Restless legs syndrome: Wikis

  
  

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Restless legs syndrome
Classification and external resources

Sleep pattern of a Restless Legs Syndrome patient (red) vs. a healthy sleep pattern (blue).
ICD-10 G25.8
ICD-9 333.94
OMIM 102300 608831
DiseasesDB 29476
eMedicine neuro/509
MeSH D012148
.Restless legs syndrome (RLS), also known as Wittmaack-Ekbom's syndrome, and colloquially as "the jimmylegs" is a condition that is characterized by an irresistible urge to move one's body to stop uncomfortable or odd sensations.^ The main symptom of restless legs syndrome (RLS) is an irresistible urge to move your legs because of uncomfortable and sometimes painful sensations deep within your legs.
  • Health: Restless Legs Syndrome (RLS); Restless legs syndrome (RLS) is a disorder related ... 18 January 2010 0:19 UTC www.mainegeneral.org [Source type: General]
  • Exempla Healthcare Online Library 9 February 2010 16:32 UTC www.exempla.org [Source type: FILTERED WITH BAYES]

^ Restless legs syndrome and related disorders .
  • Restless legs syndrome and related disorders: the causes, diagnosis, treatment, ... 18 January 2010 0:19 UTC www.henryfordhealth.org [Source type: Academic]
  • Restless legs syndrome and related disorders 9 February 2010 16:32 UTC adam.about.com [Source type: Academic]

^ Paulson GW. Restless legs syndrome.

.It most commonly affects the legs, but can also affect the arms or torso, and even phantom limbs.^ Typically, cellulitis affects the legs, but it can also affect the arms.
  • Causes of Restless Legs Syndrome - WrongDiagnosis.com 18 January 2010 0:19 UTC www.wrongdiagnosis.com [Source type: Academic]

^ Cellulitis typically affects the legs, but it can also affect the arms.
  • Causes of Restless Legs Syndrome - WrongDiagnosis.com 18 January 2010 0:19 UTC www.wrongdiagnosis.com [Source type: Academic]

^ PLMS usually affects the legs, but it also can affect the arms.
  • Restless Legs Syndrome, All Sections (printer-friendly) 18 January 2010 0:19 UTC www.nhlbi.nih.gov [Source type: FILTERED WITH BAYES]

[1] .Moving the affected body part modulates the sensations, providing temporary relief.^ PMID 19372293 Moving the affected body part modulates the sensations, providing temporary relief.
  • Restless Leg Syndrome - eHow.com 9 February 2010 16:32 UTC www.ehow.com [Source type: FILTERED WITH BAYES]

^ Moving the limbs provides temporary relief for this chronic condition.

^ The patient draws temporary relief by moving the body part that is affected.
  • Restless Leg Syndrome 9 February 2010 16:32 UTC ezinearticles.com [Source type: Academic]

.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.^ PLMS causes your legs or arms to twitch or jerk about every 10 to 60 seconds during sleep.
  • Restless Legs Syndrome, All Sections (printer-friendly) 18 January 2010 0:19 UTC www.nhlbi.nih.gov [Source type: FILTERED WITH BAYES]

^ Restless legs syndrome (RLS) is a neurological disorder characterized by unpleasant sensations in the legs and an uncontrollable urge to move when at rest in an effort to relieve these feelings.
  • Restless Leg Syndrome: Symptoms and Cures 18 January 2010 0:19 UTC www.welltellme.com [Source type: General]

^ Those with RLS or PLMD may suffer sensations of twitching, tingling, gnawing, numbing, searing, aching, burning, itching, grabbing, tugging or pulling.
  • Restless Leg Syndrome and Periodic Limb Movement 18 January 2010 0:19 UTC www.exempla.org [Source type: Academic]

.Some controversy surrounds the marketing of drug treatments for RLS. It is a 'spectrum' disease with some people experiencing only a minor annoyance and others experiencing major issues.^ Some people experience them regularly; others only on isolated occurrences.
  • Leg Disorders (Restless Legs Syndrome and Nocturnal Leg Cramps) 18 January 2010 0:19 UTC www.preventdisease.com [Source type: Academic]

^ RLS in some people.
  • Restless Leg Syndrome natural supplements, vitamins, herbs : by Ray Sahelian, M.D., alternative treatment for restless leg syndrome, exercise 9 February 2010 16:32 UTC www.raysahelian.com [Source type: FILTERED WITH BAYES]

^ Some people experience them regularly, others only on isolated occurrences.
  • Restless legs syndrome and related disorders: the causes, diagnosis, treatment, ... 18 January 2010 0:19 UTC www.henryfordhealth.org [Source type: Academic]

Contents

Signs and symptoms

.The sensations—and the need to move—may return immediately after ceasing movement or at a later time.^ In this context, a "leg movement" is usually a sudden bending of his knee or hip associated with a lateral movement of the limb, then a return to the previous position.
  • Sleep apnea, restless legs syndrome, RLS, periodic limb movements, PLMS, PLMD, paresthesias, dysesthesias, obstructive sleep apnea, REM, Stage 1, RBD, REM behavior disorder, parasomnias, narcolepsy, insomnia, cataplexy, benzodiazepines, opioids, gabapentin, neurontin, carbidopa-levidopa, clonazepam, iron deficiency, sleep hygiene, sleepiness, sleep walking, daytime sleepiness, upper airway, CPAP, hypoxemia, UVVP, uvula, Somnoplasty, obesity, airway obstruction, EEG, electroencephalogram, EMG, Epworth Sleepiness Scale, BiPAP, sleep efficiency, Lawrence Martin, M.D. 9 February 2010 16:32 UTC www.lakesidepress.com [Source type: FILTERED WITH BAYES]

^ In some cases, you may not feel any unpleasant sensations but still feel the urge to move your legs or your arms.
  • CIGNA - Restless Legs Syndrome 18 January 2010 0:19 UTC www.cigna.com [Source type: FILTERED WITH BAYES]
  • New York Health - Restless Legs Syndrome (RLS). Restless legs syndrome (RLS) is... 9 February 2010 16:32 UTC www.svcmc.org [Source type: General]
  • Exempla Healthcare Online Library 9 February 2010 16:32 UTC www.exempla.org [Source type: FILTERED WITH BAYES]

^ Its hard to describe, it’s like an itchy sensation but from the inside, I need to stretch and then that’s not enough and my muscles feel alive all the time!
  • Restless legs and arms syndrome – Vinh Pham 18 January 2010 0:19 UTC vinhboy.com [Source type: Original source]
  • Restless legs and arms syndrome – Vinh Pham 18 January 2010 0:19 UTC vinhboy.com [Source type: Original source]

.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.^ It may even start in childhood.
  • Restless Legs Syndrome 18 January 2010 0:19 UTC healthy-ojas.com [Source type: FILTERED WITH BAYES]
  • Restless Legs Syndrome, What Is 18 January 2010 0:19 UTC www.nhlbi.nih.gov [Source type: General]
  • Restless Legs Syndrome | Womens Health Base 18 January 2010 0:19 UTC www.womenshealthbase.com [Source type: FILTERED WITH BAYES]
  • Restless Leg Syndrome 18 January 2010 0:19 UTC restlessleg-syndrome.org [Source type: General]
  • Restless Legs Syndrome, All Sections (printer-friendly) 18 January 2010 0:19 UTC www.nhlbi.nih.gov [Source type: FILTERED WITH BAYES]

^ RLS may start at any age, including early childhood, and is a progressive disease for a certain percentage of sufferers, although it has been known for the symptoms to disappear permanently in some sufferers.
  • Restless Legs Syndrome Support Group - DailyStrength 18 January 2010 0:19 UTC www.dailystrength.org [Source type: General]

^ Rarely, restless legs may be an early symptom of Parkinson disease.

[citation needed]
.
  • "An urge to move, usually due to uncomfortable sensations that occur primarily in the legs, but occasionally in the arms or elsewhere."^ The irritating sensation to move your legs .
    • all natural Night Time Leg Calm for Restless Leg Syndrome and Periodic Limb Movement 9 February 2010 16:32 UTC www.naturesinventory.com [Source type: General]

    ^ The urge to move the legs usually is due to unpleasant feelings in the legs.
    • About Restless Legs Syndrome - RLS 18 January 2010 0:19 UTC www.sleepassociation.org [Source type: FILTERED WITH BAYES]

    ^ Legs, and sometimes arms, demand to be moved.
    • Restless Legs Syndrome, Robert H. Yoakum, Book - Barnes & Noble 9 February 2010 16:32 UTC search.barnesandnoble.com [Source type: FILTERED WITH BAYES]

    [citation needed]
.The sensations are unusual and unlike other common sensations, and those with RLS have a hard time describing them.^ The sensations are unusual and unlike other common sensations, and those with RLS have a hard time describing them.
  • Restless Leg syndrome � Information Causes Treatment Effect 18 January 2010 0:19 UTC peoples-health.com [Source type: FILTERED WITH BAYES]
  • What is Restless Leg Syndrome? 18 January 2010 0:19 UTC www.disabled-world.com [Source type: FILTERED WITH BAYES]
  • Restless legs syndrome - Psychology Wiki 9 February 2010 16:32 UTC psychology.wikia.com [Source type: Academic]
  • Restless Leg Syndrome - eHow.com 9 February 2010 16:32 UTC www.ehow.com [Source type: FILTERED WITH BAYES]

^ The sensations are unusual and unlike othercommon sensations, and those with RLS have a hard time describing them.

^ The sensations felt by RLS patients are unusual and unlike other common sensations, and it can be very difficult to describe them.
  • An irresistible urge to move your legs during sleep 9 February 2010 16:32 UTC www.sleepandyou.com [Source type: FILTERED WITH BAYES]

People use words such as: uncomfortable, "antsy", electrical, creeping, painful, itching, pins and needles, pulling, creepy-crawly, ants inside the legs, numbness, and many others. It is sometimes described as feeling similar to a limb "falling asleep". See formication. .While it may be impossible to describe the sensation to someone without RLS, other RLS sufferers can easily relate to the peculiar sensation.^ Patients with RLS often describe the urge to move, uncomfortable sensations, and pain, which begin or worsen during rest or inactivity such as lying or sitting.
  • Restless Legs Syndrome: Editor's Note 18 January 2010 0:19 UTC www.medscape.com [Source type: Academic]

^ RLS sufferers may show no outward signs of problems other than inability to relax or ease the pain.
  • Restless Leg Syndrome and Periodic Limb Movement 18 January 2010 0:19 UTC www.exempla.org [Source type: Academic]

^ Those with RLS or PLMD may suffer sensations of twitching, tingling, gnawing, numbing, searing, aching, burning, itching, grabbing, tugging or pulling.
  • Restless Leg Syndrome and Periodic Limb Movement 18 January 2010 0:19 UTC www.exempla.org [Source type: Academic]

.The sensation and the urge can occur in any body part; the most cited location is legs, followed by arms.^ The sensation and the urge can occur in any body part; the most cited location is legs, followed by arms.
  • Restless Leg syndrome � Information Causes Treatment Effect 18 January 2010 0:19 UTC peoples-health.com [Source type: FILTERED WITH BAYES]
  • What is Restless Leg Syndrome? 18 January 2010 0:19 UTC www.disabled-world.com [Source type: FILTERED WITH BAYES]
  • Restless legs syndrome - Psychology Wiki 9 February 2010 16:32 UTC psychology.wikia.com [Source type: Academic]

^ The sensation and the urge can occur in any body part; the mostcited location is legs, followed by arms.

^ Although most patients experience the sensations in their legs, the sensations also may occur in the arms or elsewhere.
  • Restless Legs Syndrome: Detection and Management in Primary Care - July 1, 2000 - American Family Physician 9 February 2010 16:32 UTC www.aafp.org [Source type: Academic]

.Some people have little or no sensation, yet still have a strong urge to move.^ Some people have little or no sensation, yet still have a strong urge to move.
  • Restless Legs Syndrome 18 January 2010 0:19 UTC flowcushion.com [Source type: FILTERED WITH BAYES]
  • Restless Leg syndrome � Information Causes Treatment Effect 18 January 2010 0:19 UTC peoples-health.com [Source type: FILTERED WITH BAYES]
  • What is Restless Leg Syndrome? 18 January 2010 0:19 UTC www.disabled-world.com [Source type: FILTERED WITH BAYES]
  • Restless legs syndrome - Psychology Wiki 9 February 2010 16:32 UTC psychology.wikia.com [Source type: Academic]
  • restless legs 9 February 2010 16:32 UTC www.asktheneurologist.com [Source type: FILTERED WITH BAYES]

^ For some people, the sensations are also felt in the arms.
  • http://medicalcenter.osu.edu/patientcare/healthcare_services/lung_diseases/sleep/rls/Pages/index.aspx 18 January 2010 0:19 UTC medicalcenter.osu.edu [Source type: Academic]
  • Restless Legs Syndrome (RLS) 18 January 2010 0:19 UTC healthlibrary.brighamandwomens.org [Source type: Academic]
  • Restless Legs Syndrome (RLS) - New York Presbyterian Hospital 18 January 2010 0:19 UTC nyp.org [Source type: FILTERED WITH BAYES]
  • Saint Anne's Hospital - Restless Legs Syndrome (RLS) 18 January 2010 0:19 UTC www.saintanneshospital.org [Source type: FILTERED WITH BAYES]
  • Main Line Health - Restless Legs Syndrome (RLS) 18 January 2010 0:19 UTC www.mainlinehealth.org [Source type: Academic]
  • Bloomington Hospital - Restless Legs Syndrome (RLS) 18 January 2010 0:19 UTC www.bloomingtonhospital.org [Source type: Academic]
  • Restless Legs Syndrome (RLS) 9 February 2010 16:32 UTC www.massgeneral.org [Source type: FILTERED WITH BAYES]

^ (These sensations may involve a strong urge to move the legs.
  • Restless Leg Syndrome - Sleep Medicine Centers of WNY 9 February 2010 16:32 UTC www.sleepmedicinecenters.com [Source type: FILTERED WITH BAYES]

.
  • "Motor restlessness, expressed as activity, that relieves the urge to move."^ Restless legs syndrome (RLS) is a neurological disorder characterized by unpleasant sensations in the legs and an uncontrollable urge to move when at rest in an effort to relieve these feelings.
    • Restless Leg Syndrome: Symptoms and Cures 18 January 2010 0:19 UTC www.welltellme.com [Source type: General]

    ^ The main symptom of restless legs syndrome (RLS) is an irresistible urge to move your legs because of uncomfortable and sometimes painful sensations deep within your legs.
    • CIGNA - Restless Legs Syndrome 18 January 2010 0:19 UTC www.cigna.com [Source type: FILTERED WITH BAYES]
    • New York Health - Restless Legs Syndrome (RLS). Restless legs syndrome (RLS) is... 9 February 2010 16:32 UTC www.svcmc.org [Source type: General]
    • Exempla Healthcare Online Library 9 February 2010 16:32 UTC www.exempla.org [Source type: FILTERED WITH BAYES]

    ^ Moving your legs relieves the urge and the unpleasant feelings.
    • Restless Legs Syndrome, All Sections (printer-friendly) 18 January 2010 0:19 UTC www.nhlbi.nih.gov [Source type: FILTERED WITH BAYES]

    [citation needed]
Movement will usually bring immediate relief; however, this relief will often be only temporary and partial. .Walking is most common; however, doing stretches, yoga, biking, or other physical activity may relieve the symptoms.^ Certain activities can relieve RLS symptoms.
  • Restless Legs Syndrome, All Sections (printer-friendly) 18 January 2010 0:19 UTC www.nhlbi.nih.gov [Source type: FILTERED WITH BAYES]

