P, Pearce JM |title=Restless leg syndrome in pregnancy |journal=BMJ |volume=297 |issue=6662 |pages=1543 |year=1988 |pmid=3147073 |doi=}}</ref> |
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===Genetics=== |
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More than 60% of cases of RLS are familial<ref>{{cite journal | author = Lavigne GJ, Montplaisir JY | title = Restless legs syndrome and sleep bruxism: prevalence and association among Canadians. | journal = Sleep | volume = 17 | issue = 8 | pages = 739-43 | year = 1994 | id = PMID 7701186}}</ref> and are inherited in an [[autosomal dominant]] fashion with [[variable penetrance]]. |
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No one knows the exact cause of RLS at present. Research and brain autopsies have implicated both dopaminergic system and iron insufficiency in the [[substantia nigra]] (study published in Neurology, 2003).<ref>{{cite journal | author = Connor J, Boyer P, Menzies S, Dellinger B, Allen R, Ondo W, Earley C | title = Neuropathological examination suggests impaired brain iron acquisition in restless legs syndrome. | journal = Neurology | volume = 61 | issue = 3 | pages = 304-9 | year = 2003 | id = PMID 12913188}}</ref> Iron is an essential cofactor for the formation of L-dopa, the precursor of dopamine. |
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Five genetic loci found by [[linkage]] are currently known: |
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The first genetic locus was discovered in one large [[French Canadian]] family and maps on [[chromosome]] 12q.<ref>{{cite journal | author = Desautels A, Turecki G, Montplaisir J, Sequeira A, Verner A, Rouleau G | title = Identification of a major susceptibility locus for restless legs syndrome on chromosome 12q. | journal = Am J Hum Genet | volume = 69 | issue = 6 | pages = 1266-70 | year = 2001 | id = PMID 11704926}}</ref><ref>{{cite journal | author = Desautels A, Turecki G, Montplaisir J, Xiong L, Walters AS, Ehrenberg BL, Brisebois K, Desautels AK, Gingras Y, Johnson WG, Lugaresi E, Coccagna G, Picchietti DL, Lazzarini A, Rouleau GA | title = Restless legs syndrome: confirmation of linkage to chromosome 12q, genetic heterogeneity, and evidence of complexity. | journal = Arch Neurol | volume = 62 | issue = 4 | pages = 591-6 | year = 2005 | id = PMID 15824258}}</ref> This locus was discovered, however, using an [[autosomal recessive]] inheritance model. Evidence for this locus was also found using a [[transmission disequilibrium test]] (TDT) in 12 [[Bavarian]] families.<ref>{{cite journal | author = Winkelmann J, Lichtner P, Pütz B, Trenkwalder C, Hauk S, Meitinger T, Strom T, Muller-Myhsok B | title = Evidence for further genetic locus heterogeneity and confirmation of RLS-1 in restless legs syndrome. | journal = Mov Disord | volume = 21 | issue = 1 | pages = 28-33 | year = 2006 | id = PMID 16124010}}</ref> |
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The remainder of the linkage loci were discovered using an autosomal dominant model of inheritance. |
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The second RLS locus maps to chromosome 14q and was discovered in one [[Italians|Italian]] family.<ref>{{cite journal | author = Bonati MT, Ferini-Strambi L, Aridon P, Oldani A, Zucconi M, Casari G | title = Autosomal dominant restless legs syndrome maps on chromosome 14q. | journal = Brain | volume = 126 | issue = Pt 6 | pages = 1485-92 | year = 2003 | id = PMID 12764067}}</ref> Evidence for this locus was found in one French Canadian family.<ref>{{cite journal | author = Levchenko A, Montplaisir J, Dubé M, Riviere J, St-Onge J, Turecki G, Xiong L, Thibodeau P, Desautels A, Verlaan D, Rouleau G | title = The 14q restless legs syndrome locus in the French Canadian population. | journal = Ann Neurol | volume = 55 | issue = 6 | pages = 887-91 | year = 2004 | id = PMID 15174026}}</ref> Also, an [[association]] study in a large sample 159 [[trios]] of [[European ethnic groups|European]] descent showed some evidence for this locus.<ref>{{cite journal | author = Kemlink D, Polo O, Montagna P, Provini F, Stiasny-Kolster K, Oertel W, de Weerd A, Nevsimalova S, Sonka K, Högl B, Frauscher B, Poewe W, Trenkwalder C, Pramstaller PP, Ferini-Strambi L, Zucconi M, Konofal E, Arnulf I, Hadjigeorgiou GM, Happe S, Klein C, Hiller A, Lichtner P, Meitinger T, Müller-Myshok B, Winkelmann J | title = Family-based association study of the restless legs syndrome loci 2 and 3 in a European population. | journal = Ann Neurol | volume = 22 | issue = 2 | pages 207-12 | year = 2007 | id = PMID 17133505}}</ref> |
