A woman who had a constant urge to move her right leg while sitting or lying down
1. 42-year old woman consulted me last month with complaints of constant urge to move her right leg for past 12 years. Symptoms occurred mostly in evenings and nights.
#MedTwitter #neurotwitter
1. 42-year old woman consulted me last month with complaints of constant urge to move her right leg for past 12 years. Symptoms occurred mostly in evenings and nights.
#MedTwitter #neurotwitter
2. She would develop crawling sensation and discomfort in right leg while sitting for long or lying down, which would go away only after she jerked or vigorously shook her leg.
She remained reasonably well during the day.
She remained reasonably well during the day.
3. These symptoms occurred on daily basis causing sleep disturbance (she could #sleep only 5 hours at night).
She felt tired during day and found it hard to concentrate.
She was unable to sit for long while travelling or during meetings during daytime.
She felt tired during day and found it hard to concentrate.
She was unable to sit for long while travelling or during meetings during daytime.
4. She had consulted several #physicians who could not find anything wrong and treated her with calcium and multivitamin supplements.
She was referred to a #psychiatrist once suspecting a psychological basis of her illness. That also did not help.
She was referred to a #psychiatrist once suspecting a psychological basis of her illness. That also did not help.
5. After about 5 years into her illness, she gave up consulting doctors and decided to suffer, accepting the illness as her “fate”.
After about 7 years, she decided to give another try and she came to my OPD.
After about 7 years, she decided to give another try and she came to my OPD.
6. I carefully analyzed her symptoms. She had discomfort in right leg, aggravated with sitting or lying down, worse in evenings and nights.
This resulted in an urge to shake the leg and she felt good soon after shaking her leg.
This resulted in an urge to shake the leg and she felt good soon after shaking her leg.
7. These symptoms were typical of Restless Leg syndrome (#RLS).
It is a #clinical #diagnosis and no tests are needed to confirm the diagnosis.
It is a common illness and may affect 10% of population.
#Restlesslegsyndrome
It is a #clinical #diagnosis and no tests are needed to confirm the diagnosis.
It is a common illness and may affect 10% of population.
#Restlesslegsyndrome
8. I started her on a single dose of #dopamine agonist to be taken at nights.
She responded well and had no symptoms at one month follow up.
She had never felt so relaxed while sitting or sleeping during the past 12 years.
She responded well and had no symptoms at one month follow up.
She had never felt so relaxed while sitting or sleeping during the past 12 years.
9. There is a lack of awareness about RLS among physicians and about 40-50% patients remain undiagnosed for >5 years.
It usually affects both legs, but uncommonly only one leg or arms can also be affected.
It usually affects both legs, but uncommonly only one leg or arms can also be affected.
10. Take home message:
Discomfort or abnormal sensation in one or both legs, occurring while sitting or lying down, worse at nights; with an urge to shake the leg and symptoms disappearing after that are typical of RLS.
Medical treatment is effective in relieving the symptoms.
Discomfort or abnormal sensation in one or both legs, occurring while sitting or lying down, worse at nights; with an urge to shake the leg and symptoms disappearing after that are typical of RLS.
Medical treatment is effective in relieving the symptoms.
• • •
Missing some Tweet in this thread? You can try to
force a refresh