^ Walking is the most commonly selected activity.
  • Restless Leg Syndrome Fact Sheet - UK HealthCare 18 January 2010 0:19 UTC www.ukhealthcare.uky.edu [Source type: FILTERED WITH BAYES]

^ Walking is most common; however, doing stretches, yoga, biking, or other physical activity may relieve the symptoms.
  • Restless Legs Syndrome 18 January 2010 0:19 UTC flowcushion.com [Source type: FILTERED WITH BAYES]
  • Restless Leg syndrome � Information Causes Treatment Effect 18 January 2010 0:19 UTC peoples-health.com [Source type: FILTERED WITH BAYES]

Continuous, fast up-and-down movements of the leg, 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.^ Sometimes a specific type of movement will help a person more than another.
  • Restless Leg syndrome � Information Causes Treatment Effect 18 January 2010 0:19 UTC peoples-health.com [Source type: FILTERED WITH BAYES]

^ To further complicate things, more than 80 percent of people with RLS also experience a condition known as periodic limb movement disorder (PLMD).
  • Restless Leg Syndrome 18 January 2010 0:19 UTC www.dlife.com [Source type: FILTERED WITH BAYES]

^ There is no specific examination but it is important to rule out other disorders and a sleep study is sometimes helpful to identify the problem.
  • Restless Legs Syndrome Health Video | LIVESTRONG.COM 18 January 2010 0:19 UTC www.livestrong.com [Source type: General]

  • "Worsening of symptoms by relaxation."[citation needed]
Any type of inactivity involving sitting or lying down: reading a book, a plane ride, watching TV or a movie, or 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.^ The symptoms of RLS vary in severity and duration from person to person.
  • Restless Legs Syndrome Fact Sheet: National Institute of Neurological Disorders and Stroke (NINDS) 18 January 2010 0:19 UTC www.ninds.nih.gov [Source type: Academic]
  • Effective, Natural Treatment For Restless Leg Syndrome (RLS) 18 January 2010 0:19 UTC myherbalremedy.com [Source type: FILTERED WITH BAYES]
  • Restless Leg Syndrome Fact Sheet - UK HealthCare 18 January 2010 0:19 UTC www.ukhealthcare.uky.edu [Source type: FILTERED WITH BAYES]
  • Health Talk - Restless Leg Syndrome 18 January 2010 0:19 UTC www.healthtalk.ca [Source type: FILTERED WITH BAYES]
  • Health Talk - Restless Leg Syndrome 18 January 2010 0:19 UTC www.healthtalk.ca [Source type: FILTERED WITH BAYES]
  • Effective, Natural Treatment For Restless Leg Syndrome (RLS) 9 February 2010 16:32 UTC myherbalremedy.com [Source type: FILTERED WITH BAYES]
  • Health Talk - Restless Leg Syndrome 9 February 2010 16:32 UTC www.healthtalk.ca [Source type: FILTERED WITH BAYES]

^ This depends on several factors: the severity of the person’s RLS, the degree of restfulness, the duration of the inactivity, etc.
  • Restless Leg syndrome � Information Causes Treatment Effect 18 January 2010 0:19 UTC peoples-health.com [Source type: FILTERED WITH BAYES]
  • Restless legs syndrome - Psychology Wiki 9 February 2010 16:32 UTC psychology.wikia.com [Source type: Academic]

^ RLS can affect people of all ages but is more likely to develop in those over the age of 45, with symptoms becoming more severe and more frequent as the person gets older.

.
  • "Variability over the course of the day-night cycle, with symptoms worse in the evening and early in the night."^ Are your symptoms worse at night?
    • Restless legs syndrome 18 January 2010 0:19 UTC www.cnn.com [Source type: General]
    • Restless legs syndrome 18 January 2010 0:19 UTC www.studentnews.cnn.com [Source type: General]
    • OhioHealth - Restless legs syndrome 18 January 2010 0:19 UTC www.ohiohealth.com [Source type: General]
    • Restless legs syndrome 9 February 2010 16:32 UTC edition2.cnn.com [Source type: General]

    ^ Symptoms that start or get worse in the evening or at night.
    • Restless Legs Syndrome, All Sections (printer-friendly) 18 January 2010 0:19 UTC www.nhlbi.nih.gov [Source type: FILTERED WITH BAYES]

    ^ Your symptoms are worse at night.
    • Restless legs syndrome 18 January 2010 0:19 UTC www.cnn.com [Source type: General]
    • Restless legs syndrome 18 January 2010 0:19 UTC www.studentnews.cnn.com [Source type: General]
    • OhioHealth - Restless legs syndrome 18 January 2010 0:19 UTC www.ohiohealth.com [Source type: General]
    • Restless legs syndrome 9 February 2010 16:32 UTC edition2.cnn.com [Source type: General]

    [citation needed]
.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.^ Some people experience them regularly; others only on isolated occurrences.
  • Leg Disorders (Restless Legs Syndrome and Nocturnal Leg Cramps) 18 January 2010 0:19 UTC www.preventdisease.com [Source type: Academic]

^ Symptoms that happen and are worse later in the day, evening, and during the night.

^ The symptoms are worse in the evening and during the night.
  • Sleep Apnea Restless Legs 18 January 2010 0:19 UTC www.clinicalsleep.com [Source type: FILTERED WITH BAYES]

NIH criteria

In 2003, a National Institutes of Health (NIH) consensus panel modified their criteria to include the following:
.
  1. an urge to move the limbs with or without sensations
  2. improvement with activity
  3. worsening at rest
  4. worsening in the evening or night.^ Both can worsen in the evening and night.
    • Restless Legs Syndrome, Robert H. Yoakum, Book - Barnes & Noble 9 February 2010 16:32 UTC search.barnesandnoble.com [Source type: FILTERED WITH BAYES]

    ^ The diagnosis is clinical, requiring an urge to move the legs usually accompanied by an uncomfortable sensation, occurrence at rest, improvement with activity, and worsening of symptoms in the evening or at night.
    • Restless Legs Syndrome - July 15, 2008 - American Family Physician 18 January 2010 0:19 UTC www.aafp.org [Source type: Academic]

    ^ The urge to move your legs and the sensations are worse in the evening or at night.
    • Health: Restless Legs Syndrome (RLS); Restless legs syndrome (RLS) is a disorder related ... 18 January 2010 0:19 UTC www.mainegeneral.org [Source type: General]
    • Restless Legs Syndrome (RLS), SVCMC; New York NY 18 January 2010 0:19 UTC www.svcmc.org [Source type: FILTERED WITH BAYES]
    • Exempla Healthcare Online Library 9 February 2010 16:32 UTC www.exempla.org [Source type: FILTERED WITH BAYES]

    [2]
.RLS is either primary or secondary.^ RLS can occur in either the idiopathic (primary) form or a secondary form.
  • Secondary Causes of Restless Leg Syndrome in Older people 9 February 2010 16:32 UTC www.rebuildermedical.com [Source type: Academic]

^ RLS can be primary or secondary.
  • Restless Legs Syndrome: eMedicine Neurology 18 January 2010 0:19 UTC emedicine.medscape.com [Source type: Academic]

^ Primary and secondary RLS .
  • Patient information leaflet - Restless leg syndrome 9 February 2010 16:32 UTC www.cks.nhs.uk [Source type: FILTERED WITH BAYES]

.
  • Primary RLS is considered idiopathic, or with no known cause.^ This is considered secondary RLS. When no other cause is found for RLS symptoms, it is considered a primary disorder.
    • Restless Legs Syndrome (RLS) and Sleep | National Sleep Foundation - Information on Sleep Health and Safety 18 January 2010 0:19 UTC www.sleepfoundation.org [Source type: FILTERED WITH BAYES]
    • Restless Legs Syndrome -Allmemoryfoam.com - Articles on the Importance of Sleep 9 February 2010 16:32 UTC www.allmemoryfoam.com [Source type: FILTERED WITH BAYES]

    ^ The specific cause of primary RLS is not known.
    • Restless Legs Syndrome - a knol by Daniel 18 January 2010 0:19 UTC knol.google.com [Source type: Academic]

    ^ Primary, or idiopathic, RLS occurs naturally.
    • Patient information leaflet - Restless leg syndrome 9 February 2010 16:32 UTC www.cks.nhs.uk [Source type: FILTERED WITH BAYES]

    .Primary RLS usually begins before approximately 40 to 45 years of age.^ I have suffered from RLS for over 40 years.
    • restless leg syndrome - Health and Fitness - Comcast.net Community 18 January 2010 0:19 UTC community.comcast.net [Source type: FILTERED WITH BAYES]

    ^ The RLS starts before the age of 45, and tends to be hereditary.
    • What Is Restless Legs Syndrome? What Causes Restless Legs Syndrome? 9 February 2010 16:32 UTC www.medicalnewstoday.com [Source type: Academic]

    ^ I have had RLS for over 40 years.
    • Restless Leg Syndrome 18 January 2010 0:19 UTC www.shawnhogan.com [Source type: Original source]

    .In primary RLS, the onset is often slow.^ In primary RLS, the onset is often slow.
    • Restless legs syndrome - Psychology Wiki 9 February 2010 16:32 UTC psychology.wikia.com [Source type: Academic]

    ^ Though RLS is diagnosed most often in people in their middle years, many individuals with RLS, particularly those with primary RLS, can trace their symptoms back to childhood.
    • Restless Leg Syndrome - Sleep Medicine Centers of WNY 9 February 2010 16:32 UTC www.sleepmedicinecenters.com [Source type: FILTERED WITH BAYES]

    ^ Both primary and secondary RLS can be worsened by surgery of any kind, however back surgery or injury is often associated with causing RLS. RLS often worsens in pregnancy .
    • Restless legs syndrome - Psychology Wiki 9 February 2010 16:32 UTC psychology.wikia.com [Source type: Academic]

    .The RLS may disappear for months, or even years.^ Pregnant women may experience RLS, especially in their last trimester, with symptoms usually disappearing within 4 weeks of delivery.

    ^ Some women may experience RLS during pregnancy, particularly in the last few months.

    ^ May 22, 2009 8:34 AM Guest : I am 55, male, and had RLS for about ten years.
    • Supplements for Restless Legs Syndrome: Vitamins, Minerals and Herbs Can Relieve Agony of RLS 18 January 2010 0:19 UTC naturalmedicine.suite101.com [Source type: Academic]

    .It is often progressive and gets worse as the person ages.^ The condition has no known cause and no known cure and often gets worse as a person ages.
    • Restless Leg Syndrome: An Ayurvedic and Personal Perspective | CA College of Ayurveda :: Ayurveda School 18 January 2010 0:19 UTC www.ayurvedacollege.com [Source type: FILTERED WITH BAYES]

    ^ It is often progressive and gets worse as the person ages.
    • Restless legs syndrome - Psychology Wiki 9 February 2010 16:32 UTC psychology.wikia.com [Source type: Academic]

    ^ RLS can affect people of all ages but is more likely to develop in those over the age of 45, with symptoms becoming more severe and more frequent as the person gets older.

    .RLS in children is often misdiagnosed as growing pains.
  • Secondary RLS often has a sudden onset and may be daily from the very beginning.^ Those with late-onset RLS usually do not have a family history of RLS. Their condition is more likely the result of a problem with the nervous system, and symptoms may include pain in the lower legs.
    • Restless legs syndrome and related disorders: the causes, diagnosis, treatment, ... 18 January 2010 0:19 UTC www.henryfordhealth.org [Source type: Academic]
    • Restless legs syndrome and related disorders 9 February 2010 16:32 UTC adam.about.com [Source type: Academic]

    ^ Anorexia, nausea, or vomiting may occur after the onset of pain.
    • Causes of Restless Legs Syndrome - WrongDiagnosis.com 18 January 2010 0:19 UTC www.wrongdiagnosis.com [Source type: Academic]

    ^ Many adults who have RLS can recall being told as a child that they had growing pains or can remember parents rubbing their legs to help them fall asleep.
    • Restless legs syndrome 18 January 2010 0:19 UTC www.studentnews.cnn.com [Source type: General]
    • OhioHealth - Restless legs syndrome 18 January 2010 0:19 UTC www.ohiohealth.com [Source type: General]
    • Restless legs syndrome - Valley Health System 18 January 2010 0:19 UTC www.valleyhealth.com [Source type: FILTERED WITH BAYES]
    • Restless legs syndrome 9 February 2010 16:32 UTC edition2.cnn.com [Source type: General]

    .It often occurs after the age of 40, however it can occur earlier.^ It often occurs after the age of 40, however it can occur earlier.
    • Restless legs syndrome - Psychology Wiki 9 February 2010 16:32 UTC psychology.wikia.com [Source type: Academic]

    ^ Causes, incidence, and risk factors Restless leg syndrome (RLS) occurs most often in middle-aged and older adults.

    ^ Q: downs syndrome and age A: I'm 40 and my husbands 34 we have a 3 yr old and 1 yr old that turned out just fine..however i'm pregnant now and scared as you...
    • Sleep problem: Restless legs syndrome | BabyCenter 18 January 2010 0:19 UTC www.babycenter.com [Source type: General]

    It is most associated with specific medical conditions or the use of certain drugs (see below).

Causes

Disease mechanism

.Most research on the disease mechanism of restless legs syndrome has focused on the dopamine and iron system.^ MRI measurement of brain iron in patients with restless legs syndrome.

^ Restless legs syndrome and related disorders .
  • Restless legs syndrome and related disorders: the causes, diagnosis, treatment, ... 18 January 2010 0:19 UTC www.henryfordhealth.org [Source type: Academic]
  • Restless legs syndrome and related disorders 9 February 2010 16:32 UTC adam.about.com [Source type: Academic]

^ Paulson GW. Restless legs syndrome.

[3][4] .These hypotheses are based on the observation that levodopa and iron can be used to treat RLS, but also on findings from functional brain imaging (such as positron emission tomography and functional magnetic resonance imaging), autopsy series and animal experiments.^ Pergolide mesylate is an ergot-derived dopamine agonist used in low doses to treat RLS and in much higher doses to treat Parkinson’s disease.
  • Restless legs syndrome: Manifestations, treatment and dental implications -- Friedlander et al. 137 (6): 755 -- The Journal of the American Dental Association 18 January 2010 0:19 UTC jada.ada.org [Source type: Academic]

^ Medications used to treat RLS may cause harm to the fetus and should be discussed with a doctor.

