Tuesday, May 24, 2011

Electrified Legs or Restless Leg Syndrome

Lately my legs are feeling electrified.  And as a result, I am not able to fall asleep.

Terrible, I know, but it's really starting to drive me crazy!

I go to bed, and literally my legs feel ENERGIZED like I need to get up and run around, even though I am mentally wiped.  Serious conundrum I have. And Apparently so do many others. Like 7 % of the general population.

I of course, self diagnosed my electric leg problem as Restless Leg Syndrome, or perhaps some mild Peripheral Neuropathy, and shared this brilliant epiphany with my Family Doc. He gave me some samples of Caltrate, a Calcium Vit D multivit supplement and told me to trial it.. I now take it daily, and thought it may be assisting, until the last few week.

As a result of my issue I needed more info and did a brief literature review:

Merlino and company define Restless Leg Syndrome as below:

 Restless legs syndrome (RLS) is a sensorimotor disorder characterised by a complaint of an almost irresistible urge to move the legs.

Yup!  That's me, that's me.  Like even sitting in my office today my legs are vibrating. But is it RLS or some other Neuropathy related to my 29 year history of Type 1 DM.

Well the above article adds;

Furthermore, recent studies show that RLS may be associated also to type 2 diabetes mellitus and to multiple sclerosis.

May be linked?  So I continue my search.

Garcia-Borreguero from the Institution Sleep Research Institute, Madrid, Spain adds:
Recent data from the REST (RLS Epidemiology, Symptoms, and Treatment) general population study show that symptoms of RLS are present in approximately 7% of the general population, and that 2-3% experience moderate or severe symptoms at least twice a week.

RLS is associated with a significant impairment of quality of life, comparable with that seen in chronic medical conditions such as diabetes or depression.

Man, this better not be another diabetes "Problem" to deal with.

One more study done by Gemignani, Franco and colleagues concluded:

Our data show that RLS is a relevant feature of diabetic neuropathy, as a frequent and potentially treatable manifestation of small fiber involvement in the course of DM and IGT/IFG.
Once again supporting a linking of RLS and DM, Wonderful!!!  Now what can I do about it?

Schapira from the UK links not only Diabetes, but also a genetic component to RLS.  Funny my Dad who doesn't have Diabetes, goes to bed at night and vibrates so much Mom frequently kicks him out of bed.  To quote the study directly:
Four essential diagnostic criteria for restless legs syndrome (RLS) have been identified. Patients experience an urge to move the legs, which typically begins or worsens during periods of rest. The symptoms are at least partially relieved by movement, and are typically worse in the evening and night than in the day. All four criteria are necessary to confirm the diagnosis of RLS. In addition, a family history of RLS, the presence of periodic leg movements in sleep, and a positive response to dopaminergic therapy are useful supportive clinical features to confirm the diagnosis. Whilst many cases of RLS are idiopathic, secondary RLS is often observed in pregnant women, patients who have severe renal dysfunction, or in those with iron deficiency.
I then looked into what can be done about my vibrating legs.  Satija add this about treatment and prognosis.

Treatment of RLS is usually rewarding. Most patients respond robustly to dopamine receptor agonists. Over time, response may lessen, or the patients may develop 'augmentation', whereby they have a worsening of symptoms, usually in the form of an earlier onset. Other treatment options include gabapentin, or similar antiepileptic drugs, and opioids.

So my drug options are laid out above. Not to fussy about the options. Basically Parkinson's, Narcotics, and Anti seizure meds.  I'll pass, for now anyway. Not to mention my Doctor is pretty stingy when it comes to handing out pills.

I did find a web site soley devoted to us people with Electrified Legs, AKA RLS. Check it out at http://www.rls.org/

After reading the site suggestions I have a plan to:

Reduce Caffeine, toughie for me, but okay, the website actually recommends eliminating it, Not!!!
Exercise - already in the plan, just need to do it daily
Hot Bath - Try to fit that one in, I have a hard time just using the bathroom in my house
Practice good sleep hygiene - Bed at the same time, Up at the same time
Limit Alcohol - Not hard for this guy
Review Meds that worsen - Apparently Antihistamines worsen it, Benadryll, Gravol, Anti Allergy meds
Diet - Needs to be balanced, hmmm, define balanced, that is a whole topic to itself
Lab Work - Apparently Iron Deficiency Anemia, and RLS are linked.

Merlino, G. ; Valente, M. ; Serafini, A.; Gigli, G. L. Title Restless legs syndrome: diagnosis, epidemiology, classification and consequences.Neurological Sciences. 28(1) (Suppl 1):S37-S46, January 2007.

Garcia-Borreguero, Diego Institution Sleep Research Institute, Madrid, Spain.Tine to REST: epidemiology and burden. Source European Journal of Neurology. 13 (Supplement 3):15-20, October 2006.Gemignani, Franco; Brindani, Francesca; Vitetta, Francesca; Marbini, Adriana; Calzetti, Stefano Institution Department of Neurosciences, University of Parma, Parma, Italy. Restless legs syndrome in diabetic neuropathy: a frequent manifestation of small fiber neuropathy. Journal of the Peripheral Nervous System. 12(1):50-53, March 2007. 

 Schapira, A. H. V. Institution University Department of Clinical Neurosciences, Royal Free & University College Medical School and Institute of Neurology, UCL, London, UK  RLS patients: who are they?. European Journal of Neurology. 13 (Supplement 2):2-7, October 2006.

Satija, Pankaj; Ondo, William G. Institution Department of Neurology, Baylor College of Medicine, Houston, Texas, USA. Restless Legs Syndrome: Pathophysiology, Diagnosis and Treatment.[Review]
Source CNS Drugs. 22(6):497-518, June 01, 2008.


Reyna said...

I love it when you go all "nerdy" on us Trev. You are amazing with your research and resources.

AND...DEAR GOD...limit caffeine?! You are insane man!!! GO FOR THE DRUGS. J/K. I get it. Good luck, that has to be annoying.

Sarah said...

limit caffeine and take hot baths...what next they'll suggest you get a full nights rest, don't these people know that if we had all these things occurring already we'd probably not have any of these "problems"!
Hope your legs are a little less electric (boogy woogy woogy!) today!

sam said...

There is a spray called privic that will help you with your restless leg syndrome