Restless leg syndrome

What is Restless Leg Syndrome?

Restless Leg Syndrome (RLS) is condition where the individual develops a strong, irresistible urge to move their legs whenever they sit or lie down. This may be accompanied by uncomfortable sensations in their legs, which RLS patients described as painful, tingling, crawling, pulling or creeping. This entity has been known for at least a few hundred years, but it was only in the 1940s when it was officially named.

When do the symptoms of RLS occur?

The symptoms are precipitated by prolonged sitting or inactivity, or while the individual is traveling, attending a long meeting, watching a movie, or at a concert, or even while trying to relax or trying to sleep. Typically, the symptoms begin or worsen in the early evening and at night. Stretching or walking may provide some relief as long as the activity continues.

Does RLS impair sleep?

Yes. As a matter of fact, sufferers usually seek medical attention because of inability to get enough sleep, not realizing RLS is causing the disruption in their sleep. Many have been treated as a sleep disorder. The right diagnosis could be missed by the physician if his or her index of suspicion for RLS is low, leading to severe frustration among patients and physicians alike.

Are men more affected by RLS?

No, Restless Leg Syndrome affects more women than men, and can start at any age. Studies show that more than 50 percent of those with RLS have a family member with RLS also.

What could mimic RLS?

Some conditions that could be confused with Restless Leg Syndrome are calcium deficiency, varicose vein leg discomfort, leg pains among those taking anti-cholesterol drug Lipitor, blockage of arterial circulation in the leg from hardening of the artery and/or diabetes mellitus, and fibromyalgia. There are also other neurological and metabolic entities that could cause leg discomfort.

How is RLS diagnosed?

Basically, through medical interview and physical examination (to rule out other possible causes), by deduction and elimination process. Laboratory tests, such as blood tests and X-rays, etc., are not diagnostic, but may be useful in discarding other diseases on the “suspected” list of possibilities. This is why keen awareness and a high index of suspicion on the part of the attending healthcare provider are essential in making the accurate diagnosis. RLS could be a very elusive culprit.

Are referrals necessary?

In this day and age of medical sophistication and specialization, a testament to the obvious fact that no one individual can know everything, a RLS sufferer may be referred by the initial attending physician to other specialists. While this may not be a welcome inconvenience and added expenses for the patient, sending the patient to specialists is an honest act of concern and dedication on the part of a physician for the ultimate benefit of the patient. This holds especially true for RLS, a baffling condition that could really challenge the diagnostician.

What is “therapeutic diagnosis”?

When the preponderance of evidences point to a certain disease entity but the physician is still not 100 percent certain because of lack of a laboratory diagnostic aid and objective confirmation, the physician may try to treat the patient with a medication that best suits the clinical picture. This trial, if successful, not only improves or cures the patient, but also confirms the diagnosis the physician suspected. While this is not the usual scenario, sometimes the physician is left with no choice but to rely on his training, experience and diagnosis skills in treating his patient, when laboratory tests are not helpful or are impotent.

Is there a drug available for RLS?

Yes. A “new” drug has been approved by the US Food and Drug Administration in May 2005 for the treatment of Restless Leg Syndrome in the United States. It’s actually an old drug being used for the treatment of Parkinson’s Disease and now found effective for Restless Leg Syndrome also. The medication is known by the brand names Adartel and Requip (chemical name: ropinirole).

This and other health articles are compiled in a book listed in the US Library of Congress which you could view at www.phillipschua.com.

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Philip S. Chua, MD, FACS, FPCS, Cardiac Surgeon Emeritus in Northwest Indiana and chairman of cardiac surgery from 1997 to 2010 at Cebu Doctors University Hospital, where he holds the title of Physician Emeritus in Surgery, is based in Las Vegas, Nevada. He is a Fellow of the American College of Surgeons, the Philippine College of Surgeons, and the Denton A. Cooley Cardiovascular Surgical Society. He is the chairman of the Filipino United Network – USA,  a 501(c)(3) humanitarian foundation in the United States. Email: [email protected]

Dr. Philip S. Chua

Philip S. Chua, MD, FACS, FPCS, Cardiac Surgeon Emeritus in Northwest Indiana and chairman of cardiac surgery from 1997 to 2010 at Cebu Doctors University Hospital, where he holds the title of Physician Emeritus in Surgery, is based in Las Vegas, Nevada. He is a Fellow of the American College of Surgeons, the Philippine College of Surgeons, and the Denton A. Cooley Cardiovascular Surgical Society. He is the chairman of the Filipino United Network – USA, a 501(c)(3) humanitarian foundation in the United States.

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