^ In addition, blood tests may be performed to check for underlying conditions such as iron deficiency, diabetes , kidney disease, vitamin or mineral deficiencies that may cause RLS. .
  • Natural Remedies for the Treatment of Restless Leg Syndrome 18 January 2010 0:19 UTC www.nativeremedies.com [Source type: FILTERED WITH BAYES]

[5] .Differences in dopamine- and iron-related markers have also been demonstrated in the cerebrospinal fluid of individuals with RLS.[6] A connection between these two systems is demonstrated by the finding of low iron levels in the substantia nigra of RLS patients, although other areas may also be involved.^ The common connection between RLS and Parkinson's disease, in turn, may be not having enough iron in these patients.
  • Restless legs syndrome and related disorders: the causes, diagnosis, treatment, ... 18 January 2010 0:19 UTC www.henryfordhealth.org [Source type: Academic]

^ He indicated that RLS is associated with low iron.
  • Cure Restless Leg Syndrome with Remedies from Earth Clinic. 18 January 2010 0:19 UTC www.earthclinic.com [Source type: General]

^ The levels of ferritin in the cerebrospinal fluid were significantly lower in patients with RLS than in controls, although serum levels were similar between the two groups.
  • Restless Legs Syndrome - July 15, 2008 - American Family Physician 18 January 2010 0:19 UTC www.aafp.org [Source type: Academic]

[7]

Underlying disorders

.The most commonly associated medical condition is iron deficiency (specifically blood ferritin below 50 µg/L[8]), which accounts for just over 20% of all cases of RLS. Other conditions associated with RLS include varicose vein or venous reflux, folate deficiency, magnesium deficiency, sleep apnea, uremia, diabetes, thyroid disease, peripheral neuropathy, Parkinson's disease and certain auto-immune disorders such as Sjögren's syndrome, celiac disease, and rheumatoid arthritis.^ Other conditions-such as leg cramps, certain nerve disorders, or arthritis-can produce symptoms that are similar to those of restless legs syndrome.
  • Health: Restless Legs Syndrome (RLS); Restless legs syndrome (RLS) is a disorder related ... 18 January 2010 0:19 UTC www.mainegeneral.org [Source type: General]
  • New York Health - Restless Legs Syndrome (RLS). Restless legs syndrome (RLS) is... 9 February 2010 16:32 UTC www.svcmc.org [Source type: General]

^ Specific characteristics of RLS include: .
  • Restless legs syndrome and related disorders: the causes, diagnosis, treatment, ... 18 January 2010 0:19 UTC www.henryfordhealth.org [Source type: Academic]

^ Other associated features commonly found in RLS include: Sleep disturbances and daytime fatigue.

.RLS can also worsen in pregnancy.^ Pregnancy or hormonal changes may temporarily worsen RLS symptoms.

^ Stress and pregnancy Stress tends to worsen the symptoms of RLS. Pregnancy or hormonal changes also may temporarily worsen RLS signs and symptoms.
  • Restless legs syndrome - Valley Health System 18 January 2010 0:19 UTC www.valleyhealth.com [Source type: FILTERED WITH BAYES]

^ Pregnancy Pregnancy or hormonal changes may temporarily worsen RLS signs and symptoms.
  • Restless legs syndrome 18 January 2010 0:19 UTC www.cnn.com [Source type: General]
  • Restless legs syndrome 18 January 2010 0:19 UTC www.studentnews.cnn.com [Source type: General]
  • OhioHealth - Restless legs syndrome 18 January 2010 0:19 UTC www.ohiohealth.com [Source type: General]
  • Restless legs syndrome 9 February 2010 16:32 UTC edition2.cnn.com [Source type: General]

[9] .In a recent study, RLS was detected in 36% of patients attending a phlebology (vein disease) clinic, compared to 18% in a control group.^ In an open label study (12 patients), tramadol (Ultram) taken at night improved RLS symptoms.
  • Restless Legs Syndrome - July 15, 2008 - American Family Physician 18 January 2010 0:19 UTC www.aafp.org [Source type: Academic]

^ A sleep study (polysomnography) is not routinely indicated in the work-up of RLS, 25 because RLS is diagnosed on the basis of history and clinical findings.
  • Restless Legs Syndrome: Detection and Management in Primary Care - July 1, 2000 - American Family Physician 9 February 2010 16:32 UTC www.aafp.org [Source type: Academic]

^ Recent studies have shown that decreased iron stores (indicated by serum ferritin levels below 50 ng per mL [50 µg per L] can exacerbate RLS symptoms.
  • Restless Legs Syndrome: Detection and Management in Primary Care - July 1, 2000 - American Family Physician 9 February 2010 16:32 UTC www.aafp.org [Source type: Academic]

[10]
.Certain medications may worsen RLS in those who already have it, or cause it secondarily.^ Certain medical conditions, medications, and environmental stresses can cause RLS. Medications .
  • Restless legs syndrome and related disorders 9 February 2010 16:32 UTC adam.about.com [Source type: Academic]

^ Avoid the use of medications that may worsen RLS, such as antidepressants.
  • Restless Legs Syndrome (RLS) | ThirdAge Articles 18 January 2010 0:19 UTC www.thirdage.com [Source type: General]
  • Restless Legs Syndrome (RLS) ; Seattle Washington WA 18 January 2010 0:19 UTC www.swedish.org [Source type: FILTERED WITH BAYES]

^ It may also be caused or made worse by certain medications.
  • Restless Legs Syndrome -Allmemoryfoam.com - Articles on the Importance of Sleep 9 February 2010 16:32 UTC www.allmemoryfoam.com [Source type: FILTERED WITH BAYES]

.These include: some antiemetics (the dopaminergic ones), certain antihistamines (often in over-the-counter cold medications), many antidepressants (both older TCAs and newer SSRIs), antipsychotics, and certain anticonvulsants.^ Some words used to describe these sensations include: creeping, itching, pulling, creepy-crawly, tugging or gnawing.

^ Because there is no cure for RLS, the primary aim of treatment is to relieve symptoms , increase the amount and quality of sleep, and treat or correct any underlying condition that may cause RLS. Some drugs and medications that are associated with RLS include caffeine, alcohol, antihistamine blockers, anti-seizure medicines, anti-nausea medicines, and certain antidepressants.
  • Natural Remedies for the Treatment of Restless Leg Syndrome 18 January 2010 0:19 UTC www.nativeremedies.com [Source type: FILTERED WITH BAYES]

^ It may help to avoid antidepressants, antihistamines, cold and sinus medicine, antipsychotic medicine, and certain antinausea drugs (metoclopramide or prochlorperazine).
  • New York Health - Restless Legs Syndrome (RLS). Restless legs syndrome (RLS) is... 9 February 2010 16:32 UTC www.svcmc.org [Source type: General]

.Treatment of underlying conditions, or cessation of use of the offending drug, often eliminates the RLS. Restless legs syndrome can occur as a result of the benzodiazepine withdrawal syndrome when discontinuing benzodiazepine tranquillisers or sleeping pills.^ Restless legs syndrome and related disorders .
  • Restless legs syndrome and related disorders: the causes, diagnosis, treatment, ... 18 January 2010 0:19 UTC www.henryfordhealth.org [Source type: Academic]

^ The treatment of the restless legs syndrome with clonazepam: a prospective controlled study.
  • Restless Legs Syndrome: Editor's Note 18 January 2010 0:19 UTC www.medscape.com [Source type: Academic]

^ Restless leg syndrome (RLS) occurs most often in middle-aged and older adults.
  • Restless leg syndrome 9 February 2010 16:32 UTC www.drexelmed.edu [Source type: Academic]

.A sedative hypnotic with a short half life may also induce restless legs syndrome when the dose wears off as part of a rebound effect.^ Low doses of narcotics may sometimes relieve symptoms of restless leg syndrome.
  • Restless leg syndrome 9 February 2010 16:32 UTC www.drexelmed.edu [Source type: Academic]

^ RLS = restless legs syndrome .
  • Restless Legs Syndrome - July 15, 2008 - American Family Physician 18 January 2010 0:19 UTC www.aafp.org [Source type: Academic]

^ How is restless legs syndrome treated?
  • Health: Restless Legs Syndrome (RLS); Restless legs syndrome (RLS) is a disorder related ... 18 January 2010 0:19 UTC www.mainegeneral.org [Source type: General]
  • New York Health - Restless Legs Syndrome (RLS). Restless legs syndrome (RLS) is... 9 February 2010 16:32 UTC www.svcmc.org [Source type: General]
  • Exempla Healthcare Online Library 9 February 2010 16:32 UTC www.exempla.org [Source type: FILTERED WITH BAYES]

[11]
.Hypoglycemia has also been found to worsen RLS symptoms.^ Caffeine also has been implicated in the worsening of RLS symptoms.
  • Restless Legs Syndrome: Detection and Management in Primary Care - July 1, 2000 - American Family Physician 9 February 2010 16:32 UTC www.aafp.org [Source type: Academic]

^ Symptoms of RLS generally worsen over time.
  • What Is Restless Legs Syndrome? What Causes Restless Legs Syndrome? 9 February 2010 16:32 UTC www.medicalnewstoday.com [Source type: Academic]

^ Hypoglycemia has also been found to worsen RLS symptoms.
  • Restless Legs Syndrome 18 January 2010 0:19 UTC flowcushion.com [Source type: FILTERED WITH BAYES]
  • Restless legs syndrome - Psychology Wiki 9 February 2010 16:32 UTC psychology.wikia.com [Source type: Academic]

[12] .Opioid detoxification has also recently been associated with provocation of RLS-like symptoms during withdrawal.^ Because of the overlap between RLS and PLMS, it is likely that bupropion would improve, or at least not exacerbate, symptoms of RLS. Currently, no RCTs on the effects of bupropion on the symptoms of RLS have been conducted.
  • Restless Legs Syndrome - July 15, 2008 - American Family Physician 18 January 2010 0:19 UTC www.aafp.org [Source type: Academic]

^ Patients with newly diagnosed RLS or RLS patients with a recent exacerbation of symptoms should have their serum ferritin levels measured.
  • Restless Legs Syndrome: Detection and Management in Primary Care - July 1, 2000 - American Family Physician 9 February 2010 16:32 UTC www.aafp.org [Source type: Academic]

^ Patients who withdraw from these drugs typically experience very severe RLS symptoms for the first 2 days after stopping.
  • Restless legs syndrome and related disorders: the causes, diagnosis, treatment, ... 18 January 2010 0:19 UTC www.henryfordhealth.org [Source type: Academic]
  • Restless legs syndrome and related disorders 9 February 2010 16:32 UTC adam.about.com [Source type: Academic]

[13] .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.^ I looked to see what would help that problem and found- 3 -simple exercies and when I did those I slept all night long.
  • Cure Restless Leg Syndrome with Remedies from Earth Clinic. 18 January 2010 0:19 UTC www.earthclinic.com [Source type: General]

^ Lifestyle changes and OTC medications Some simple lifestyle changes and OTC (over-the-counter) medications may help alleviate RLS symptoms, such as: Painkillers - if symptoms are very mild, ibuprofen has been found to relieve patients' symptoms.
  • What Is Restless Legs Syndrome? What Causes Restless Legs Syndrome? 9 February 2010 16:32 UTC www.medicalnewstoday.com [Source type: Academic]

^ Avoiding caffeine, alcohol, and nicotine also improves some cases of RLS. Some patients recommend alternative treatments for RLS, such as acupuncture and massage.
  • Restless legs syndrome and related disorders: the causes, diagnosis, treatment, ... 18 January 2010 0:19 UTC www.henryfordhealth.org [Source type: Academic]

.Some doctors believe it is caused by irregular electrical impulses from the brain.^ Some experts believe that this may supply clues for the genetic cause of RLS. Environmental and Dietary Factors .
  • Leg Disorders (Restless Legs Syndrome and Nocturnal Leg Cramps) 18 January 2010 0:19 UTC www.preventdisease.com [Source type: Academic]

^ Some doctors do not recognize the condition and may believe that the symptoms are caused by other conditions, such as insomnia, stress, muscle cramps, or arthritis.
  • CIGNA - Restless Legs Syndrome 18 January 2010 0:19 UTC www.cigna.com [Source type: FILTERED WITH BAYES]
  • Health: Restless Legs Syndrome (RLS); Restless legs syndrome (RLS) is a disorder related ... 18 January 2010 0:19 UTC www.mainegeneral.org [Source type: General]
  • Exempla Healthcare Online Library 9 February 2010 16:32 UTC www.exempla.org [Source type: FILTERED WITH BAYES]

^ Some doctors believe the condition is often misdiagnosed as nervousness or insomnia or under-diagnosed, because sufferers don’t seek medical attention.
  • Voices of Restless Leg Syndrome - Well Blog - NYTimes.com 18 January 2010 0:19 UTC well.blogs.nytimes.com [Source type: General]

[citation needed]
Both primary and secondary RLS can be worsened by surgery of any kind, however back surgery or injury can be associated with causing RLS.[14]
.Some experts believe RLS and periodic limb movement disorder are strongly associated with ADHD in some children.^ It was also effective for periodic leg movement disorder.
  • Restless legs syndrome and related disorders: the causes, diagnosis, treatment, ... 18 January 2010 0:19 UTC www.henryfordhealth.org [Source type: Academic]

^ Now I have confirmed rls, and periodic limb movement disorder.

^ RLS and periodic limb movement disorder are thought by some experts to be strongly associated with attention-deficit hyperactivity disorder (ADHD) in some children.
  • Leg Disorders (Restless Legs Syndrome and Nocturnal Leg Cramps) 18 January 2010 0:19 UTC www.preventdisease.com [Source type: Academic]

Dopamine appears to factor into both conditions. .In addition, many types of medication for the treatment of both conditions affect dopamine levels in the brain.^ I tried many natural, holistic, nutritional and therapy solutions for years, til the level of suffering finally compelled me to try the standard medical treatment and risk its potential side effects.

^ In addition, many of the foremost medical specialists in the field have contributed their knowledge and experience to make this the most comprehensive and timely source of information on this disease.
  • Restless Legs Syndrome, Robert H. Yoakum, Book - Barnes & Noble 9 February 2010 16:32 UTC search.barnesandnoble.com [Source type: FILTERED WITH BAYES]

^ If this treatment is not effective, the doctor may prescribe drugs—such as levodopa or dopamine agonists—that help increase a chemical in the brain called dopamine .
  • CIGNA - Restless Legs Syndrome 18 January 2010 0:19 UTC www.cigna.com [Source type: FILTERED WITH BAYES]
  • Exempla Healthcare Online Library 9 February 2010 16:32 UTC www.exempla.org [Source type: FILTERED WITH BAYES]

[15]
The cause vs. effect of certain conditions and behaviors that are observed in some patients (ex. carrying excess weight, lack of exercise, suffering from depression or other mental illnesses) does not appear to be well established. The loss of sleep due to RLS could be the cause of the conditions, or the medication used to treat a condition could be the cause of an individual's RLS.[16][17]

Genetics

.More than 60% of cases of RLS are familial[18] and are inherited in an autosomal dominant fashion with variable penetrance.^ More than 70% of affected children in one study had at least one biological parent with RLS. .
  • Restless legs syndrome and related disorders: the causes, diagnosis, treatment, ... 18 January 2010 0:19 UTC www.henryfordhealth.org [Source type: Academic]

^ There is also some evidence of a recessive inheritance, meaning that RLS cases can be transmitted by the less dominant, or recessive, gene.
  • Restless Legs Syndrome, Robert H. Yoakum, Book - Barnes & Noble 9 February 2010 16:32 UTC search.barnesandnoble.com [Source type: FILTERED WITH BAYES]

^ Men and women appear to be affected equally in middle-aged populations, but women in the older age groups are more likely to have RLS than are older men.
  • Restless legs syndrome: Manifestations, treatment and dental implications -- Friedlander et al. 137 (6): 755 -- The Journal of the American Dental Association 18 January 2010 0:19 UTC jada.ada.org [Source type: Academic]

.No one knows the exact cause of RLS at present.^ The exact cause of RLS isn't fully understood at present.
  • Restless legs syndrome - information, symptoms and treatments 18 January 2010 0:19 UTC hcd2.bupa.co.uk [Source type: FILTERED WITH BAYES]