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The third locus maps to chromosome 9p and was discovered in two unrelated [[United States|American]] families.<ref>{{cite journal | author = Chen S, Ondo WG, Rao S, Li L, Chen Q, Wang Q | title = Genomewide linkage scan identifies a novel susceptibility locus for restless legs syndrome on chromosome 9p. | journal = Am J Hum Genet | volume = 74 | issue = 5 | pages 876-85 | year = 2004 | id = PMID 15077200}}</ref> Evidence for this locus was also found by the TDT in a large Bavarian family,<ref>{{cite journal | author = Liebetanz KM, Winkelmann J, Trenkwalder C, Pütz B, Dichgans M, Gasser T, Müller-Myhsok B | title = RLS3: fine-mapping of an autosomal dominant locus in a family with intrafamilial heterogeneity. | journal = Neurology | volume = 67 | issue = 2 | pages 320-1 | year = 2006 | id = PMID 16864828}}</ref> as well as in a [[Germany|German]] family, in which significant linkage to this locus was found.<ref>{{cite journal | author = Lohmann-Hedrich K, Neumann A, Kleensang A, Lohnau T, Muhle H, Djarmati A, König IR, Pramstaller PP, Schwinger E, Kramer PL, Ziegler A, Stephani U, Klein C | title = Evidence for linkage of restless legs syndrome to chromosome 9p. | journal = Neurology | volume = 0 | issue = 0 | pages 0 | year = 2007 | id = PMID 18032746}}</ref> |
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The next locus maps to chromosome 20p and was discovered in a large French Canadian family with RLS.<ref>{{cite journal | author = Levchenko A, Provost S, Montplaisir JY, Xiong L, St-Onge J, Thibodeau P, Rivière JB, Desautels A, Turecki G, Dubé MP, Rouleau GA | title = A novel autosomal dominant restless legs syndrome locus maps to chromosome 20p13. | journal = Neurology | volume =67 | issue = 5 | pages 900-1 | year = 2006 | id = PMID 16966564}}</ref> |
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The fifth locus maps to chromosome 2p and was found in three related families from population isolate in [[South Tyrol]].<ref>{{cite journal | author = Pichler I, Marroni F, Volpato CB, Gusella JF, Klein C, Casari G, De Grandi A, Pramstaller PP | title = Linkage analysis identifies a novel locus for restless legs syndrome on chromosome 2q in a South Tyrolean population isolate. | journal = Neurology | volume =79 | issue = 4 | pages 716-23 | year = 2006 | id = PMID 16960808}}</ref> |
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Three genes, [[MEIS1]], [[BTBD9]] and [[MAP2K5]], were found to be associated to RLS.<ref>{{cite journal | author = Winkelmann J, Schormair B, Lichtner P, Ripke S, Xiong L, Jalilzadeh S, Fulda S, Pütz B, Eckstein G, Hauk S, Trenkwalder C, Zimprich A, Stiasny-Kolster K, Oertel W, Bachmann CG, Paulus W, Peglau I, Eisensehr I, Montplaisir J, Turecki G, Rouleau G, Gieger C, Illig T, Wichmann HE, Holsboer F, Müller-Myhsok B, Meitinger T | title = Genome-wide association study of restless legs syndrome identifies common variants in three genomic regions. | journal = Nat Genet | volume =39 | issue = 8 | pages 1000-6 | year = 2006 | id = PMID 17637780}}</ref> |
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Their role in RLS [[pathogenesis]] is still unclear. |
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There is also some evidence that [[periodic limb movements in sleep]] (PLMS) are associated with {{Gene|BTBD9}} on chromosome 6p21.2.<ref name="pmid17634447">{{cite journal |author=Stefansson H, Rye DB, Hicks A, ''et al'' |title=A genetic risk factor for periodic limb movements in sleep |journal=N. Engl. J. Med. |volume=357 |issue=7 |pages=639–47 |year=2007 |pmid=17634447 |doi=10.1056/NEJMoa072743 |url=http://content.nejm.org/cgi/pmidlookup?view=short&pmid=17634447&promo=ONFLNS19}}</ref> |
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==Diagnosis== |
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{{ section-stub }} |
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==Prevention== |
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{{ section-stub }} |
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== Treatment == |
