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Restless Legs Syndrome in adults (SPI)

Restless Legs Syndrome in adults (SPI)

The Restless Legs Syndrome or SPI was first described by Ekbom in 1945. It is characterized by different sensory symptoms and the imperative need to move. It is defined as a urgent need to move the legs, generating brief repetitive movements of the legs, ranging from the subtle extension of the hallux (big toe or thick toe) until hip, knee and ankle flexion.

Content

  • 1 Main features of the SPI
  • 2 Prevalence of SPI
  • 3 Types of SPI
  • 4 SPI Sensory Perceptions
  • 5 Associated morbidity
  • 6 Treatment of SPI
  • 7 Contributes to the relief of restless legs

Main features of the SPI

This syndrome usually includes uncomfortable and unpleasant sensations in the lower limbs. To diagnose it as such must occur at least three times a week and have manifested for a minimum of three months; as long as the discomfort is not caused by another physical, mental or drug use disorder.

Patients who suffer from it present clinically significant discomfort such as deterioration at the social, occupational, academic, behavioral level and even in their cognitive functioning. It is characterized by an urgent need to move the legs, with the following characteristics:

  1. Starts or worsens during periods of rest or inactivity
  2. It is partially or totally relieved by movement.
  3. It has circadian influence, because it worsens more in the afternoon or at night than during the day. Or, it occurs only in the afternoon or at night.

Usually, although not exclusively, it affects the legs, but it can also affect the arms.

Involuntary movements occur when awake or during sleep: about 80% of people with leg syndrome perform periodic limb movements while they sleep, the DSM-V classifies it within sleep-wake disorders.

SPI Prevalence

Estimates of the prevalence of the syndrome vary between 9% to 15% of the adult population. Many patients do not manifest the syndromic picture of the disorder until 40 or 60 years, since the prevalence increases with age and there are approximately twice as many cases in women as in men.

The severity of symptoms is associated with cognitive and behavioral deterioration, may show symptoms of hyperactivity or attention deficit.

When restless legs syndrome manifests or Willis-Ekbom disease (EWE) during pregnancy, the problem may be transitory, although pregnant women who suffered from it have a four times greater risk of presenting it more severely at another later stage of their life.

Types of SPI

The restless legs syndrome can be:

  1. Idiopathic. It includes a genetic component, with a family history between 18.5% and 59.6% of patients have this subtype.
  2. Secondary or symptomatic. because of an iron deficiency, pregnancy, uremia, neurological problems or another disease.

SPI Sensory Perceptions

The need for movement is usually accompanied by abnormal sensations and perceptions, patients describe them in different ways such as: burning, pain, tingling or "insects that crawl under the skin or worms", sensations of electrical current, oppression, feeling of fuss, shaking, bubbling, beating or restlessness and discomfort. Sayings symptom sensory tend to relieve themselves with movement and to worsen while at rest, these manifestations can mean an underlying medical condition, so it is important to seek medical attention: the course of restless legs syndrome is usually a chronic disorder with a tendency to get worse, although periods of remission are common, especially in young adults.

Associated morbidity

Restless legs syndrome, often It is associated with metabolic and cardiovascular diseases and in turn, the presence of the syndrome could represent a risk factor for cardiovascular disease. Although the association with other diseases is still being studied, it can be related to others such as:

  1. Diabetes
  2. Impaired glucose tolerance
  3. Dyslipidemia
  4. Obesity
  5. Rheumatological disorders
  6. Peripheral neuropathy
  7. Radiculopathy
  8. Parkinson's disease
  9. Multiple sclerosis (MS)
  10. Charcot-MarieTooth disease
  11. Spinal cord injuries
  12. Sleep problems and insomnia
  13. Anemia
  14. Renal insufficiency

A consequence of the restless legs syndrome that aggravates the condition and contributes to the detriment of well-being in patients are sleep disturbances, among the most frequent we find that most suffer insomnia, especially related to problems in the phase of initiation of the dream, likewise, refer that their "sleep is not restorative" and a drowsiness Excessive during the day. Therefore, when sleeping problems persist, it is necessary to seek medical advice in order to sleep better.