^ No one knows the exact cause of RLS at present.
  • Restless legs syndrome - Psychology Wiki 9 February 2010 16:32 UTC psychology.wikia.com [Source type: Academic]

^ It's a horrible curse and no one knows what causes it.
  • restless leg syndrome - Health and Fitness - Comcast.net Community 18 January 2010 0:19 UTC community.comcast.net [Source type: FILTERED WITH BAYES]

.Research and brain autopsies have implicated both dopaminergic system and iron insufficiency in the substantia nigra (study published in Neurology, 2003).^ Researchers are investigating neurologic (nervous system) problems that may arise either in the spinal cord or the brain.
  • Restless legs syndrome and related disorders: the causes, diagnosis, treatment, ... 18 January 2010 0:19 UTC www.henryfordhealth.org [Source type: Academic]
  • Restless legs syndrome and related disorders 9 February 2010 16:32 UTC adam.about.com [Source type: Academic]

^ Recent studies using MRI’s or autopsies have shown low iron levels in the brain.
  • RLS WTF | GonZoville.com 9 February 2010 16:32 UTC www.gonzoville.com [Source type: Original source]

^ It has been demonstrated that RLS and PLMD frequently are seen in children diagnosed with ADHD. To further complicate the issue, RLS, PLMD, and ADHD all respond to dopaminergic agents, and dopaminergic deficits have been suspected as an etiology for both RLS and ADHD through brain imaging studies.
  • Restless Legs Syndrome in Children 18 January 2010 0:19 UTC www.ncbi.nlm.nih.gov [Source type: Academic]

[19] .Iron is an essential cofactor for the formation of L-dopa, the precursor of dopamine.^ Iron is an essential cofactor for the formation of L-dopa, the precursor of dopamine.
  • Restless legs syndrome - Psychology Wiki 9 February 2010 16:32 UTC psychology.wikia.com [Source type: Academic]

^ The conversion of tyrosine to L-dopa, which eventually yields dopamine, involves iron.
  • ITO Textbook Chapter 6: Iron Therapy Restless Legs Syndrome (RLS) 9 February 2010 16:32 UTC www.irontherapy.org [Source type: Academic]

^ Levodopa —Levodopa (L-dopa) is a form of dihydroxyphenylalanine, the immediate precursor to dopamine.
  • Restless Leg Syndrome - RLS, Dopamine, PLMD, Periodic Limb Movement Disorder - Life Extension Health Concern 18 January 2010 0:19 UTC www.lef.org [Source type: Academic]

Six genetic loci found by linkage are currently known and are listed below. .Other than the first one in this list, the remainder of the linkage loci were discovered using an autosomal dominant model of inheritance.^ When I was a child I used to hang one foot or the other over my bed at night and tuck as much of it as possible under the mattress.
  • CNN.com - Paging Dr. Gupta Blog 18 January 2010 0:19 UTC www.cnn.com [Source type: General]

^ Complex segregation analysis of restless legs syndrome provides evidence for an autosomal dominant mode of inheritance in early age at onset families.
  • Restless Legs Syndrome: Editor's Note 18 January 2010 0:19 UTC www.medscape.com [Source type: Academic]
  • Restless Legs Syndrome -- Ryan and Slevin 20 (6): 430 -- Journal of Pharmacy Practice 18 January 2010 0:19 UTC jpp.sagepub.com [Source type: Academic]
  • Restless legs syndrome: Manifestations, treatment and dental implications -- Friedlander et al. 137 (6): 755 -- The Journal of the American Dental Association 18 January 2010 0:19 UTC jada.ada.org [Source type: Academic]

^ But, really, nothing has changed in as far as one’s actual leg muscles are concerned other than they aren’t supporting weight.
  • RLS WTF | GonZoville.com 9 February 2010 16:32 UTC www.gonzoville.com [Source type: Original source]

.
  • The first genetic locus was discovered in one large French Canadian family and maps on chromosome 12q.^ Primary RLS is believed to be an autosomal dominant disorder and, recently, scientists located a gene associated with RLS susceptibility on chromosome 12q for French-Canadian families, 14q for an Italian family, and 9p for 2 American families.
    • Restless Legs Syndrome in Children 18 January 2010 0:19 UTC www.ncbi.nlm.nih.gov [Source type: Academic]

    ^ Restless legs syndrome: confirmation of linkage to chromosome 12q, genetic heterogeneity, and evidence of complexity.
    • Restless Legs Syndrome in Children 18 January 2010 0:19 UTC www.ncbi.nlm.nih.gov [Source type: Academic]

    ^ See more articles cited in this paragraph Restless legs syndrome: confirmation of linkage to chromosome 12q, genetic heterogeneity, and evidence of complexity.
    • Restless Legs Syndrome in Children 18 January 2010 0:19 UTC www.ncbi.nlm.nih.gov [Source type: Academic]

    [20][21] .This locus was discovered, however, using an autosomal recessive inheritance model.^ In autosomal recessive type of inheritance, 2 copies of gene that codes for the disease should be present in order for the effects to materialize in a living species.

    Evidence for this locus was also found using a transmission disequilibrium test (TDT) in 12 Bavarian families.[22]
  • .
  • The second RLS locus maps to chromosome 14q and was discovered in one Italian family.^ Primary RLS is believed to be an autosomal dominant disorder and, recently, scientists located a gene associated with RLS susceptibility on chromosome 12q for French-Canadian families, 14q for an Italian family, and 9p for 2 American families.
    • Restless Legs Syndrome in Children 18 January 2010 0:19 UTC www.ncbi.nlm.nih.gov [Source type: Academic]

    ^ Autosomal dominant restless legs syndrome maps on chromosome 14q.
    • Restless Legs Syndrome: Editor's Note 18 January 2010 0:19 UTC www.medscape.com [Source type: Academic]

    ^ Bonati MT, Ferini-Strambi L., Aridon P., Oldani A., Zucconi M., Casari G. Autosomal dominant restless legs syndrome maps on chromosome 14q.
    • Restless Legs Syndrome -- Ryan and Slevin 20 (6): 430 -- Journal of Pharmacy Practice 18 January 2010 0:19 UTC jpp.sagepub.com [Source type: Academic]

    [23] .Evidence for this locus was found in one French Canadian family.^ The 14q restless legs syndrome locus in the French Canadian population.
    • Restless Legs Syndrome -- Ryan and Slevin 20 (6): 430 -- Journal of Pharmacy Practice 18 January 2010 0:19 UTC jpp.sagepub.com [Source type: Academic]

    [24] .Also, an association study in a large sample 159 trios of European descent showed some evidence for this locus.^ Earlier studies showed an association between restless legs syndrome and cardiovascular disease, but the studies had limitations.
    • Restless Legs Syndrome and Heart Disease Linked: UT Southwestern Medical Center at Dallas 9 February 2010 16:32 UTC www.utsouthwestern.edu [Source type: Academic]
    • Restless Legs Syndrome and Heart Disease Linked: UT Southwestern Medical Center at Dallas 9 February 2010 16:32 UTC www.utsouthwestern.edu [Source type: Academic]

    ^ Other studies have also found an association and some suggest that RLS may occur in between 25% and 30% of people with iron deficiencies.
    • Leg Disorders (Restless Legs Syndrome and Nocturnal Leg Cramps) 18 January 2010 0:19 UTC www.preventdisease.com [Source type: Academic]

    ^ An increased risk of melanoma has been seen in some studies of carbidopa/levodopa, but the evidence is inconclusive.
    • Restless legs syndrome: Diagnostic time-savers, Tx tips — The Journal of Family Practice 9 February 2010 16:32 UTC www.jfponline.com [Source type: Academic]

    [25]
  • .
  • The third locus maps to chromosome 9p and was discovered in two unrelated American families.^ Primary RLS is believed to be an autosomal dominant disorder and, recently, scientists located a gene associated with RLS susceptibility on chromosome 12q for French-Canadian families, 14q for an Italian family, and 9p for 2 American families.
    • Restless Legs Syndrome in Children 18 January 2010 0:19 UTC www.ncbi.nlm.nih.gov [Source type: Academic]

    ^ Chen S., Ondo WG, Rao S., Li L., Chen Q., Wang Q. Genomewide linkage scan identifies a novel susceptibility locus for restless legs syndrome on chromosome 9p.
    • Restless Legs Syndrome -- Ryan and Slevin 20 (6): 430 -- Journal of Pharmacy Practice 18 January 2010 0:19 UTC jpp.sagepub.com [Source type: Academic]

    ^ Evidence for linkage of restless legs syndrome to chromosome 9p: are there two distinct loci?
    • Restless legs syndrome and related disorders 9 February 2010 16:32 UTC adam.about.com [Source type: Academic]

    [26] Evidence for this locus was also found by the TDT in a large Bavarian family,[27] as well as in a German family, in which significant linkage to this locus was found.[28]
  • .
  • The next locus maps to chromosome 20p and was discovered in a large French Canadian family with RLS.[29]
  • The fifth locus maps to chromosome 2p and was found in three related families from population isolate in Bolzano-Bozen.^ The 14q restless legs syndrome locus in the French Canadian population.
    • Restless Legs Syndrome: Editor's Note 18 January 2010 0:19 UTC www.medscape.com [Source type: Academic]

    ^ Primary RLS is believed to be an autosomal dominant disorder and, recently, scientists located a gene associated with RLS susceptibility on chromosome 12q for French-Canadian families, 14q for an Italian family, and 9p for 2 American families.
    • Restless Legs Syndrome in Children 18 January 2010 0:19 UTC www.ncbi.nlm.nih.gov [Source type: Academic]

    ^ Much of the research comes from studies of families with a strong history of RLS-related conditions.
    • Restless legs syndrome and related disorders 9 February 2010 16:32 UTC adam.about.com [Source type: Academic]

    [30]
  • .
  • The sixth locus is located on chromosome 16p12.1 and was discovered by Levchenko et al.^ Levchenko A., Montplaisir J., Dubé M-P., et al.
    • Restless Legs Syndrome -- Ryan and Slevin 20 (6): 430 -- Journal of Pharmacy Practice 18 January 2010 0:19 UTC jpp.sagepub.com [Source type: Academic]

    in 2008[31].
.Three genes, MEIS1, BTBD9 and MAP2K5, were found to be associated to RLS.[32] Their role in RLS pathogenesis is still unclear.^ This pathogenesis is supported by magnetic resonance imaging studies that found decreased amounts of iron in the substantia nigra of patients with RLS when compared with iron levels in control patients.
  • Restless legs syndrome: Manifestations, treatment and dental implications -- Friedlander et al. 137 (6): 755 -- The Journal of the American Dental Association 18 January 2010 0:19 UTC jada.ada.org [Source type: Academic]

^ Other studies have also found an association and some suggest that RLS may occur in between 25% and 30% of people with iron deficiencies.
  • Leg Disorders (Restless Legs Syndrome and Nocturnal Leg Cramps) 18 January 2010 0:19 UTC www.preventdisease.com [Source type: Academic]

More recently, a fourth gene, PTPRD was found to be associated to RLS [33]
There is also some evidence that periodic limb movements in sleep (PLMS) are associated with BTBD9 on chromosome 6p21.2.[34]

Diagnosis

.The diagnosis of RLS relies essentially on a good medical history and physical examination.^ RLS for 4yrs, and medication only slightly helping, my husband experienced a "good nights sleep" after the FIRST application.
  • all natural Night Time Leg Calm for Restless Leg Syndrome and Periodic Limb Movement 9 February 2010 16:32 UTC www.naturesinventory.com [Source type: General]

^ Reviewing your signs, symptoms and medical history If you think you may have RLS, consult your doctor.
  • Restless legs syndrome - Valley Health System 18 January 2010 0:19 UTC www.valleyhealth.com [Source type: FILTERED WITH BAYES]

^ The diagnosis of RLS is based on patient complaint, the results of comprehensive medical and family histories, and normal physical and neurological examinations.
  • Restless legs syndrome: Manifestations, treatment and dental implications -- Friedlander et al. 137 (6): 755 -- The Journal of the American Dental Association 18 January 2010 0:19 UTC jada.ada.org [Source type: Academic]

.Sleep registration in a laboratory (polysomnography) is not necessary for the diagnosis.^ A laboratory analysis is not necessary for the diagnosis, but it can help exclude secondary causes of RLS. Initial laboratory tests include a basic metabolic panel and ferritin level.
  • Restless Legs Syndrome - July 15, 2008 - American Family Physician 18 January 2010 0:19 UTC www.aafp.org [Source type: Academic]

.Peripheral neuropathy, radiculopathy and leg cramps should be considered in the differential diagnosis; in these conditions, pain is often more pronounced than the urge to move.^ Among the conditions that might cause leg cramps are: .
  • Restless legs syndrome and related disorders 9 February 2010 16:32 UTC adam.about.com [Source type: Academic]

^ Restless legs syndrome (RLS) is a neurological disorder characterized by unpleasant sensations in the legs and an uncontrollable urge to move when at rest in an effort to relieve these feelings.
  • Restless Leg Syndrome: Symptoms and Cures 18 January 2010 0:19 UTC www.welltellme.com [Source type: General]

^ According to my neurologist, my leg jerks and sudden muscle twitches, are the result of PLM and not RLS. I do not have an urge to move my legs.
  • CNN.com - Paging Dr. Gupta Blog 18 January 2010 0:19 UTC www.cnn.com [Source type: General]

.Akathisia, a side effect of several antipsychotics or antidepressants, is a more constant form of leg restlessness without discomfort.^ Severe restless legs syndrome.
  • Leg Disorders (Restless Legs Syndrome and Nocturnal Leg Cramps) 18 January 2010 0:19 UTC www.preventdisease.com [Source type: Academic]

^ Long-term effect of dopaminergic drugs in restless legs.
  • Restless legs syndrome: Diagnostic time-savers, Tx tips — The Journal of Family Practice 9 February 2010 16:32 UTC www.jfponline.com [Source type: Academic]

^ All antiseizure drugs have potentially severe side effects.
  • Restless legs syndrome and related disorders: the causes, diagnosis, treatment, ... 18 January 2010 0:19 UTC www.henryfordhealth.org [Source type: Academic]

.Doppler ultrasound evaluation of the vascular system is essential in all cases to rule out venous disorders which is common etiology of RLS. A rare syndrome of painful legs and moving toes has been described, with no known cause.^ Restless legs syndrome and related disorders .
  • Restless legs syndrome and related disorders 9 February 2010 16:32 UTC adam.about.com [Source type: Academic]

^ What causes restless legs syndrome?
  • Exempla Healthcare Online Library 9 February 2010 16:32 UTC www.exempla.org [Source type: FILTERED WITH BAYES]

^ The primary cause of restless legs syndrome is not known.
  • Leg Disorders (Restless Legs Syndrome and Nocturnal Leg Cramps) 18 January 2010 0:19 UTC www.preventdisease.com [Source type: Academic]

[35]

Prevention

.Other than preventing the underlying causes, no method of preventing restless legs has been established or studied.^ What causes restless legs syndrome?
  • Exempla Healthcare Online Library 9 February 2010 16:32 UTC www.exempla.org [Source type: FILTERED WITH BAYES]

^ Ekbom K. Restless legs: a clinical study.
  • Restless Legs Syndrome: Editor's Note 18 January 2010 0:19 UTC www.medscape.com [Source type: Academic]
  • Restless Legs Syndrome -- Ryan and Slevin 20 (6): 430 -- Journal of Pharmacy Practice 18 January 2010 0:19 UTC jpp.sagepub.com [Source type: Academic]

