RESTLESS LEGS SYNDROME
RESTLESS LEGS SYNDROME usually affects a person’s legs - but can affect the arms as well. An otherwise healthy person can develop restless legs syndrome, a problem which is in no way related to psychological problems or emotional disorders. Out of every 100 people, 5 to 10 persons experiences Restless Legs Syndrome. In about 30% of cases Restless Legs Syndrome is passed down from parent to child but for the other 70% of cases a definite cause is not necessarily known. Conditions associated with restless legs include iron deficiency, anemia, poor blood circulation in the legs, nerve problems, muscle disorders, kidney disorders, alcoholism, and vitamin or mineral deficiencies. Stopping or starting certain medications, consumption of caffeine, smoking, fatigue, hot temperatures or extended time in cold temperatures are factors which may trigger RLS. Movements of Restless Legs Syndrome (RLS) are voluntary movements, which happen in response to uncomfortable feelings in a person’s arms or legs when the person is awake. People characterize restless legs in many different ways, but all describe unpleasant “creepy, crawly” sensations that occur in the legs when they are sitting or lying still, especially at bedtime. The uncomfortable feelings are noticed most often, but not limited to, the calves of the legs and is temporarily relieved by stretching or moving the legs. RLS can be painful, or disturbing enough to cause insomnia. The constant need to stretch or move the legs to get rid of the symptoms may prevent a person from falling asleep, resulting in extreme daytime tiredness and fatigue. Restless Legs Symptoms are not the same as “leg cramps” and are rarely described as “legs burning, tingling, pins and needles, falling asleep.” Restless legs can keep a person from enjoying trips, movies, or just sitting still. Bed partners often complain of being kicked, having covers pulled, and in some extreme cases being knocked out of the bed!Proper diagnosis is important. The first step for treating RLS is to determine if there is an underlying problem, such as iron deficiency, anemia, diabetes, arthritis or the use of some medications. For example, studies have shown that correcting a “low normal” Ferritin level with iron supplementation can correct symptoms of RLS in many cases.
PERIODIC LIMB MOVEMENT DISORDER (PLMD)
Also referred to as NOCTURNAL MYOCLONUS, Periodic Limb Movement Disorder (PLMD) refers to movements you make while asleep. These are involuntary or unconscious and often undetected. The movements usually appear to be a bending of the ankle, knee or hip in an upward jerking or kicking motion. These come in groups or “clusters” about every 30 seconds for a while, then they may stop for a while, then restart . . . and so on throughout the night and so on throughout the night. Unless the bed sharer or an observer becomes aware of these movements, they go untreated until symptoms of sleepiness or interrupted sleep are experienced. Typical symptoms may include difficulty falling asleep, difficulty staying asleep, or restless sleep. According to the American Academy of Sleep Medicine’s literature, PLMD contributes to the inability to sleep in two out of every ten people who have been diagnosed with insomnia. Periodic Limb Movements are more common in people who have narcolepsy or kidney disease but may be present in many other individuals. If a person experiences periodic limb movements five or more times during sleep then this is often serious enough to prevent good quality sleep. A person with PLMD may experience “micro-arousals” in sleep and may seek medical help because they have difficulty falling asleep or staying asleep.
Most people with RLS have periodic limb movements - but those with PLMD often do not have RLS.
Some antidepressants and other medications make RLS and PLMD worse. Changing to another medication may help reduce limb movements and other symptoms. Fortunately, the same drugs that help RLS can also relieve PLMD. PLEASE, DO NOT CHANGE PRESCRIPTION DRUGS, WITHOUT THE OVERSIGHT OF YOUR PHYSICIAN.
Restless Legs Syndrome and Periodic Limb Movement Disorder are problems for which remedies are
available. Some home remedies help relieve symptoms in especially mild RLS. These include hot baths,
massages, heating pads, ice packs, etc. Prescription medications may be needed in more pronounced
cases. There are two relatively new medications, Mirapex and Requip, which are very effective in treating
RLS and PLMD in many cases. Other medications are available and new treatments are in the research
phase. Today, symptom control and physical management of this problem is available and within easy
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Benjamin Arbel Ph.D. Professor of Early Modern History Incumbent of the Chair for the History and Culture of the Jewry of Salonika and Greece Department of History Tel Aviv University List of Publications June 2009 A. BOOKS AND MONOGRAPHS 1. Trading Nations. Jews and Venetians in the Early Modern Eastern Mediterranean (Leiden, 1995), xi+237 pp. 2. Cyprus, the Franks and Venice (13t