Knowing our genealogy is important to predict this type of condition, since it affects 2% of school-age children, and half of them have a paternal history with the condition in common. Restless legs syndrome is also related to acatisia, an imperative need for movement, due to a neurological disorder that implies the person's inability to remain still and compulsion to move.

You may be interested: Restless Legs Syndrome in children: what it is, causes and symptoms

SPI treatment

It is necessary to adopt a healthy lifestyle and avoid practices that alter the body's balance as much as possible, since the syndromic picture of the condition can be exacerbated by: lack of sleep hygiene, consumption of tobacco, alcohol, coffee, as well as some psychoactive drugs such as antipsychotics, antidepressants, antihistamines, neuroleptics and other dopamine blocking agents. So it is convenient to do everything possible so that the condition is not complicated, applying the strategies suggested by health professionals so that there is a symptom relief.

The Society of Movement Disorders (MDS-UPDRS), the European Federation of Neurological Sciences and the European Study Group on Restless Legs Syndrome (EURLSSG), emphasize the timely recognition of factors that exacerbate symptoms, in identifying the etiology and comorbidity. Ozone therapy as a complementary therapy helps improve blood circulation, while purifying the blood and contributes to well-being by reducing the symptoms of Willis-Ekbom Disease or SPI.

When associated with some iron deficiency, they often consider the iron supplementation As part of the treatment, it is important to include in the diet of patients with this syndrome, foods rich in this mineral, such as: nuts, seeds, spirulina, lean meats, dark green leafy vegetables (spinach, chard, watercress, etc.), whole grains and legumes such as lentils, chickpeas, soybeans and peas.

It is convenient not to fall into the overmedicalization of the condition, especially when the symptoms are rare, often the annoying symptoms are relieved by implementing the recommendations provided by the doctor to improve the quality of life, ideally referred to patients with neurologist, sleep specialist and psychologist, since The syndrome can generate high levels of physical and emotional distress in affected people, start a therapeutic process with a psychologist, can help improve cognitive-behavioral aspects, as well as provide coping strategies for stress management, anxiety and relaxation techniques, among others.

Life is never stagnation. It's constant movement, movement without rhythm,Well, as we constantly change. Things live moving and gain strength while they do" Bruce Lee

The legs push us forward along the path of life, sticking to painful memories of the past or fear of the future, may be a part of a psychological component that exacerbates this condition, promoting physical and mental flexibilityIt can help improve the condition, it is advisable to accompany medical treatment with cognitive behavioral therapy (CBT) or therapies that involve artistic activities such as music therapy and the development of some artistic activity as a way of occupational therapy.

Contributes to the relief of restless legs

You will not be able to reach peace, if you do not discover before the obstacles that prevent you from reaching it. You carry peace within: Discover it!" Anthony de Mello

  1. Detoxifies of your body once or twice a year.
  2. Massage your legs with almond oil and essentials before bedtime: melaleuca, mint, roman chamomile and lavender provide relief and help rest, it can be applied not only in lower limbs, you can also put a little on your temples, behind your ears, in your ears, neck and neck. If you have had a lot of discomfort you can massage your legs when you wake up or before taking your bath.
  3. Ozone therapy, since it contributes to the relief of symptoms, purifies the body and is indicated for most of the conditions with which the restless leg syndrome has comorbidity.
  4. Take a relaxing bath in the tub, adding a bit of Epsom salts, helps beautify your skin and reduce both anxiety and excess stress.
  5. Practice the hike Mindfulness, at least 5 days a week for 30 minutes has great physical and emotional benefits.
  6. Suggestions at the alpha level to program improvement and decrease in the manifestation of symptoms.
  7. Biofeedback

Links

//www.bmj.com/bmj/section-pdf/187542?path=/bmj/344/7858/Clinical_Review.full.pdf

Bibliographic references

  1. American Psychiatric Association (2014). Reference guide for the diagnostic criteria of the DSM-5. Washington, D.C .: American Psychiatric Publishing.
  2. Nemiah, John, C. (1996). Glossary of Psychiatry. 7th. Ed. Of the American Psychiatric Press, Inc. Madrid, Spain: Díaz De Santos, S.A.