Restless Legs Syndrome - Causes

Restless legs syndrome (RLS) is a common neurological sensory-motor disorder that is characterized by intense restlessness and unpleasant creeping sensations deep inside the lower legs.

Pathophysiology of RLS remains incompletely understood. RLS may be generated by dopamine dysfunction locally within the central nervous system.

There are two types of restless legs syndrome - primary and secondary:
  • When no cause can be found it is known as idiopathic, or primary restless legs syndrome.
  • Secondary restless legs syndrome can occur as a complication of another health condition

Primary restless legs syndrome can run in families and is most common in people younger than 40. Nearly half of people with RLS also have a family member with the condition.

Secondary restless legs syndrome affects about 30% of people with RLS. Secondary restless legs syndrome is usually caused by another health condition such as:
  • Iron deficiency (Most commonly secondary restless legs syndrome may present as a sign of undiagnosed anemia)
  • Parkinson’s disease
  • Chronic kidney disease
  • Diabetes
  • Peripheral neuropathy
  • Pregnancy (especially in the last trimester and symptoms usually go away within a month after delivery)
  • Multiple sclerosis
  • Hypothyroidism
  • Rheumatoid arthritis
  • Chronic venous insufficiency

Medications - certain medications may cause or worsen RLS, or cause it secondarily, including:
  • Antinausea drugs (prochlorperazine or metoclopramide)
  • Antipsychotic drugs (lithium, haloperidol or phenothiazine derivatives)
  • Antidepressants (both older TCAs and newer SSRIs)
  • Certain antihistamines
  • Certain anticonvulsants
  • Calcium channel blockers

Other reported triggers include:
  • Excessive smoking, caffeine or alcohol
  • Sleep deprivation
  • Being overweight or obese
  • Stress
  • Lack of exercise

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