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An algorithm for treating primary RLS (RLS without any secondary medical condition including [[Iron deficiency (medicine)|iron deficiency]], [[varicose vein]], [[thyroid]], etc.) was created by leading RLS researchers at the [[Mayo Clinic]] and is endorsed by the Restless Legs Syndrome Foundation. This document provides guidance to both the treating physician and the patient, and includes both nonpharmacological and pharmacological treatments.<ref name="MayoAlgo">[http://www.mayoclinicproceedings.com/inside.asp?AID=1698&UID Mayo Clinic Algorithm] also available [http://www.mayoclinicproceedings.com/pdf/7907/7907crc.pdf as .pdf]</ref> Treatment of primary RLS should not be considered unless all the secondary medical conditions are ruled out. Drug therapy in RLS is not curative and is known to have significant side effects and needs to be considered with caution. The secondary form of RLS has the potential for cure if the precipitating medical condition ([[iron deficiency]], venous reflux/[[varicose vein]], [[thyroid]], etc.) is managed effectively. |
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===Iron supplements=== |
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According to some guidelines {{Fact|date=December 2007}}, all people with RLS should have their [[ferritin]] levels tested; ferritin levels should be at least 50 mcg for those with RLS. Oral iron supplements, taken under a doctor's care, can increase ferritin levels. For some people, increasing ferritin will eliminate or reduce RLS symptoms. A ferritin level of 50 mcg is not sufficient for some sufferers and increasing the level to 80 mcg may greatly reduce symptoms. However, at least 40% of people will not notice any improvement. Treatment with IV iron is being tested at the US [[Mayo Clinic]] and [[Johns Hopkins Hospital]]. It is dangerous to take iron supplements without first having ferritin levels tested, as many people with RLS do not have low ferritin and taking iron when it is not called for can cause [[iron overload disorder]], potentially a very dangerous condition.<ref name="pmid17516455">{{cite journal |
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|author=Oertel WH, Trenkwalder C, Zucconi M, ''et al'' |
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|title=State of the art in restless legs syndrome therapy: Practice recommendations for treating restless legs syndrome |
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|journal=Mov Disord |
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|volume= |
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|issue= |
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|pages= |
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|year=2007 |
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|pmid=17516455 |
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|doi=10.1002/mds.21545 |
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}}</ref> |
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===Pharmaceuticals=== |
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For those whose RLS disrupts or prevents sleep or regular daily activities, medication may be required. Many doctors currently use, and the [[Mayo Clinic]] [[algorithm]] includes,<ref name="MayoAlgo" /> medication from four categories: |
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#[[Dopamine agonist]]s such as [[ropinirole]], [[pramipexole]], [[carbidopa]]/[[levodopa]] or [[pergolide]]. [[Ropinirole]] (Requip) was first approved In 2005 by the [[US Food and Drug Administration]] (FDA) to treat moderate to severe Restless Legs Syndrome. The drug was first approved for [[Parkinson's disease]] in 1997. [[Pramipexole]] (Mirapex, Sifrol, Mirapexen in the EU) received a positive recommendation by the EU Scientific Committee in February 2006. The FDA approved Mirapex for sale in the US in 2006. [[Rotigotine]] (Neupro), which is delivered by a [[transdermal patch]] was approved by the FDA in May 2007. It was approved for sale in the EU in 2007. There are some issues with the use of dopamine augmentation. Dopamine agonists may cause augmentation. This is a medical condition where the drug itself causes symptoms to increase in severity and/or occur earlier in the day. Dopamine agonists may also cause rebound, when symptoms increase as the drug wears off. Also, a recent study indicated that dopamine agonists used in restless leg patients can lead to an increase in [[compulsive gambling]].<ref>[http://www.mayoclinic.org/news2007-rst/3918.html "Medical Therapy for Restless Legs Syndrome may Trigger Compulsive Gambling", Mayo Clinic in Rochester, February 08, 2007]</ref> |