^ Restless legs syndrome — Comprehensive overview covers symptoms, treatment of disorder that can cause insomnia.
  • Restless legs syndrome - Valley Health System 18 January 2010 0:19 UTC www.valleyhealth.com [Source type: FILTERED WITH BAYES]

Treatment

.Treatment of restless legs syndrome involves identifying the cause of symptoms when possible.^ Restless legs syndrome — Comprehensive overview covers symptoms, treatment of disorder that can cause insomnia.
  • Restless legs syndrome - Valley Health System 18 January 2010 0:19 UTC www.valleyhealth.com [Source type: FILTERED WITH BAYES]

^ Restless legs syndrome and related disorders .
  • Restless legs syndrome and related disorders 9 February 2010 16:32 UTC adam.about.com [Source type: Academic]

^ The treatment of the restless legs syndrome with clonazepam: a prospective controlled study.
  • Restless Legs Syndrome: Editor's Note 18 January 2010 0:19 UTC www.medscape.com [Source type: Academic]

.Pharmacotherapy involves dopamine agonists which are first line drugs for daily restless legs syndrome; gabapentin and opioids can be used for treatment resistant cases.^ Treatment of restless legs syndrome with gabapentin: a double-blind, cross-over study.
  • Restless Legs Syndrome: Editor's Note 18 January 2010 0:19 UTC www.medscape.com [Source type: Academic]

^ Opioid and dopamine antagonist drug challenges in untreated restless legs syndrome patients.
  • Restless Legs Syndrome: Editor's Note 18 January 2010 0:19 UTC www.medscape.com [Source type: Academic]

^ Restless legs syndrome induced by lithium.
  • Restless Legs Syndrome: Editor's Note 18 January 2010 0:19 UTC www.medscape.com [Source type: Academic]

[36] .The dopamine agonists pergolide, pramipexole, ropinirole, and cabergoline are preferred over levodopa as levodopa has problems of commonly having a rebound effect.^ Dopamine agonists can be ergot-derived (such as cabergoline) or non-ergot derived (such as pramipexole and ropinirole).
  • Restless legs syndrome and related disorders 9 February 2010 16:32 UTC adam.about.com [Source type: Academic]

^ If this treatment is not effective, the doctor may prescribe drugs—such as levodopa or dopamine agonists—that help increase a chemical in the brain called dopamine .
  • Exempla Healthcare Online Library 9 February 2010 16:32 UTC www.exempla.org [Source type: FILTERED WITH BAYES]

^ Effect of nonergot dopamine agonists on symptoms of restless legs syndrome.
  • Restless legs syndrome: Diagnostic time-savers, Tx tips — The Journal of Family Practice 9 February 2010 16:32 UTC www.jfponline.com [Source type: Academic]

[37] .An algorithm for treating primary RLS (i.e., RLS that is not the result of another medical condition) was created by leading researchers at the Mayo Clinic and is endorsed by the Restless Legs Syndrome Foundation.^ Restless legs syndrome and related disorders .
  • Restless legs syndrome and related disorders 9 February 2010 16:32 UTC adam.about.com [Source type: Academic]

^ Learning about restless legs syndrome: .
  • Exempla Healthcare Online Library 9 February 2010 16:32 UTC www.exempla.org [Source type: FILTERED WITH BAYES]

^ Review Restless legs syndrome: what is it?
  • Restless Legs Syndrome in Children 18 January 2010 0:19 UTC www.ncbi.nlm.nih.gov [Source type: Academic]

.This document provides guidance to both the treating physician and the patient, and includes both nonpharmacological and pharmacological treatments.^ This document provides guidance to both the treating physician and the patient, and includes both nonpharmacological and pharmacological treatments.
  • Restless Legs Syndrome 18 January 2010 0:19 UTC flowcushion.com [Source type: FILTERED WITH BAYES]
  • Restless legs syndrome - Psychology Wiki 9 February 2010 16:32 UTC psychology.wikia.com [Source type: Academic]

^ For many people, treating an underlying cause or effective pharmacological treatment of primary RLS and implementation of coping strategies provides relief from most symptoms.
  • Restless Legs Syndrome -Allmemoryfoam.com - Articles on the Importance of Sleep 9 February 2010 16:32 UTC www.allmemoryfoam.com [Source type: FILTERED WITH BAYES]

^ Nonpharmacologic treatments include moderate exercise; good sleep hygiene; elimination of alcohol, caffeine, and nicotine; and hot baths, massage, and stretching.
  • Restless Legs Syndrome -- Ryan and Slevin 20 (6): 430 -- Journal of Pharmacy Practice 18 January 2010 0:19 UTC jpp.sagepub.com [Source type: Academic]

[38] .Treatment of primary RLS should not be considered until possible precipitating medical conditions are ruled out, especially venous disorders.^ RLS is considered a neurological disorder and can also be genetic.

^ There is a genetic predisposition to RLS, which is common in those with early-onset RLS. RLS may be a primary condition, or it may be secondary to iron deficiency, pregnancy, renal failure, the use of certain medications, or a spinal cord injury.
  • Restless Legs Syndrome - July 15, 2008 - American Family Physician 18 January 2010 0:19 UTC www.aafp.org [Source type: Academic]

^ ADHD may be overdiagnosed, and children suspected of this disorder should be evaluated for RLS, PLMD, and OSA by a sleep specialist or a pediatric neurologist.
  • Restless Legs Syndrome in Children 18 January 2010 0:19 UTC www.ncbi.nlm.nih.gov [Source type: Academic]

.Drug therapy in RLS is not curative and is known to have side effects such as nausea, dizziness, hallucinations, orthostatic hypotension, and sudden sleep attacks during the daytime.^ Such side effects may persist.
  • Leg Disorders (Restless Legs Syndrome and Nocturnal Leg Cramps) 18 January 2010 0:19 UTC www.preventdisease.com [Source type: Academic]

^ Nausea, headache, fatigue, dizziness, orthostatic hypotension, and vomiting—the most common side effects of pramipexole and ropinirole—usually decrease in severity after 7 to 10 days of therapy.
  • Restless legs syndrome: Diagnostic time-savers, Tx tips — The Journal of Family Practice 9 February 2010 16:32 UTC www.jfponline.com [Source type: Academic]

^ All antiseizure drugs have potentially severe side effects.
  • Restless legs syndrome and related disorders: the causes, diagnosis, treatment, ... 18 January 2010 0:19 UTC www.henryfordhealth.org [Source type: Academic]
  • Restless legs syndrome and related disorders 9 February 2010 16:32 UTC adam.about.com [Source type: Academic]

In addition, it can be expensive (about $100–150 per month for life), and thus it needs to be considered with caution.[citation needed]
.Secondary RLS has the potential for cure if the precipitating medical conditions, anaemia, venous disorder, etc., are managed effectively.^ There is a genetic predisposition to RLS, which is common in those with early-onset RLS. RLS may be a primary condition, or it may be secondary to iron deficiency, pregnancy, renal failure, the use of certain medications, or a spinal cord injury.
  • Restless Legs Syndrome - July 15, 2008 - American Family Physician 18 January 2010 0:19 UTC www.aafp.org [Source type: Academic]

^ Medications such as SSRIs and TCAs can precipitate RLS or PLMD in predisposed individuals, and switching to another class of antidepressants is recommended.
  • Restless Legs Syndrome in Children 18 January 2010 0:19 UTC www.ncbi.nlm.nih.gov [Source type: Academic]

^ Factors or conditions that may worsen or precipitate RLS in children have yet to be explored.
  • Restless Legs Syndrome in Children 18 January 2010 0:19 UTC www.ncbi.nlm.nih.gov [Source type: Academic]

.In many instances the alleged secondary conditions might be the only conditions causing the RLS; these include iron deficiency, varicose veins, and thyroid problems.^ Among the conditions that might cause leg cramps are: .
  • Restless legs syndrome and related disorders: the causes, diagnosis, treatment, ... 18 January 2010 0:19 UTC www.henryfordhealth.org [Source type: Academic]
  • Restless legs syndrome and related disorders 9 February 2010 16:32 UTC adam.about.com [Source type: Academic]

^ Many people, however, have RLS without any of these problems: Pregnancy.
  • Leg Disorders (Restless Legs Syndrome and Nocturnal Leg Cramps) 18 January 2010 0:19 UTC www.preventdisease.com [Source type: Academic]

^ RLS can either be primary or arise from secondary causes that lead to iron deficiency.
  • Restless Legs Syndrome: Editor's Note 18 January 2010 0:19 UTC www.medscape.com [Source type: Academic]

.Karl Ekbom in his original thesis on RLS in 1945 had suspected venous disease in about 12.5% of the cases he studied.^ Permalink You obviously know very little about RLS or the background of the disease.

^ TREAT RLS 2: a 12-week, double-blind, randomized, parallel-group, placebo-controlled study.
  • Restless Legs Syndrome -- Ryan and Slevin 20 (6): 430 -- Journal of Pharmacy Practice 18 January 2010 0:19 UTC jpp.sagepub.com [Source type: Academic]

^ Ropinirole in the treatment of restless legs syndrome: results from the TREAT RLS 1 study, a 12 week, randomised, placebo controlled study in 10 European countries.
  • Restless Legs Syndrome -- Ryan and Slevin 20 (6): 430 -- Journal of Pharmacy Practice 18 January 2010 0:19 UTC jpp.sagepub.com [Source type: Academic]

.But due to the unavailability of Doppler ultrasound imaging technology (the diagnostic tool that detects the abnormal blood flow in the veins, "Venous Reflux", the pathological basis for varicose veins) at that time, Ekbom may have underestimated the role of venous disease.^ Impaired communication between the damaged nerves of the sympathetic nervous system and the brain may cause interference with normal signals for sensations, temperature, and blood flow.
  • Causes of Restless Legs Syndrome - WrongDiagnosis.com 18 January 2010 0:19 UTC www.wrongdiagnosis.com [Source type: Academic]

^ The patient may also exhibit elevated blood pressure, dyspnea, arrhythmias, and abnormal respirations.
  • Causes of Restless Legs Syndrome - WrongDiagnosis.com 18 January 2010 0:19 UTC www.wrongdiagnosis.com [Source type: Academic]

^ Chest X-rays, arterial blood gas measurements, and computed tomography scans are common diagnostic tools.
  • Causes of Restless Legs Syndrome - WrongDiagnosis.com 18 January 2010 0:19 UTC www.wrongdiagnosis.com [Source type: Academic]

.In uncontrolled prospective series, improvement of RLS was achieved in a high percentage of patients who had presented with a combination of RLS and venous disease and had sclerotherapy or other treatment for the correction of venous insufficiency.^ RLS patients: who are they?
  • Restless legs syndrome: Diagnostic time-savers, Tx tips — The Journal of Family Practice 9 February 2010 16:32 UTC www.jfponline.com [Source type: Academic]

^ (Both carbamazepine and valproate have also been studied for the treatment of RLS symptoms, but at best, provided only modest improvements.
  • Restless legs syndrome: Diagnostic time-savers, Tx tips — The Journal of Family Practice 9 February 2010 16:32 UTC www.jfponline.com [Source type: Academic]

^ Studies confirmed that this drug could cause serious damage to the heart valves of patients who take it.
  • Restless legs syndrome and related disorders: the causes, diagnosis, treatment, ... 18 January 2010 0:19 UTC www.henryfordhealth.org [Source type: Academic]

[39][40]

Stretching and shaking legs

.Stretching the muscles in the legs can bring instant and permanent relief, lasting several days or longer.^ But relief may be temporary and only last while you are walking, stretching, or moving your legs.
  • Exempla Healthcare Online Library 9 February 2010 16:32 UTC www.exempla.org [Source type: FILTERED WITH BAYES]

^ With proctalgia fugax, muscle spasms of the rectum and pelvic floor produce sudden, severe episodes of rectal pain that last up to several minutes and then disappear.
  • Causes of Restless Legs Syndrome - WrongDiagnosis.com 18 January 2010 0:19 UTC www.wrongdiagnosis.com [Source type: Academic]

^ Severe pain with passive muscle stretching is the cardinal symptom of compartment syndrome.
  • Causes of Restless Legs Syndrome - WrongDiagnosis.com 18 January 2010 0:19 UTC www.wrongdiagnosis.com [Source type: Academic]

This does not work for everyone: sometimes relief is temporary, and discomfort can return within the span of a few seconds.[41][42] One stretching method[citation needed] consists of bending over from a standing position and reaching out one's hands to the ground (touching the toes if possible). This position is held for 10 to 20 seconds and repeated 3 times.

Iron supplements

.According to some guidelines[citation needed], all people with RLS should have their ferritin levels tested; ferritin levels should be at least 50 µg for those with RLS. Oral iron supplements, taken under a doctor's care, can increase ferritin levels.^ Some studies have reported RLS in 25 - 30% of people with low iron levels.
  • Restless legs syndrome and related disorders: the causes, diagnosis, treatment, ... 18 January 2010 0:19 UTC www.henryfordhealth.org [Source type: Academic]
  • Restless legs syndrome and related disorders 9 February 2010 16:32 UTC adam.about.com [Source type: Academic]

^ People who are iron deficient might try oral iron supplements.
  • Leg Disorders (Restless Legs Syndrome and Nocturnal Leg Cramps) 18 January 2010 0:19 UTC www.preventdisease.com [Source type: Academic]

^ People with RLS should have a test for iron deficiency.
  • Restless legs syndrome and related disorders: the causes, diagnosis, treatment, ... 18 January 2010 0:19 UTC www.henryfordhealth.org [Source type: Academic]
  • Restless legs syndrome and related disorders 9 February 2010 16:32 UTC adam.about.com [Source type: Academic]

.For some people, increasing ferritin will eliminate or reduce RLS symptoms.^ Dopaminergic agonists -- reduce RLS symptoms 2.
  • Restless Legs Syndrome -Allmemoryfoam.com - Articles on the Importance of Sleep 9 February 2010 16:32 UTC www.allmemoryfoam.com [Source type: FILTERED WITH BAYES]

^ This may be the first symptom of RLS in some people.
  • Restless legs syndrome and related disorders - Introduction 18 January 2010 0:19 UTC www.umm.edu [Source type: Academic]
  • Restless legs syndrome and related disorders: the causes, diagnosis, treatment, ... 18 January 2010 0:19 UTC www.henryfordhealth.org [Source type: Academic]
  • Restless legs syndrome and related disorders 9 February 2010 16:32 UTC adam.about.com [Source type: Academic]
  • Restless Leg Syndrome Background - Restless Leg Syndrome Health Information - NY Times Health 9 February 2010 16:32 UTC health.nytimes.com [Source type: FILTERED WITH BAYES]

^ Dopaminergic agents -- reduce RLS symptoms 3.
  • Restless Legs Syndrome -Allmemoryfoam.com - Articles on the Importance of Sleep 9 February 2010 16:32 UTC www.allmemoryfoam.com [Source type: FILTERED WITH BAYES]

.A ferritin level of 50 µg is not sufficient for some sufferers and increasing the level to 80 µg may greatly reduce symptoms.^ Some patients report that symptoms don't occur if they sleep late in the morning, so, if feasible, changing sleep patterns may be helpful.
  • Leg Disorders (Restless Legs Syndrome and Nocturnal Leg Cramps) 18 January 2010 0:19 UTC www.preventdisease.com [Source type: Academic]

