Restless Leg Syndrome:
•URGE CRITERIA FOR RESTLESS LEG SYNDROME
U-Urge to move limbs
R-Rest or inactivity precipitates or worsens the symptoms
G-Getting up or moving improves the sensation
E-Evening or first-half of night time appearance or worsening
•Creepy-crawly or unpleasant
deep ache within the thighs or calves (very serious- arms).
•Nocturnal discomfort usually interferes with sleep, and patients may report daytime sleepiness as a consequence.
•Incidence: 5-10% (very common) ; Females and old people more.
•Etiology:
1.)Primary: Genetic (AD)
2.) Secondary:
a.) Iron deficiency is the most common treatable cause, and iron replacement should be considered if the ferritin level is less than 50 ng/mL.
b.) Peripheral neuropathies and uremia.
c.) Pregnancy
•Can be worsened by pregnancy, caffeine,alcohol, antidepressants, lithium, neuroleptics, and antihistamines.
Rx:
1.) 1st line: D2/3 agonists: Pramipexole,Ropinirole
2.) Other: Opioids,BZDs,Pregabalin and Gabapentin.