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#[[Opioid]]s such as [[propoxyphene]], [[oxycodone]], or [[methadone]], etc. |
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#[[Benzodiazepine]]s, which often assist in staying asleep and reducing awakenings from the movements |
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#[[Anticonvulsant]]s, which often help people who experience the RLS sensations as painful, such as [[gabapentin]] |
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Recently, several major pharmaceutical companies are reported to be marketing drugs without an explicit approval for RLS, which are "off-label" applications for drugs approved for other diseases. The Restless Leg Foundation<ref>* [http://www.rls.org/NETCOMMUNITY/Page.aspx?&pid=471&srcid=-2 RLS Foundation]</ref> received 44% of its $1.4 million in funding from these pharmaceutical groups<ref>[http://www.newscientist.com/channel/health/mg19225755.100-patient-groups-special-swallowing-the-best-advice.html Marshall, Jessica, and Peter Aldhous. "Patient Groups Special." New Scientist, 10/26/06]</ref> |
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===The non drug musculoskeletal approach=== |
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The "non drug musculoskeletal approach" has been developed by a small group of doctors working at the London College of Osteopathic Medicine, London, UK and this produces relief of symptoms in 80–90% of patients. A small pilot study carried out at the London College of Osteopathic Medicine, using a specific form of manipulation, showed successful relief of symptoms in more that 80% of sufferers <ref>Peters T W, "Restless Legs", ''Osteopathy Today'', October 2001.</ref>. This followed the empirical observation that a large proportion of RLS sufferers have a "somatic dysfunction" at the lowermost level of the lumbar spine, and that a specific type of gentle manipulation could relieve their symptoms. One study has shown that RLS patients have increased rather than the normal decreased spinal cord excitability during sleep<ref>Bara J et al. "Periodic limb movements in sleep: state dependent excitability of the spinal flexor reflex". ''Neurology'' 2000: 54(8):1609–1616. Cited in ''Medical Bulletin'', The Restless Legs Foundation, www.rls.org.</ref> and this fits with the osteopathic concept of spinal facilitation postulated by Korr. Specific types of manipulation appear to reduce this excessive sensory input and relieve symptoms. This non drug treatment approach is free of the side effects associated with many of the drug treatments outlined above. |
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==Prognosis== |
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{{ section-stub }} |
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== Epidemiology == |
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Restless leg syndrome affects an estimated 7.2% of the general population in the U.S.A., but claims about the prevalence of RLS can be confusing because its severity varies enormously between individual sufferers; only a minority of sufferers (2.7% of population) experience daily or severe symptoms.<ref name="allen2005">{{cite journal |author=Allen R, Walters A, Montplaisir J, Hening W, Myers A, Bell T, Ferini-Strambi L |title=Restless legs syndrome prevalence and impact: REST general population study |journal=Arch. Intern. Med. |volume=165 |issue=11 |pages=1286–92 |year=2005 |pmid=15956009}}</ref> |
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Often sufferers think they are the only ones to be afflicted by this peculiar condition and are relieved when they find out that many others also suffer from it. The severity and frequency of the disorder vary tremendously. Many people only experience symptoms when they try to sleep, while others experience symptoms during the day. It is common to experience symptoms on long car rides or during any long period of inactivity (like watching television or a movie, attending a musical or theatrical performance, etc.) Approximately 80–90% of people with RLS also have PLMD, [[Nocturnal myoclonus|periodic limb movement disorder]], which causes slow "jerks" or flexions of the affected body part. These occur during sleep (PLMS = periodic limb movement while sleeping) or while awake (PLMW—periodic limb movement while waking). |