^ Toxic blood levels of some drugs, such as theophylline, lidocaine, Indocin, meperidine, penicillins, and cimetidine, may cause generalized seizures.
  • Causes of Restless Legs Syndrome - WrongDiagnosis.com 18 January 2010 0:19 UTC www.wrongdiagnosis.com [Source type: Academic]

^ If the infection spreads to the nervous system, meningitis may develop; signs and symptoms include fever, headache, nuchal rigidity, and change in level of consciousness (LOC).
  • Causes of Restless Legs Syndrome - WrongDiagnosis.com 18 January 2010 0:19 UTC www.wrongdiagnosis.com [Source type: Academic]

.However, at least 40% of people will not notice any improvement.^ However, at least 40% of people will not notice any improvement.
  • Restless Legs Syndrome 18 January 2010 0:19 UTC flowcushion.com [Source type: FILTERED WITH BAYES]
  • Restless legs syndrome - Psychology Wiki 9 February 2010 16:32 UTC psychology.wikia.com [Source type: Academic]

^ In the elderly, however, this condition is extremely common; more than 40% have at least five leg kicks per hour of sleep.
  • Restless Leg Syndrome : BartterSite.org 18 January 2010 0:19 UTC barttersite.org [Source type: Academic]

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.^ He indicated that RLS is associated with low iron.
  • Cure Restless Leg Syndrome with Remedies from Earth Clinic. 18 January 2010 0:19 UTC www.earthclinic.com [Source type: General]

^ Some studies have reported RLS in 25 - 30% of people with low iron levels.
  • Restless legs syndrome and related disorders: the causes, diagnosis, treatment, ... 18 January 2010 0:19 UTC www.henryfordhealth.org [Source type: Academic]
  • Restless legs syndrome and related disorders 9 February 2010 16:32 UTC adam.about.com [Source type: Academic]

^ Ferritin levels are low.
  • Restless legs syndrome and related disorders: the causes, diagnosis, treatment, ... 18 January 2010 0:19 UTC www.henryfordhealth.org [Source type: Academic]
  • Restless legs syndrome and related disorders 9 February 2010 16:32 UTC adam.about.com [Source type: Academic]

[43]

Pharmaceuticals

.For those whose RLS disrupts or prevents sleep or regular daily activities, medication may be required.^ "The direct data would suggest that the disrupted sleep and arousals that occur with RLS are really what's contributing to hypertension and heightened autonomic nervous system activity, which in turns leads to cardiovascular [problems]," says Dr. Rye.
  • Restless Legs Syndrome and Heart Disease Linked: UT Southwestern Medical Center at Dallas 9 February 2010 16:32 UTC www.utsouthwestern.edu [Source type: Academic]
  • Restless Legs Syndrome and Heart Disease Linked: UT Southwestern Medical Center at Dallas 9 February 2010 16:32 UTC www.utsouthwestern.edu [Source type: Academic]

^ REM-sleep brain activity is comparable to that in waking, but the muscles are virtually paralyzed, possibly preventing people from acting out their dreams.
  • Leg Disorders (Restless Legs Syndrome and Nocturnal Leg Cramps) 18 January 2010 0:19 UTC www.preventdisease.com [Source type: Academic]

^ Medicines may be tried when symptoms are severe and interfere with sleep and daily functioning.
  • Exempla Healthcare Online Library 9 February 2010 16:32 UTC www.exempla.org [Source type: FILTERED WITH BAYES]

Many doctors currently use, and the Mayo Clinic algorithm includes,[38] medication from four categories:
.
  1. Dopamine agonists such as ropinirole, pramipexole, carbidopa/levodopa or pergolide.^ Dopamine agonists can be ergot-derived (such as cabergoline) or non-ergot derived (such as pramipexole and ropinirole).
    • Restless legs syndrome and related disorders: the causes, diagnosis, treatment, ... 18 January 2010 0:19 UTC www.henryfordhealth.org [Source type: Academic]
    • Restless legs syndrome and related disorders 9 February 2010 16:32 UTC adam.about.com [Source type: Academic]

    ^ Ropinirole (Requip) is a non-ergotamine dopamine agonist.
    • Restless legs syndrome and related disorders: the causes, diagnosis, treatment, ... 18 January 2010 0:19 UTC www.henryfordhealth.org [Source type: Academic]

    ^ Nonpharmacologic therapy should be suggested for all patients with RLS, but pharmacologic therapy may be required, and evidence is strongest for levodopa and dopamine agonists.
    • Restless Legs Syndrome: Editor's Note 18 January 2010 0:19 UTC www.medscape.com [Source type: Academic]

    .Ropinirole (Requip) was first approved In 2005 by the US Food and Drug Administration (FDA) to treat moderate to severe Restless Legs Syndrome.^ Restless legs syndrome and related disorders .
    • Restless legs syndrome and related disorders: the causes, diagnosis, treatment, ... 18 January 2010 0:19 UTC www.henryfordhealth.org [Source type: Academic]
    • Restless legs syndrome and related disorders 9 February 2010 16:32 UTC adam.about.com [Source type: Academic]

    ^ Severe restless legs syndrome.
    • Leg Disorders (Restless Legs Syndrome and Nocturnal Leg Cramps) 18 January 2010 0:19 UTC www.preventdisease.com [Source type: Academic]

    ^ There are several theories about the cause of restless legs syndrome.
    • RLS WTF | GonZoville.com 9 February 2010 16:32 UTC www.gonzoville.com [Source type: Original source]

    .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 for early stage Parkinson's disease; it is not yet approved for RLS in the US. The Neupro patch has been withdrawn from the US market due to problems with the medication delivery system.^ Rotigotine is a unique dopamine agonist that is being developed in patch form for RLS. In May 2007, the FDA approved this patch for treatment of early Parkinson's disease.
    • Restless legs syndrome and related disorders: the causes, diagnosis, treatment, ... 18 January 2010 0:19 UTC www.henryfordhealth.org [Source type: Academic]

    ^ The condition also occurs when drugs to treat Parkinson's disease are withdrawn.
    • Restless legs syndrome and related disorders: the causes, diagnosis, treatment, ... 18 January 2010 0:19 UTC www.henryfordhealth.org [Source type: Academic]

    ^ The Food and Drug Administration (FDA) approved pramipexole (Mirapex) for use in moderate-to-severe RLS in November 2006.
    • Restless legs syndrome and related disorders: the causes, diagnosis, treatment, ... 18 January 2010 0:19 UTC www.henryfordhealth.org [Source type: Academic]

    .Rotigotine (Neupro), was approved for sale in the EU in 2007 for not only advanced stage Parkinson's disease but also for RLS. There are some issues with the use of dopamine agonists.^ Dopamine receptor agonists in the therapy of Parkinson's disease.
    • Restless Legs Syndrome: Editor's Note 18 January 2010 0:19 UTC www.medscape.com [Source type: Academic]

    ^ Rotigotine is a unique dopamine agonist that is being developed in patch form for RLS. In May 2007, the FDA approved this patch for treatment of early Parkinson's disease.
    • Restless legs syndrome and related disorders: the causes, diagnosis, treatment, ... 18 January 2010 0:19 UTC www.henryfordhealth.org [Source type: Academic]

    ^ Scheller DA Extended receptor profile of rotigotine, a nonergolinic dopamine agonist for the treatment of Parkinson's disease.
    • Restless Legs Syndrome -- Ryan and Slevin 20 (6): 430 -- Journal of Pharmacy Practice 18 January 2010 0:19 UTC jpp.sagepub.com [Source type: Academic]

    .Dopamine agonists may cause augmentation.^ About 30% of patients who take dopamine receptor agonists have reported augmentations symptoms.
    • Restless legs syndrome and related disorders: the causes, diagnosis, treatment, ... 18 January 2010 0:19 UTC www.henryfordhealth.org [Source type: Academic]
    • Restless legs syndrome and related disorders 9 February 2010 16:32 UTC adam.about.com [Source type: Academic]

    ^ If this treatment is not effective, the doctor may prescribe drugs—such as levodopa or dopamine agonists—that help increase a chemical in the brain called dopamine .
    • Exempla Healthcare Online Library 9 February 2010 16:32 UTC www.exempla.org [Source type: FILTERED WITH BAYES]

    ^ Rotigotine is a unique dopamine agonist that is being developed in patch form for RLS. In May 2007, the FDA approved this patch for treatment of early Parkinson's disease.
    • Restless legs syndrome and related disorders: the causes, diagnosis, treatment, ... 18 January 2010 0:19 UTC www.henryfordhealth.org [Source type: Academic]

    .This is a medical condition where the drug itself causes symptoms to increase in severity and/or occur earlier in the day.^ Augmentation of symptoms can occur (usually symptoms occurring earlier in the day).
    • Restless Legs Syndrome | Doctor | Patient UK 9 February 2010 16:32 UTC www.patient.co.uk [Source type: FILTERED WITH BAYES]

    ^ This is a medical condition where the drug itself causes symptoms to increase in severity and/or occur earlier in the day.
    • Restless legs syndrome - Psychology Wiki 9 February 2010 16:32 UTC psychology.wikia.com [Source type: Academic]

    ^ A related phenomenon, augmentation, involves an increase in symptom intensity, earlier daily onset of symptoms, decrease in medication efficacy, or expansion of symptoms to other parts of the body.

    .Dopamine agonists may also cause rebound, when symptoms increase as the drug wears off.^ Also, your doctor may prescribe sedative-hypnotics (including benzodiazepines and the newer non-benzodiazepine drugs like zolpidem [Ambien], zaleplon [Sonata], and eszopiclone [Lunesta]), alone or together with dopamine agonists, opioids, or anticonvulsants.
    • Exempla Healthcare Online Library 9 February 2010 16:32 UTC www.exempla.org [Source type: FILTERED WITH BAYES]

    ^ Adding a drug called entacapone (Comtan) may prolong the duration of action of carbidopa-levodopa therapy (Sinemet), but it can cause nausea.
    • Restless legs syndrome and related disorders: the causes, diagnosis, treatment, ... 18 January 2010 0:19 UTC www.henryfordhealth.org [Source type: Academic]
    • Restless legs syndrome and related disorders 9 February 2010 16:32 UTC adam.about.com [Source type: Academic]

    ^ Dopaminergic drugs (drugs that increase levels of dopamine) are the standard medicines for treating severe RLS, PLMD, or both.
    • Restless legs syndrome and related disorders: the causes, diagnosis, treatment, ... 18 January 2010 0:19 UTC www.henryfordhealth.org [Source type: Academic]
    • Restless legs syndrome and related disorders 9 February 2010 16:32 UTC adam.about.com [Source type: Academic]

    .Also, a recent study indicated that dopamine agonists used in restless leg patients can lead to an increase in compulsive gambling.^ Effect of nonergot dopamine agonists on symptoms of restless legs syndrome.
    • Restless legs syndrome: Diagnostic time-savers, Tx tips — The Journal of Family Practice 9 February 2010 16:32 UTC www.jfponline.com [Source type: Academic]

    ^ Dopamine agonists for the treatment of restless legs syndrome.
    • Restless legs syndrome: Diagnostic time-savers, Tx tips — The Journal of Family Practice 9 February 2010 16:32 UTC www.jfponline.com [Source type: Academic]

    ^ The first step in treating a patient who complains of sleeplessness and restless legs syndrome is to try to improve sleep and eliminate possible causes of restless legs syndrome (RLS).
    • Restless legs syndrome and related disorders 9 February 2010 16:32 UTC adam.about.com [Source type: Academic]

    [44]
  2. .
  3. Opioids are sometimes used when restless legs syndrome occurs with neuropathic pain or when other treatments fail to provide relief.^ Restless legs syndrome and related disorders .
    • Restless legs syndrome and related disorders: the causes, diagnosis, treatment, ... 18 January 2010 0:19 UTC www.henryfordhealth.org [Source type: Academic]
    • Restless legs syndrome and related disorders 9 February 2010 16:32 UTC adam.about.com [Source type: Academic]

    ^ The treatment of the restless legs syndrome with clonazepam: a prospective controlled study.
    • Restless Legs Syndrome: Editor's Note 18 January 2010 0:19 UTC www.medscape.com [Source type: Academic]

    ^ Learning about restless legs syndrome: .
    • Exempla Healthcare Online Library 9 February 2010 16:32 UTC www.exempla.org [Source type: FILTERED WITH BAYES]

    [45]
  4. .
  5. Benzodiazepines, such as diazepam, which often in addition to symptom relief assist in staying asleep and reducing awakenings from the movements
  6. Anticonvulsants, such as carbamazepine, help people who experience the RLS sensations as painful.^ Patients with RLS often describe the urge to move, uncomfortable sensations, and pain, which begin or worsen during rest or inactivity such as lying or sitting.
    • Restless Legs Syndrome: Editor's Note 18 January 2010 0:19 UTC www.medscape.com [Source type: Academic]

    ^ The main symptom of restless legs syndrome (RLS) is an irresistible urge to move your legs because of uncomfortable and sometimes painful sensations deep within your legs.
    • Exempla Healthcare Online Library 9 February 2010 16:32 UTC www.exempla.org [Source type: FILTERED WITH BAYES]

    ^ After they are asleep, most people with RLS also have involuntary or jerking leg movements called periodic limb movements .
    • Exempla Healthcare Online Library 9 February 2010 16:32 UTC www.exempla.org [Source type: FILTERED WITH BAYES]

    [46]
.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.^ "With the approval of Requip for moderate-to-severe primary RLS, we're proud to be able to offer effective relief to millions of people who live with this condition, many of whom have suffered for years without treatment."
  • Restless Leg Syndrome drug, REQUIP, approved by FDA 9 February 2010 16:32 UTC www.medicalnewstoday.com [Source type: Academic]

^ It is not addictive and does not have the severe side effects of other RLS drugs, but more research is needed to determine its usefulness.
  • Restless legs syndrome and related disorders: the causes, diagnosis, treatment, ... 18 January 2010 0:19 UTC www.henryfordhealth.org [Source type: Academic]

^ But please don’t think that just cause the drug companies are ‘touting’ a disease you haven’t heard of it makes that disease any less real or debilitating.
  • RLS WTF | GonZoville.com 9 February 2010 16:32 UTC www.gonzoville.com [Source type: Original source]

The Restless Legs Syndrome Foundation[47] received 44% of its $1.4 million in funding from these pharmaceutical groups[48]

Ropinirole vs. Pramipexole

.A meta-analysis published November 2007 combined previous 6-12 week long placebo-controlled studies done for ropinirole and pramipexole to indirectly compare adverse reactions and efficacy.^ TREAT RLS 2: a 12-week, double-blind, randomized, parallel-group, placebo-controlled study.
  • Restless Legs Syndrome: Editor's Note 18 January 2010 0:19 UTC www.medscape.com [Source type: Academic]
  • Restless Legs Syndrome -- Ryan and Slevin 20 (6): 430 -- Journal of Pharmacy Practice 18 January 2010 0:19 UTC jpp.sagepub.com [Source type: Academic]

^ Ropinirole in the treatment of restless legs syndrome: results from the TREAT RLS 1 study, a 12 week, randomised, placebo controlled study in 10 European countries.
  • Restless Legs Syndrome: Editor's Note 18 January 2010 0:19 UTC www.medscape.com [Source type: Academic]
  • Restless Legs Syndrome -- Ryan and Slevin 20 (6): 430 -- Journal of Pharmacy Practice 18 January 2010 0:19 UTC jpp.sagepub.com [Source type: Academic]

