NEUROPATHY-RESTLESS LEG SYNDROME

SUMMARY

1. Patient may complain of “painful” legs but closer questioning reveals restlessness; need to move to relieve it.

2. Symptoms that are worse at night and are absent or negligible in the morning.

3. A strong and often overwhelming need or urge to move the affected limb(s), often assoc. with paresthesias or dysesthesias.

4. Sensory symptoms that are triggered by rest, relaxation, or sleep & relieved with movement, the relief persists as long as the movement continues.

5. Associated with iron deficiency, renal disease, meds: DA-SSRI, synucleinopathy–can precede motor parkinsonism by decades

MANAGEMENT
6. Reduce caffeine, alcohol, and tobacco, regular sleep pattern.

7. Dopamine agonist (pramipexole etc), L-DOPA (wears off), Gabapentin.

Reference(s)

Wilkinson, I., Furmedge, D. and Sinharay, R. (2017). Oxford handbook of clinical medicine. Oxford: Oxford University Press. Get it on Amazon.
Feather, A., Randall, D. and Waterhouse, M. (2020). Kumar And Clark’s Clinical Medicine. 10th ed. S.L.: Elsevier Health Sciences. Get it on Amazon.
Hannaman, R. A., Bullock, L., Hatchell, C. A., & Yoffe, M. (2016). Internal medicine review core curriculum, 2017-2018. CO Springs, CO: MedStudy.
Therapeutic Guidelines. Melbourne: Therapeutic Guidelines Limited. https://www.tg.org.au [Accessed 2021].