Restless legs syndrome

Introduction Restless leg syndrome, also known as restless leg syndrome, is a sensorimotor disorder. The main clinical manifestation is that during nighttime sleep, extreme discomfort occurs in both lower extremities, forcing the patient to constantly move the lower limbs or walk down, resulting in The patient has a severe sleep disorder. The cause of the disease is still unclear. Often complicated by the stomach surgery, uremia, alcoholism, and mental factors are of certain importance to the onset. Especially when conceiving, watching movies, and drama, symptoms are prone to occur. Some people think that this disease is autonomic dysfunction. Infectious diseases, vitamin deficiency, diabetes, and various anemias may be the cause of the disease. Some people think that it is an autosomal dominant disease, and there are several people in the same family. It has been mentioned that the use of phenylthiazine, sudden withdrawal of barbiturates can induce the disease. Some people think that the most likely cause is that abnormal accumulation of metabolic products is caused by muscles. It has also been reported to be associated with inadequate CAPD (peritoneal dialysis) or local blood circulation disorders.

Cause

The disease has two types of primary and secondary. The primary cause is unknown, and children often have a family history. Secondary is common in the following reasons: uremia, iron deficiency anemia, folic acid deficiency, pregnancy, rheumatoid arthritis, Parkinson's disease, multifocal neuropathy, metabolic diseases and drugs.

The cause of restless leg syndrome is more complicated, and the etiology of Western medicine is still unknown. The following factors are thought to be related to the disease.

Genetic factor

Ekbom (1960) considered that the pathogenesis of RLS was associated with genetic factors, with similar diseases in 43% of the reported patients, and several families were dominantly inherited.

2. Local ischemia theory

RLS occurs mostly during quiet rests, and it can also occur when working in cold environments for a long time. Symptoms can often be relieved after activity, compression, beating of local muscles or application of vasodilators. Limb blood flow examinations in some patients also showed reduced blood flow. According to the above facts, many scholars believe that the disease is caused by local tissue blood circulation disorders, resulting in tissue hypoxia and accumulation of metabolic products.

3. Endocrine factors

RLS is also common in pregnant women. A retrospective diagnosis of 486 newly-born women was found, and 11.3% of the patients were found to have the disease. Jolivet (1953) reported that 27% of pregnant women had RLS performance.

4. Metabolism and nutritional disorders

Most of the severe RLS are complicated by diabetes, uremia, alcoholism, cancer, hypercholesterolemia and hematoporphyria, so some people think that it may be metabolic peripheral neuropathy caused by metabolic disorders. Also considered to be associated with anemia and iron deficiency. Of the 77 patients with this disease reported by Ekbom (1966), 1/4 of serum iron was below normal. Aspenstrom (1964) reported that 42% of the 80 iron-deficient patients found in health checkups had RLS. Behrman (1955) confirmed that the patient's discomfort after oral or injection of iron was significantly improved.

5. Other causes

Some venous thrombosis and varicose of the lower extremities, partial gastrectomy, taking phenothiazines and barbiturates, and mental factors such as anxiety or depression have been reported to have some relationship with the disease.

an examination

Related inspection

Renal function test blood routine muscle tone examination urine routine

The diagnostic criteria for primary RLS are:

(1) Discomfort in the legs (stinging, tingling, nervousness, pain) accompanied by uncontrollable body movements.

(2) Symptoms appear at rest, mainly in the evening, can affect sleep; serious illness changes at any time (such as weekly, monthly), can affect the upper limbs.

(3) Some symptoms can be partially or completely relieved by some manipulation of the limbs (such as squatting, shaking, rubbing, walking).

(4) There are no symptoms and signs of other nervous systems.

Differential diagnosis

Differential diagnosis:

(1) Calf cramps during sleep:

Many people have had the experience of calf cramps during sleep at night. Calf cramps are actually abnormal muscles and muscles that cause leg muscles or muscle groups. At this time, the tensile strength of the muscle bundle is significantly greater than the tensile strength of the muscle bundle when the muscles are normally contracted. Therefore, there is acidulence or comparison when the calf cramps. Intense painful feeling. In general, seizures can last for a few seconds or tens of seconds.

(2) Periodic leg movement in sleep:

During sleep at night, periodic involuntary movements of the bilateral foot muscles occur. Often coexisting with restless leg syndrome, both have a common pathophysiological basis, alone with no paresthesia, and awakening due to lower limb movement during sleep, patients often complain of insomnia.

(3) painful legs and moving toes:

Pain in the lower extremities and feet, accompanied by discomfort, characteristic involuntary movements of the toes, one or both limbs can occur. This patient can have abnormal pain in the lower extremities and can often persist. The involuntary movement of the lower limbs is mainly manifested by the flexion of the toes and the internal and external rotation, the flexion and extension of the joints of the feet, and the nature and characteristics of the pain of restless leg syndrome. Common in spinal cord and nerve ending diseases such as heel pain, back pain, sciatica.

(4) Calf muscles after walking:

After walking, calf tendon is also a frequent occurrence. Due to excessive walking or running time, the muscles of the lower limbs are overworked.

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