^ Ropinirole for restless legs syndrome: a placebo-controlled crossover trial.
  • Restless Legs Syndrome: Editor's Note 18 January 2010 0:19 UTC www.medscape.com [Source type: Academic]
  • Restless Legs Syndrome -- Ryan and Slevin 20 (6): 430 -- Journal of Pharmacy Practice 18 January 2010 0:19 UTC jpp.sagepub.com [Source type: Academic]

.It found that while both drugs had the same efficacy, pramipexole had significantly lower incidences of nausea, vomiting and dizziness.^ Associated findings include dyspnea, nausea, vomiting, tachycardia, dizziness, diaphoresis, belching, and palpitations.
  • Causes of Restless Legs Syndrome - WrongDiagnosis.com 18 January 2010 0:19 UTC www.wrongdiagnosis.com [Source type: Academic]

^ It may be accompanied by dyspnea, nausea, vomiting, dizziness, and palpitations.
  • Causes of Restless Legs Syndrome - WrongDiagnosis.com 18 January 2010 0:19 UTC www.wrongdiagnosis.com [Source type: Academic]

^ Other signs and symptoms include shortness of breath, nausea and vomiting, tachycardia, dizziness, diaphoresis, belching, and palpitations.
  • Causes of Restless Legs Syndrome - WrongDiagnosis.com 18 January 2010 0:19 UTC www.wrongdiagnosis.com [Source type: Academic]

.This led the authors to conclude "differences in efficacy and tolerability favouring pramipexole over ropinirole can be observed."^ These problems have not been reported with ropinirole or pramipexole, which are chemically different then pergolide.
  • Restless legs syndrome and related disorders: the causes, diagnosis, treatment, ... 18 January 2010 0:19 UTC www.henryfordhealth.org [Source type: Academic]

[49]

The non drug musculoskeletal approach

.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 appears to produce relief of symptoms in 80–90% of patients.^ The longer a patient uses these drugs, the worse their withdrawal symptoms.
  • Restless legs syndrome and related disorders: the causes, diagnosis, treatment, ... 18 January 2010 0:19 UTC www.henryfordhealth.org [Source type: Academic]
  • Restless legs syndrome and related disorders 9 February 2010 16:32 UTC adam.about.com [Source type: Academic]

^ A small percentage of patients may develop encephalitis or hemorrhagic fever leading to shock and hemorrhage.
  • Causes of Restless Legs Syndrome - WrongDiagnosis.com 18 January 2010 0:19 UTC www.wrongdiagnosis.com [Source type: Academic]

^ In 30% of patients, skin lesions develop 4 to 6 weeks after onset of other symptoms and may last for several weeks.
  • Causes of Restless Legs Syndrome - WrongDiagnosis.com 18 January 2010 0:19 UTC www.wrongdiagnosis.com [Source type: Academic]

.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 [50].^ Showing improvement when the medicine dopamine is used.
  • Exempla Healthcare Online Library 9 February 2010 16:32 UTC www.exempla.org [Source type: FILTERED WITH BAYES]

^ Patients in the study reported relief or freedom from symptoms after 4 weeks of use.
  • Restless legs syndrome and related disorders: the causes, diagnosis, treatment, ... 18 January 2010 0:19 UTC www.henryfordhealth.org [Source type: Academic]

^ Some patients report relief with the use of the opiate fentanyl (Duragesic), available in skin patch form.
  • Restless legs syndrome and related disorders: the causes, diagnosis, treatment, ... 18 January 2010 0:19 UTC www.henryfordhealth.org [Source type: Academic]
  • Restless legs syndrome and related disorders 9 February 2010 16:32 UTC adam.about.com [Source type: Academic]

.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.^ There is no “cure” for RLS. There are some methods that might help eleviate the symptoms, for some sufferers, but the rls will always be there, it never goes away.
  • RLS WTF | GonZoville.com 9 February 2010 16:32 UTC www.gonzoville.com [Source type: Original source]

^ This depends on: How often the symptoms occur How severe the symptoms are How effective moving around is in relieving the symptoms The degree of sleep disturbance suffered There are two main types of Restless Legs Syndrome .
  • What Is Restless Legs Syndrome? What Causes Restless Legs Syndrome? 9 February 2010 16:32 UTC www.medicalnewstoday.com [Source type: Academic]

^ In fact, a small 2000 study suggested that nearly half of patients may experience RLS-type symptoms in the upper part of the body, specifically the arms.
  • Leg Disorders (Restless Legs Syndrome and Nocturnal Leg Cramps) 18 January 2010 0:19 UTC www.preventdisease.com [Source type: Academic]

.One study has shown that RLS patients have increased rather than the normal decreased spinal cord excitability during sleep[51] and this fits with the osteopathic concept of spinal facilitation postulated by Korr.^ In one 2001 study, patients practiced sleep hygiene and sleep restriction.
  • Leg Disorders (Restless Legs Syndrome and Nocturnal Leg Cramps) 18 January 2010 0:19 UTC www.preventdisease.com [Source type: Academic]

^ Of the anticonvulsants studied in RLS patients, gabapentin has been shown to most effectively decrease symptoms.
  • Restless legs syndrome: Diagnostic time-savers, Tx tips — The Journal of Family Practice 9 February 2010 16:32 UTC www.jfponline.com [Source type: Academic]

^ One study did show an increase in symptoms of sleep apnea in RLS patients treated with opioids.
  • Restless legs syndrome: Diagnostic time-savers, Tx tips — The Journal of Family Practice 9 February 2010 16:32 UTC www.jfponline.com [Source type: Academic]

.Specific types of manipulation appear to reduce this excessive sensory input and relieve symptoms.^ Symptoms appear late in the disease and may also include loss of peripheral vision and reduced visual acuity (especially at night) that isn’t correctable with glasses.
  • Causes of Restless Legs Syndrome - WrongDiagnosis.com 18 January 2010 0:19 UTC www.wrongdiagnosis.com [Source type: Academic]

^ In fact, a small 2000 study suggested that nearly half of patients may experience RLS-type symptoms in the upper part of the body, specifically the arms.
  • Leg Disorders (Restless Legs Syndrome and Nocturnal Leg Cramps) 18 January 2010 0:19 UTC www.preventdisease.com [Source type: Academic]

.This non drug treatment approach is free of the side effects associated with many of the drug treatments outlined above.^ All antiseizure drugs have potentially severe side effects.
  • Restless legs syndrome and related disorders: the causes, diagnosis, treatment, ... 18 January 2010 0:19 UTC www.henryfordhealth.org [Source type: Academic]
  • Restless legs syndrome and related disorders 9 February 2010 16:32 UTC adam.about.com [Source type: Academic]

^ A new gabapentin product is in phase III clinical trials for the treatment of RLS. The new drug, known as XP13512, converts to gabapentin in the intestines, and therefore may reduce some of the side effects experienced by patients taking antiseizure medications.
  • Restless legs syndrome and related disorders: the causes, diagnosis, treatment, ... 18 January 2010 0:19 UTC www.henryfordhealth.org [Source type: Academic]
  • Restless legs syndrome and related disorders 9 February 2010 16:32 UTC adam.about.com [Source type: Academic]

^ Studies are conflicting at this point, but, due to other known side effects of benzodiazepines, pregnant women should not use these drugs, if possible.
  • Restless legs syndrome and related disorders: the causes, diagnosis, treatment, ... 18 January 2010 0:19 UTC www.henryfordhealth.org [Source type: Academic]
  • Restless legs syndrome and related disorders 9 February 2010 16:32 UTC adam.about.com [Source type: Academic]

Prognosis

.RLS is generally a lifelong condition for which there is no cure.^ Like there is no cure for diabetes.
  • Cure Restless Leg Syndrome with Remedies from Earth Clinic. 18 January 2010 0:19 UTC www.earthclinic.com [Source type: General]

^ RLS is a misnomer, as there is no cure.
  • Cure Restless Leg Syndrome with Remedies from Earth Clinic. 18 January 2010 0:19 UTC www.earthclinic.com [Source type: General]

^ I researched RLS only to learn there was no cure or treatment.
  • all natural Night Time Leg Calm for Restless Leg Syndrome and Periodic Limb Movement 9 February 2010 16:32 UTC www.naturesinventory.com [Source type: General]

.Symptoms may gradually worsen with age, though more slowly for those with the idiopathic form of RLS than for patients who also suffer from an associated medical condition.^ Symptoms will gradually worsen over time.
  • What Is Restless Legs Syndrome? What Causes Restless Legs Syndrome? 9 February 2010 16:32 UTC www.medicalnewstoday.com [Source type: Academic]

^ The medicine also may be helpful for patients with RLS who are undergoing dialysis.
  • Restless legs syndrome and related disorders: the causes, diagnosis, treatment, ... 18 January 2010 0:19 UTC www.henryfordhealth.org [Source type: Academic]
  • Restless legs syndrome and related disorders 9 February 2010 16:32 UTC adam.about.com [Source type: Academic]

^ Locations on chromosomes 14 and 9 may also be associated with hereditary forms of RLS. .
  • Restless legs syndrome and related disorders: the causes, diagnosis, treatment, ... 18 January 2010 0:19 UTC www.henryfordhealth.org [Source type: Academic]

.Nevertheless, current therapies can control the disorder, minimizing symptoms and increasing periods of restful sleep.^ Sleep-related movement disorders: Restless legs syndrome and periodic limb movement disorder section of Sleep disorders.
  • Exempla Healthcare Online Library 9 February 2010 16:32 UTC www.exempla.org [Source type: FILTERED WITH BAYES]

^ Clonazepam may be particularly helpful for children with both periodic limb movement disorder and symptoms of attention deficit hyperactivity disorder.
  • Restless legs syndrome and related disorders: the causes, diagnosis, treatment, ... 18 January 2010 0:19 UTC www.henryfordhealth.org [Source type: Academic]
  • Restless legs syndrome and related disorders 9 February 2010 16:32 UTC adam.about.com [Source type: Academic]

^ Cramps that awaken people during sleep are very common, and they are not part of restless legs syndrome or periodic limb movement disorder.
  • Restless legs syndrome and related disorders: the causes, diagnosis, treatment, ... 18 January 2010 0:19 UTC www.henryfordhealth.org [Source type: Academic]
  • Restless legs syndrome and related disorders 9 February 2010 16:32 UTC adam.about.com [Source type: Academic]

.In addition, some patients have remissions, periods in which symptoms decrease or disappear for days, weeks, or months, although symptoms usually eventually reappear.^ In 30% of patients, skin lesions develop 4 to 6 weeks after onset of other symptoms and may last for several weeks.
  • Causes of Restless Legs Syndrome - WrongDiagnosis.com 18 January 2010 0:19 UTC www.wrongdiagnosis.com [Source type: Academic]

^ Some patients have found that hot or cold baths before bed help to relieve symptoms; others report that massaging their legs or stretching leads to an improvement in symptoms.
  • Restless legs syndrome: Diagnostic time-savers, Tx tips — The Journal of Family Practice 9 February 2010 16:32 UTC www.jfponline.com [Source type: Academic]

^ Every day for 2 weeks, the patient should record all sleep-related information, including responses to questions listed above described on a daily basis.
  • Restless legs syndrome and related disorders: the causes, diagnosis, treatment, ... 18 January 2010 0:19 UTC www.henryfordhealth.org [Source type: Academic]

.A diagnosis of RLS does not indicate the onset of another neurological disease.^ However, Parkinson's disease itself does not seem to increase the risk for RLS. Nor does RLS early in life predispose a person to Parkinson's later on.
  • Restless legs syndrome and related disorders 9 February 2010 16:32 UTC adam.about.com [Source type: Academic]

^ However, Parkinson's disease itself does not seem to increase the risk for RLS. Nor does RLS early in life predispose to Parkinson's later on.
  • Restless legs syndrome and related disorders: the causes, diagnosis, treatment, ... 18 January 2010 0:19 UTC www.henryfordhealth.org [Source type: Academic]

Epidemiology

.Claims about the prevalence of restless legs syndrome can be confusing because its severity and frequency varies enormously between individual sufferers.^ Restless legs syndrome and related disorders .
  • Restless legs syndrome and related disorders: the causes, diagnosis, treatment, ... 18 January 2010 0:19 UTC www.henryfordhealth.org [Source type: Academic]
  • Restless legs syndrome and related disorders 9 February 2010 16:32 UTC adam.about.com [Source type: Academic]

^ Learning about restless legs syndrome: .
  • Exempla Healthcare Online Library 9 February 2010 16:32 UTC www.exempla.org [Source type: FILTERED WITH BAYES]

^ What causes restless legs syndrome?
  • Exempla Healthcare Online Library 9 February 2010 16:32 UTC www.exempla.org [Source type: FILTERED WITH BAYES]

.RLS affects an estimated 7% to 10% of the general population in North America and Europe.^ Restless legs syndrome (RLS) is an unsettling and poorly understood movement disorder affecting 3 - 15% of the general population.
  • Restless legs syndrome and related disorders 9 February 2010 16:32 UTC adam.about.com [Source type: Academic]

^ Restless legs syndrome (RLS) is a poorly understood movement disorder affecting 3 - 15% of the general population.
  • Restless legs syndrome and related disorders 9 February 2010 16:32 UTC adam.about.com [Source type: Academic]

^ The disorder affects an estimated 10 - 28% of adults older than age 65.
  • Restless legs syndrome and related disorders: the causes, diagnosis, treatment, ... 18 January 2010 0:19 UTC www.henryfordhealth.org [Source type: Academic]
  • Restless legs syndrome and related disorders 9 February 2010 16:32 UTC adam.about.com [Source type: Academic]

[52][53][54] .A minority of sufferers (around 2.7% of the population) experience daily or severe symptoms.^ Medicines may be tried when symptoms are severe and interfere with sleep and daily functioning.
  • Exempla Healthcare Online Library 9 February 2010 16:32 UTC www.exempla.org [Source type: FILTERED WITH BAYES]

^ Patients who withdraw from these drugs typically experience very severe RLS symptoms for the first 2 days after stopping.
  • Restless legs syndrome and related disorders: the causes, diagnosis, treatment, ... 18 January 2010 0:19 UTC www.henryfordhealth.org [Source type: Academic]

^ After age 50, many people with this condition have daily symptoms and suffer from significant sleep loss.
  • Exempla Healthcare Online Library 9 February 2010 16:32 UTC www.exempla.org [Source type: FILTERED WITH BAYES]

[53] .RLS is twice as common in women as in men,[55] and whites are more prone to RLS than African Americans.^ It is more common in women than in men, and its frequency increases with age.
  • Restless legs syndrome and related disorders: the causes, diagnosis, treatment, ... 18 January 2010 0:19 UTC www.henryfordhealth.org [Source type: Academic]
  • Restless legs syndrome and related disorders 9 February 2010 16:32 UTC adam.about.com [Source type: Academic]

^ More than 70% of affected children in one study had at least one biological parent with RLS. .
  • Restless legs syndrome and related disorders: the causes, diagnosis, treatment, ... 18 January 2010 0:19 UTC www.henryfordhealth.org [Source type: Academic]

^ This disorder is most common in middle and later life, affecting more women than men.
  • Causes of Restless Legs Syndrome - WrongDiagnosis.com 18 January 2010 0:19 UTC www.wrongdiagnosis.com [Source type: Academic]

