Restless legs syndrome (RLS): It occurs mainly during periods of rest (e.g., when the patient is not sleeping). B. at night), sensations and restlessness in the legs with a strong urge to move, often of unclear cause. Affected are 5-10 % of the population, women more often than men. In most cases, the chronic disease begins after the 30. Year of life.
Restless legs syndrome is one of the most common neurological disorders, but until about a decade ago, it was rarely diagnosed and even more rarely treated properly. Nevertheless: Even if the origin of the disease is still unclear, there are now scientifically proven treatment options.
– Hard-to-suppress, deep-seated urge to move the legs, usually coupled with unpleasant sensory disturbances (z. B. Tingling) deep in the legs, usually rising from the lower to the upper thighs – Possibly additionally similar complaints of the arms – Increase of the complaints with rest and relaxation – Improvement of the complaints by movement – Daily rhythm of the complaints with intensification in the evening and at night (especially when going to bed), thus problems falling asleep.
In half of the cases no cause for the disease can be found. Such an idiopathic restless-legs syndrome is presumably hereditary (with several affected family members), whereby a disturbance in the neurotransmitter metabolism of the brain (more exactly in the dopamine metabolism) is suspected. In symptomatic (secondary) restless legs syndrome, on the other hand, a cause can be identified, most frequently an iron, vitamin B12 or folic acid deficiency, a kidney dysfunction or a rheumatic joint disease.
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What the doctor does
The diagnosis of restless legs syndrome is made on the basis of the symptoms. Blood tests should reveal treatable causes, and measuring nerve conduction velocity should rule out polyneuropathy, which can cause similar symptoms but is treated differently. The Aktigraf is used for objectifiable recording of leg movements.
If there is an iron, vitamin B12 or folic acid deficiency, the symptoms can often be alleviated by substitution of the nutrients. Treatment of idiopathic restless legs syndrome is more difficult. If the sleep disturbances are so strong that the concerning is very limited during the day by tiredness, medicines help. The drugs of choice are L-dopa, which is also used in the treatment of Parkinson's disease, and dopamine agonists, which supports the hypothesis of a neurotransmitter metabolism disorder as the cause. If unsuccessful, opiates or certain anti-epileptic drugs may be tried. There is currently one opiate approved in Germany for the treatment of severe to very severe forms of restless legs syndrome: Targin® . It contains a combination of the active ingredients oxycodone and naloxone and is used in a dosage that is below the opiate dosage commonly used in pain therapy. First studies suggest a good effectiveness. Common side effects include headaches, fatigue, nausea and constipation.
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Quite a few sufferers have developed their own "recipes" to keep the discomfort within limits, such as evening cycling, swimming, brushing or other massages of the legs. As long as the patient can live with their symptoms, no treatment is required.
A link between restless legs syndrome and obesity is being discussed, as overweight people are significantly more likely to develop restless legs syndrome than slim ones. However, it is unclear whether weight loss alleviates the symptoms.
– There are positive reports from homeopathy on individual constitutional treatment with high potencies; Zincum valerianicum D4 is recommended for self-treatment. . For the additional intake of vitamin (e.g. B. vitamin E or vitamins from the B family) or magnesium supplements, as is sometimes recommended, should only be chosen if it is not possible for you to meet your daily body requirements of these nutrients through your diet.