Restless legs syndrome: what it is and what to do

The name may sound witty, but for those who suffer from it there is really nothing to laugh about. Restless Legs Syndrome (in English restless legs syndrom) is a neurological disorder that affects 4-10 percent of the global population e it appears mostly at night, when there is an irresistible urge to move the lower limbs. “Some patients also complain burning, cramps, pain, electric shocks and other unpleasant sensations in the legs, without knowing how to describe them precisely, but the final result is always the same: the impossibility of falling asleep “, says the doctor Lucia Borsotti, neurologist of the CeMeDi of Turin. “The problem can rarely appear even during the day, for example, when driving a car, when you sit for a long time or when you stretch out in the afternoon to try to relax”.

What is restless legs syndrome

Its etiopathogenesis is not clear, except in the primary hereditary form, which occurs in several cases of the same family. For the rest, at the basis of restless legs syndrome there are no organic or nerve injuries, detectable through normal diagnostic tests. “This means that there are no instrumental investigations or blood tests to identify the problem.

We need a careful medical history of the neurologist, who can sometimes prescribe some tests to rule out the presence of different pathologies but with similar symptoms “, specifies Dr. Borsotti. In some cases, the restlessness of the legs may be simply due to excessive physical fatigue or a strong state of stress, as well as the feeling of cramps can be linked to one lack of mineral salts (especially magnesium and potassium) or poor circulation. «Other times, however, the legs cannot find rest due to an underlying health condition, such as iron deficiency anemia or kidney failure, or due to a state of pregnancy, although the problem usually disappears after the woman has given birth. In short, the neurologist must evaluate all these aspects to understand what is at the basis of the discomfort felt “.

What are the causes

Some studies have shown the existence of some predisposing factors to the problem, such as diabetesalcohol intake in the evening and an excess of caffeine, but the only scientifically validated association is an alteration of dopamine, a substance that performs numerous and important functions in the brain, including movement control. “Not surprisingly, its deficiency is involved in neurodegenerative diseases such as Parkinson’s disease, with which, however, the restless legs syndrome has nothing to do”.

So many consequences

Although it mainly affects women, men are not immune to it and each patient has a particular clinical course: usually, restless legs syndrome has been appearing for 30 years onwards and can have periods of spontaneous remission alternating with exacerbations. “In general, however, when it appears, it shows up every night for a period of at least six months or a year with an extent of discomfort that can vary from day to day. This extensive sleep deprivation ends up affecting quality of life, as patients experience difficulty concentrating during the day and may develop mood swings, depression or other health problems. Not to mention the greater risk of developing overweight and obesity, in the event that sleepless hours are used to consume snacks ». A study published in Lancet Neurology argues that restless legs syndrome can increase deaths from cardiovascular reasons, so never underestimate the problem.

How to recognize it

Characterizing restless legs syndrome is the irrepressible need to move the legs, accompanied often (but not always) by unpleasant sensations, such as the feeling of having something moving or crawling on the inner limbs, itching, “pulling” legs, tingling, burning, pain or electric shock. «The peculiarity lies in the fact that this symptomatology is alleviated with movement, so getting up and walking makes the discomfort regress. However, this is temporary relief, as symptoms usually tend to recur as soon as you return to a state of rest, ”says the expert.

When to worry

If the discomfort is not limited to the night hours, but also affects daily activities, or when it extends to the arms or other muscle groups, it is important to immediately carry out a medical evaluation to ascertain the nature of the disorder. “The same urgency is necessary if we notice important anatomical changes, such as a reduction in the muscles of the leg,” recommends the neurologist.

What to do

Today, restless legs syndrome can be successfully treated thanks to drugs that act on dopamine and are part of the treatment of extrapyramidal syndromes, such as Parkinson’s: “The fact that they are studied as chronic therapies reassures their safety. use, but it is still about medications “heavy”, to be used under strict medical supervisionafter a certain diagnosis, at a low dose and for at least six months, because an inappropriate use can worsen the symptoms or cause side effects, for example by inhibiting movement », warns Dr. Borsotti.

“They should be taken two hours before the night’s rest, in order to cover all the rest time, but recently a patch formulation, very easy to use, especially for those who follow other oral therapies and do not want to add an additional “appointment” with the tablets ». Not everyone can take these active ingredients, however. “Before, some tests must be prescribed to rule out metabolic problems or major systemic diseases. In the event of a contraindication, anxiolytics such as benzodiazepines, painkillers and antiepileptics can be used, but in this case they are not specific solutions so they may not completely solve the problem “, concludes the expert.