[52] .RLS occurs in 3% of individuals from the Mediterranean or Middle Eastern region, and in 1-5% of those from the Far East, indicating that different genetic or environmental factors, including diet, may play a role in the prevalence of this syndrome.^ Genetic factors may be a factor in dopamine imbalance.
  • Leg Disorders (Restless Legs Syndrome and Nocturnal Leg Cramps) 18 January 2010 0:19 UTC www.preventdisease.com [Source type: Academic]

^ RLS-type symptoms may also occur in the arms.
  • Restless legs syndrome and related disorders: the causes, diagnosis, treatment, ... 18 January 2010 0:19 UTC www.henryfordhealth.org [Source type: Academic]
  • Restless legs syndrome and related disorders 9 February 2010 16:32 UTC adam.about.com [Source type: Academic]

^ Other studies have also found an association and some suggest that RLS may occur in between 25% and 30% of people with iron deficiencies.
  • Leg Disorders (Restless Legs Syndrome and Nocturnal Leg Cramps) 18 January 2010 0:19 UTC www.preventdisease.com [Source type: Academic]

[52][56] .With age, RLS becomes more common, and RLS diagnosed at an older age runs a more severe course.^ They are particularly common in adolescence, during pregnancy, and in older age, affecting up to 70% of adults over age 50 at some point.
  • Restless legs syndrome and related disorders: the causes, diagnosis, treatment, ... 18 January 2010 0:19 UTC www.henryfordhealth.org [Source type: Academic]
  • Restless legs syndrome and related disorders 9 February 2010 16:32 UTC adam.about.com [Source type: Academic]

^ The drug is not addictive and does not have the severe side effects of other RLS drugs, but more research is needed to determine if it is useful.
  • Restless legs syndrome and related disorders: the causes, diagnosis, treatment, ... 18 January 2010 0:19 UTC www.henryfordhealth.org [Source type: Academic]
  • Restless legs syndrome and related disorders 9 February 2010 16:32 UTC adam.about.com [Source type: Academic]

^ It is more common in women than in men, and its frequency increases with age.
  • Restless legs syndrome and related disorders: the causes, diagnosis, treatment, ... 18 January 2010 0:19 UTC www.henryfordhealth.org [Source type: Academic]
  • Restless legs syndrome and related disorders 9 February 2010 16:32 UTC adam.about.com [Source type: Academic]

[57]
.RLS is even more common in individuals with iron deficiency, pregnancy and end-stage renal disease.^ Of individuals with conditions associated with iron-deficiency states, including pregnancy, renal failure, and anemia, 25-30% may develop RLS. The goals of RLS treatment include improving its symptoms and the patient's quality of life.
  • Restless Legs Syndrome: Editor's Note 18 January 2010 0:19 UTC www.medscape.com [Source type: Academic]

^ In one 2001 study, RLS in this population was strongly associated with folate deficiencies (which in turn reduce iron levels).
  • Leg Disorders (Restless Legs Syndrome and Nocturnal Leg Cramps) 18 January 2010 0:19 UTC www.preventdisease.com [Source type: Academic]

^ Iron deficiency, even at a level too mild to cause anemia, has been linked to restless legs syndrome (RLS) in some people.
  • Restless legs syndrome and related disorders: the causes, diagnosis, treatment, ... 18 January 2010 0:19 UTC www.henryfordhealth.org [Source type: Academic]
  • Restless legs syndrome and related disorders 9 February 2010 16:32 UTC adam.about.com [Source type: Academic]

[58][59] .Neurologic conditions linked to RLS include Parkinson disease, spinal cerebellar atrophy, spinal stenosis, lumbosacral radiculopathy and Charcot-Marie-Tooth disease type 2.[52] Approximately 80–90% of people with RLS also have periodic limb movement disorder (PLMD), which causes slow "jerks" or flexions of the affected body part.^ After they are asleep, most people with RLS also have involuntary or jerking leg movements called periodic limb movements .
  • Exempla Healthcare Online Library 9 February 2010 16:32 UTC www.exempla.org [Source type: FILTERED WITH BAYES]

^ The medical term for periodic limb movement disorder (PLMD) is nocturnal myoclonus.
  • Restless legs syndrome and related disorders 9 February 2010 16:32 UTC adam.about.com [Source type: Academic]

^ RLS is considered a neurological disorder and can also be genetic.

.These occur during sleep (PLMS = periodic limb movement while sleeping) or while awake (PLMW—periodic limb movement while waking).^ Periodic Limb Movement of Sleep (PLMS or PLM) is a similar condition, but occurs during sleep.
  • LegCalm (UK/EU). Natural Remedies for Restless Leg Syndrome & Periodic Limb Movement Disorder 18 January 2010 0:19 UTC www.enaturalremedies.co.uk [Source type: FILTERED WITH BAYES]

^ These movements are called periodic limb movements.
  • Exempla Healthcare Online Library 9 February 2010 16:32 UTC www.exempla.org [Source type: FILTERED WITH BAYES]

^ (Over 500 movements during a 5.5 hour sleep study).
  • all natural Night Time Leg Calm for Restless Leg Syndrome and Periodic Limb Movement 9 February 2010 16:32 UTC www.naturesinventory.com [Source type: General]

.The National Sleep Foundation's 1998 Sleep in America poll showed that up to 25 percent of pregnant women developed RLS during the third trimester.^ The National Sleep Foundation, an independent nonprofit organization, can provide you with brochures on sleep disorders and a list of accredited sleep disorder clinics.
  • Exempla Healthcare Online Library 9 February 2010 16:32 UTC www.exempla.org [Source type: FILTERED WITH BAYES]

^ Pregnant women develop it during pregnancy (some of them do not all), and then it goes away for some.
  • RLS WTF | GonZoville.com 9 February 2010 16:32 UTC www.gonzoville.com [Source type: Original source]

^ For example, pregnant women may have high ferritin levels even in their third trimester, yet still be iron deficient.
  • Restless legs syndrome and related disorders: the causes, diagnosis, treatment, ... 18 January 2010 0:19 UTC www.henryfordhealth.org [Source type: Academic]

[60]

History

Earlier studies were done by Thomas Willis (1622–1675) and by Theodor Wittmaack.[61] Another early description of the ailment and its symptoms were made by George Miller Beard (1839–1883).[61] .In a 1945 publication titled 'Restless Legs', Swedish neurologist Karl-Axel Ekbom (1907–1977)[61] described the disease and presented eight cases used for his studies.^ Ekbom K. Restless legs: a clinical study.
  • Restless Legs Syndrome -- Ryan and Slevin 20 (6): 430 -- Journal of Pharmacy Practice 18 January 2010 0:19 UTC jpp.sagepub.com [Source type: Academic]

^ Use to suffer nightly restless legs, now I may get them once a week, and once the oil is applied they restlessness is gone almost immediately.
  • all natural Night Time Leg Calm for Restless Leg Syndrome and Periodic Limb Movement 9 February 2010 16:32 UTC www.naturesinventory.com [Source type: General]

^ Thorp ML, Morris CD, Bagby SP A crossover study of gabapentin in treatment of restless legs syndrome among hemodialysis patients.
  • Restless Legs Syndrome -- Ryan and Slevin 20 (6): 430 -- Journal of Pharmacy Practice 18 January 2010 0:19 UTC jpp.sagepub.com [Source type: Academic]

[62]

Controversy

.As with many diseases with diffuse symptoms, there is controversy among physicians as to whether RLS is a distinct syndrome.^ Symptoms of RLS make sleeping difficult for many patients, and significant daytime difficulties result from the condition.
  • Restless Legs Syndrome: Editor's Note 18 January 2010 0:19 UTC www.medscape.com [Source type: Academic]

^ The main symptom of restless legs syndrome (RLS) is an irresistible urge to move your legs because of uncomfortable and sometimes painful sensations deep within your legs.
  • Exempla Healthcare Online Library 9 February 2010 16:32 UTC www.exempla.org [Source type: FILTERED WITH BAYES]

^ Purpose: The signs and symptoms, epidemiology, etiology, pathophysiology, diagnosis, pharmacologic and nonpharmacologic treatments, and options and guidelines for the treatment of restless legs syndrome (RLS) are reviewed.
  • Restless Legs Syndrome: Editor's Note 18 January 2010 0:19 UTC www.medscape.com [Source type: Academic]

.The U.S. National Institute of Neurological Disorders and Stroke publishes an information sheet[63] characterizing the syndrome but acknowledging it as a difficult diagnosis.^ American Academy of Sleep Medicine www.sleepfoundation.org -- National Sleep Foundation www.ninds.nih.gov -- National Institute of Neurological Disorders and Stroke www.nhlbi.nih.gov/about/ncsdr/ -- National Center on Sleep Disorders Research www.rls.org -- Restless Legs Syndrome Foundation www.wemove.org -- Worldwide Education and Awareness for Movement Disorders .
  • Restless legs syndrome and related disorders 9 February 2010 16:32 UTC adam.about.com [Source type: Academic]

^ Some research suggests that neurologic abnormalities involved with restless legs syndrome (RLS) and periodic limb movement disorder (PLMD) start in the brain.
  • Restless legs syndrome and related disorders: the causes, diagnosis, treatment, ... 18 January 2010 0:19 UTC www.henryfordhealth.org [Source type: Academic]

^ A half century later, the International RLS Study Group (IRLSSG) published a set of criteria to allow for a more uniform diagnosis that was recently revised and expanded (Appendix A) at an IRLSSG/National Institutes of Health workshop (Workshop).
  • Restless Legs Syndrome: Editor's Note 18 January 2010 0:19 UTC www.medscape.com [Source type: Academic]

.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 response that could be caused by any number of physical or emotional factors[citation needed].^ In some cases, these conditions may contribute to RLS, or they may have a common cause.
  • Restless legs syndrome and related disorders: the causes, diagnosis, treatment, ... 18 January 2010 0:19 UTC www.henryfordhealth.org [Source type: Academic]
  • Restless legs syndrome and related disorders 9 February 2010 16:32 UTC adam.about.com [Source type: Academic]

^ Impaired communication between the damaged nerves of the sympathetic nervous system and the brain may cause interference with normal signals for sensations, temperature, and blood flow.
  • Causes of Restless Legs Syndrome - WrongDiagnosis.com 18 January 2010 0:19 UTC www.wrongdiagnosis.com [Source type: Academic]

^ Every day for 2 weeks, the patient should record all sleep-related information, including responses to questions listed above described on a daily basis.
  • Restless legs syndrome and related disorders: the causes, diagnosis, treatment, ... 18 January 2010 0:19 UTC www.henryfordhealth.org [Source type: Academic]
  • Restless legs syndrome and related disorders 9 February 2010 16:32 UTC adam.about.com [Source type: Academic]

Other physicians consider it a real entity that has specific diagnostic criteria.[64]
.However, RLS and delusional parasitosis are entirely different conditions that share part of the Wittmaack-Ekbom syndrome eponym, as both syndromes were described by the same person, Karl-Axel Ekbom.^ Certain laboratory tests may be helpful in determining causes of restless legs syndrome (RLS) or conditions that rule it out.
  • Restless legs syndrome and related disorders: the causes, diagnosis, treatment, ... 18 January 2010 0:19 UTC www.henryfordhealth.org [Source type: Academic]
  • Restless legs syndrome and related disorders 9 February 2010 16:32 UTC adam.about.com [Source type: Academic]

^ In 1945, the syndrome was more completely characterized by Ekbom [2] who, in a presentation of 53 cases, described its classic clinical features and also offered treatments.
  • Restless Legs Syndrome: Editor's Note 18 January 2010 0:19 UTC www.medscape.com [Source type: Academic]

^ The following medical conditions are also associated with restless legs syndrome (RLS), although the relationships are not clear.
  • Restless legs syndrome and related disorders: the causes, diagnosis, treatment, ... 18 January 2010 0:19 UTC www.henryfordhealth.org [Source type: Academic]

[61]
.Many doctors express the view that the incidence of restless leg syndrome is exaggerated by manufacturers of drugs used to treat it.^ Restless legs syndrome and related disorders .
  • Restless legs syndrome and related disorders 9 February 2010 16:32 UTC adam.about.com [Source type: Academic]

^ Learning about restless legs syndrome: .
  • Exempla Healthcare Online Library 9 February 2010 16:32 UTC www.exempla.org [Source type: FILTERED WITH BAYES]

^ What causes restless legs syndrome?
  • Exempla Healthcare Online Library 9 February 2010 16:32 UTC www.exempla.org [Source type: FILTERED WITH BAYES]

[65] Others believe it is an underrecognized and undertreated disorder.[52] .Some of the controversy results from the fact that certain pharmaceutical companies used medical representatives (i.e., salespeople) to perform investigations into the treatment of RLS, even though those companies had no licensed treatments for the condition.^ The company www.123minerals.com however, uses a process that breaks down magnesium into a highly absorbable form to enter these narrow channels.

^ Maybe you just think you do thanks to the advertising savvy of pharmaceutical companies who make millions exaggerating this rare condition.

^ There was also no recurrence that night or over the next few days, even though there were times when she would have expected it to happen (when she was tired late at night, for example).

.Further, GlaxoSmithKline ran advertisements that, whilst not promoting off-license use of their drug (ropinirole) for treatment of RLS, did link to the Eckbom Support Group website.^ The drug is not addictive and does not have the severe side effects of other RLS drugs, but more research is needed to determine if it is useful.
  • Restless legs syndrome and related disorders: the causes, diagnosis, treatment, ... 18 January 2010 0:19 UTC www.henryfordhealth.org [Source type: Academic]
  • Restless legs syndrome and related disorders 9 February 2010 16:32 UTC adam.about.com [Source type: Academic]

^ To date, pramipexole is the most potent drug yet used for RLS and has resulted in dramatic improvement in symptoms.
  • Leg Disorders (Restless Legs Syndrome and Nocturnal Leg Cramps) 18 January 2010 0:19 UTC www.preventdisease.com [Source type: Academic]

^ Ropinirole in the treatment of restless legs syndrome: results from the TREAT RLS 1 study, a 12 week, randomised, placebo controlled study in 10 European countries.
  • Restless Legs Syndrome -- Ryan and Slevin 20 (6): 430 -- Journal of Pharmacy Practice 18 January 2010 0:19 UTC jpp.sagepub.com [Source type: Academic]

.That website contained statements advocating the use of ropinirole to treat RLS. The ABPI ruled against GSK in this case.^ Ropinirole in the treatment of restless legs syndrome: results from the TREAT RLS 1 study, a 12 week, randomised, placebo controlled study in 10 European countries.
  • Restless Legs Syndrome: Editor's Note 18 January 2010 0:19 UTC www.medscape.com [Source type: Academic]
  • Restless Legs Syndrome -- Ryan and Slevin 20 (6): 430 -- Journal of Pharmacy Practice 18 January 2010 0:19 UTC jpp.sagepub.com [Source type: Academic]

^ The FDA has since banned the marketing of most quinine drugs, cautioning against the off-label (non-approved) use of the drug to treat RLS. Only one form of the drug, Qualaquin, is approved for sale, for the treatment of some types of malaria.
  • Restless legs syndrome and related disorders: the causes, diagnosis, treatment, ... 18 January 2010 0:19 UTC www.henryfordhealth.org [Source type: Academic]
  • Restless legs syndrome and related disorders 9 February 2010 16:32 UTC adam.about.com [Source type: Academic]

^ They are used for treating the unpleasant leg sensations experienced by RLS patients.
  • What Is Restless Legs Syndrome? What Causes Restless Legs Syndrome? 9 February 2010 16:32 UTC www.medicalnewstoday.com [Source type: Academic]

[66]

See also

References

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