When resting legs lead to suicidal thoughts
Bite, burns, tingling, the irrepressible need to move … Restless legs syndrome is manifested by “impatience” (and the word is low) in the lower limbs. It constitutes a major cause of sleep disorders, with frequent awakenings, insomnia, an inability to go back to sleep …
Is restless leg syndrome a disease?
Restless legs syndrome is far from a recent discovery. It was described for the first time in 1685 by the English doctor Thomas Willis, who already evoked in his writings “night trees” and strange sensations in the legs. But it was not until 1945, that the disease really took a clinical form thanks to the Swedish neurologist Karl-Axel Ekbom, who makes it a precise description and proposed the term “restless leg syndrome”. The syndrome continues today to be called “Willis-Ekbom disease” by certain practitioners.
The SJSR has also long been relegated to the rank of minor disorder and has only been recognized as a neurological pathology in its own right recently. It is today coded in the international classification of sleep disorders and in the international classification of diseases (CIM-11), which allows better medical recognition and more rigorous care of patients who suffer from it.
Your child box? It may be a hip cold
Hips of hip is a very common cause of lameness in children from 3 to 10 years old. If your child has a box and refuses to set foot on the ground and presents neither wound or hematoma, if he complains of the hip and suffers from a slight fever, it is very possible that it is suffering from this benign condition which is most often declared in winter or spring.
And there are many of them: between 5 and 10 % of the population would be concerned, according to an inserm study published in 2022. More frequent in women than in men, syndrome is also more present with age: almost one in two patients begins to feel the symptoms before the age of 20, but these generally become more intense after 40 or 50 years.
What is the restless leg syndrome due to?
The SJSR is a so-called “sensorimotor” neurological affection. Patients who suffer from it feel unpleasant sensations, often described as tingling, itching, burns or electric discharges, located in the legs (sometimes arms), which only occur at rest and calm with movement. These symptoms generally intensify in the evening or at night, which strongly disrupts falling asleep and sleep.
But the biological mechanism at work in syndrome remains unknown to date. The main hypothesis is that of a dysfunction of the dopaminergic system in the brain (a region involved in the regulation of movements). Dopamine, also called pleasure hormone, plays a key role in motor control, attention, sleep, memory, cognition or motivation. An imbalance of this neurotransmitter, poorly disseminated or poorly assimilated, could be the source of strange sensations and the irresistible desire to move that patients feel, especially at rest.
In addition, several studies have shown that a low iron rate in the brain – even without a deficiency in the blood – could worsen disorders, because iron is essential to the manufacture and proper functioning of dopamine. Finally, syndrome could in certain cases be hereditary and due to genetic mutations which affect the development or regulation of the neural circuits involved in sleep and movement, but these mechanisms remain to be specified.
How is resting legs syndrome diagnosed with rest?
The diagnosis of restless legs syndrome is mainly from the patient’s testimony, because no biological examination or brain imaging alone allow the pathology to be confirmed. To identify the pathology, doctors rely on the criteria established by the International Restless Legs Syndrome Study Group (IRLSSG): an irrepressible need to move their legs, triggered by rest, relieved by movement, aggravated in the evening or at night, and not explained by another pathology.
Unfortunately, the diagnosis of restless legs syndrome is often late. According to a survey by the France EKBOM association, it takes an average of more than five years between the appearance of the first symptoms and adequate care of patients. Meanwhile, many of them are wrongly diagnosed with rheumatological, psychosomatic, even psychiatric disorders. A medical wandering which does not only harm the sleep of the patients, but sometimes aggravates anxiety or depressive disorders linked to exhaustion.
Are there treatments for restless legs syndrome?
To date, there is no curative treatment of restless legs syndrome, but several approaches make it possible to effectively relieve symptoms. The first consists in correcting a possible iron deficiency, using suitable supplements and sometimes is enough to reduce symptoms, especially in children or in the most moderate forms.
In addition, certain lifestyle rules are recommended to limit disorders: avoid caffeine, alcohol, tobacco, maintain regular sleep hours or even practice moderate but regular physical activity. Certain non -drug treatments (leg massages, warm baths, application of cold compresses or relaxation techniques) can also provide temporary relief.
In the most severe or chronic cases, drug treatments are envisaged, in particular dopaminergic agonists (ropinirole, pramipexole) close to those prescribed against Parkinson’s disease. These treatments make it possible to regulate the deficient neural circuits, but cannot completely disappear the syndrome of other drugs, such as anticonvulsants or low -dose opioids can also be offered. In all cases, this prescription must be supervised by health professionals, in order to monitor any side effects or phenomena of “increase” (paradoxical aggravation of symptoms over time)
Why should we take leg syndrome without resting?
Restless legs syndrome is well known to the general public and sometimes still remains underestimated by certain health professionals. However, it can have deep consequences and permanently alter the quality of life of patients who suffer from it. Indeed, chronic sleep disorders can cause deep fatigue, anxiety, social isolation, depression, but also, by study, increase the risk of cardiovascular disease.