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About 10% of adults in North America and Europe may experience RLS symptoms, according to the [[National Sleep Foundation]], which reports that "lower prevalence has been found in [[India]], [[Japan]] and [[Singapore]]," indicating that different genetic or environmental factors, including diet, may play a role in the prevalence of this syndrome.<ref>{{cite web |url=http://www.sleepfoundation.org/site/c.huIXKjM0IxF/b.2417141/k.C60C/Welcome.htm |title=Welcome - National Sleep Foundation |accessdate=2007-07-23 |format= |work=}}</ref> |
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== History == |
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Earlier studies were done by [[Thomas Willis]] (1622–1675) and by [[Theodor Wittmaack]].<ref name="WhoNamedIt" /> Another early description of the disease and its symptoms were made by [[George Miller Beard]] (1839-1883).<ref name="WhoNamedIt" /> In a 1945 publication titled 'Restless Legs', [[Karl-Axel Ekbom]] described the disease and presented eight cases used for his studies.<ref>Ekbom, K.-A. Restless legs: a clinical study. Acta Med. Scand. (Suppl.) 158: 1–123, 1945.</ref> |
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As with many diseases with diffuse symptoms, there is controversy among physicians as to whether RLS is a distinct syndrome. The US [[National Institute of Neurological Disorders and Stroke]] publishes an information sheet<ref>[http://www.ninds.nih.gov/disorders/restless_legs/detail_restless_legs.htm Restless Legs Syndrome Fact Sheet]</ref> characterizing the syndrome but acknowledging it as a difficult diagnosis. Some physicians doubt that RLS actually exists as a legitimate clinical entity, but believe it to be a kind of "catch-all" category, perhaps related to a general heightened [[sympathetic nervous system]] (SNS) response that could be caused by any number of physical or emotional factors {{Fact|date=August 2007}}. |
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The UK support group for RLS calls itself the "Ekbom support group" and explains that RLS and "Ekbom's Syndrome" are two names for the same condition. However, RLS and [[delusional parasitosis]] are entirely different conditions that share part of the Wittmaack-Ekbom syndrome [[List of eponymous diseases|eponym]], as both syndromes were described by the same person, Karl-Axel Ekbom.<ref name="WhoNamedIt">{{WhoNamedIt|synd|2337|Wittmaack-Ekbom syndrome}}</ref> |
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==See also == |
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*[[Actigraphy]] |
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*[[Parasomnia]] |
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*[[Disease mongering]] |
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*[[Akathisia]]: A similar condition. |
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==References== |
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{{Reflist|2}} |
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==External links== |
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* {{NINDS|restless_legs}} |
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* {{Medicinenet|restless_leg_syndrome}} |
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* [http://www.neuro.jhmi.edu/rls/aboutus.htm Center for RLS], [http://www.neuro.jhmi.edu/rls/edu.htm education] at [[Johns Hopkins]] |
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* {{DMOZ|Health/Conditions_and_Diseases/Sleep_Disorders/Restless_Legs_Syndrome/}} |
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{{Diseases of the nervous system|state=collapsed}} |
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[[ca:Síndrome de les cames neguitoses]] |
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[[es:Síndrome de las piernas inquietas]] |
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[[ja:むずむず脚症候群]] |
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[[pl:Zespół niespokojnych nóg]] |
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Revision as of 21:41, 25 March 2008
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