Leg twitching.

[imissthepub]

So, I'm just sitting here watching TV when my left leg starts twitching. It's quite painful at times but more annoying. In bed I can feel a strange tingling like tiny electric shocks running down my leg as if my foot is up against or standing on an electronic transformer? I've had this for years but only just discovered this forum. Can anyone shed any light? Please.

[Hidden]

Hello there.

This could possibly be restless legs (RLS).

The principal and defining symptom, however, of RLS is the "urge to move". When the tingling occurs do you feel as if you need to move your leg? If you don't then it may not be RLS.

If the twitching or tingling usually only occur, or are worse when you try to relax, sit still or lie down,

If it stops or improves when you do move

If this usually occurs in the evening or is worse in the evening

then it may be RLS

Do you have any other chronic medical condition e.g. thyroid dysfunction or diabetes, as these can cause RLS symptoms?

Have you been taking any medications for years, as some mediciones can trigger the symptoms?

RLS is diagnosed by family history and by its symptoms. Tgese are decsribed in the RLS diagnostic criteria. Click on the link below and comlare the symptoms yiou expereince to the criteria. If they ALL match. then you probably have RLS.

irlssg.org/diagnostic-criteria

In addition people with RLS have problems getting to sleep and can also sleep poorly, often waking up.

If you think you definitely have RLS come back for more information.

[imissthepub in reply to Hidden]

Yeah I get the urge to move my leg but don't really have a choice as it just sort of kicks out? As for the tingling sensation, I can almost imagine that my leg is like one of those illuminated billboards with the lights flashing up & down? Weird right?

[Corgis2 in reply to imissthepub]

I can relate to that as well.

[Hidden in reply to imissthepub]

Weird is commonly used to describe it!

[Hidden in reply to imissthepub]

OK, so whether this is due to RLS depends on the ither diagnostic criteria. i.e. does it usually only happen or is worse when you relax, sit or lie down? Does moving stop it or at least reduce it. Does it happan only at night or is worst at night.

Originally, I found the jerking (which I call "twitching" at its very worst when I lay down and was falling alseep.

If you believe that this is RLS then you have to decide what to do about it.

This would depend on what's causing the RLS and also on how severe it is.

As regards causes, it may be that it's caused by some other underlying medical condition. This is known as "secondary" RLS and in this case, often, treating the underlying condition may relieve the RLS. Typical conditions include thyroid dysfunction, diabetes, anaemia or kidney failure. You'd probabvaly know if you had any of these.

"Idiioptathic" RLS is without an apparent cause. In this case it is a complex inherited tendency. Often, it is brought on by a "trigger" or just gets worse as you get older. There is no cure for idiopathic RLS only ways of relieving the symptoms.

So your first option is to decide if you think you might have an underlying condition and ask your doctor for the relevant tests.

If you think it's idiopathic then you need to decide if you need to do anything to relieve the symptoms or just accept it. If you do feel you need to do something to relieve symptoms then what?

It might help to do a self assessment of how severe your RLS is. You can do this by using the RLS severity rating scale. You can find one on this web page

rls-uk.org/diagnosis

As regards relieving or controlling symptoms, these can be roughly split into 3 sorts of things

1 - non-pharmacological methods of relieving symptoms once they've started to occur, or when you think they will occur. These may provide immediate and/or short term relief.

2 - non-pharmacological things you do in the longer term and/or on a continual basis to prevent/ reduce symptoms. These may not have any immediate effect

3 - medicines - these work immediately or within a short time. If you have RLS symptoms regularly, then it's best to take them regularly.

Another forum member, Doggymom is quite knowledgeable about 1)

For 2) and 3) it will help to consult a doctor. They may be able to confirm the diagnlosis and may carry out some blood tests.

If they suspect any underlying conditions then they can carry out tests for these.

Otherwise you could ask for blood tests for "ferritin", "serum iron", "transferrin saturation, magnesium, vitamin B12/folate and vitamin D levels. Be warned that they may not know the relevance of these.

Very simply put, if your ferritin level is less than 100ug/L then your symptoms may be relieved by taking an oral iron supplement. You don't need a prescription for this. Your doctor may not know this. they think that anything above 15ug/L is OK. It isn't!

Iron is a very significant factor in RLS.

If you have any deficiency of magnesium, vit B12 or D then taking a supplement of these will help.

Also, in relation to 2) there are various "aggravating" factors which can cause RLS or make it worse. e.g.

Medicines

Tricyclic or SSRI antidpressants

Proton pump and H2 inhibitor antacids

Some anti-nausea/anti-reflux medicnes e.g. metoclopramide, domperidone

Sedating anti-histamines

Some anti- blood pressure medicines

Beta blockers

Plus

Alcohol, caffeine and refined sugar

There are various diets which some sufferers find helpful.

If you get treatment from a doctor, they will prescribe a RLS medication. This may seem a quicker and simpler solution, but it's a minefield.

You may need to be on a medication for life.

The most commonly prescribed medication for RLS was a "dopamine agonist" (DA), pramiopexole, ropinirole or rotigotine. If you read other posts on this site, you will see much is written about these. They are however, no longer the preferred first medicine to try for RLS (your doctor may not know this).

These can have some unpleasant side effects, but can be immediately very effective. However, they aren't really a long term solution because they have a high risk of complications. Hence no longer preferred.

The more up to date preferred first medicine to be tried is an alpha 2 delta ligand, either gabapentin orpregabalin. These also can have some unpleasant side effects. They're also not immediately effective and maybe take 3 - 4 weeks to become effective. They do NOT have the same high risk of complications as the DAs have, hence they're preferred.

If you do decide you need a medication, I suggest you do not let your doctor persuade you to take a DA

Takiong a medicione also does no exclude all the other things you can try, especially the iron.

Here's a link to an article which outlines the treatment of RLS

uptodate.com/contents/treat...

If you live in the UK then I can give you a link to the official national guidelines for the medical management of RLS - just say.

[dorissweda]

I think this is iron deficiency anemia, probably severe. Your doctor should check your iron levels. You may need a blood transfusion or iv iron therapy. I have extensive experience with this and I nearly died once. Good luck!!

[Hidden in reply to dorissweda]

Sorry to hear you had apparently severe iron deficiency anaemia. This can cause "secondary" RLS.

Secondary RLS caused by anaemia can be "cured" as you say by IV infusions.

However, idiopathic RLS occurs even if there is no anaemia so it can't be assumed that because someone has RLS that they have anaemia.

Iron is important for someone with idiopathic RLS, but the normal tests for iron deficiency anaemia aren't particularly useful as the deficiency is in the brain, not in the blood.

[bill54321]

The closest known discription is Awakeness Restless leg Syndrome. There is NO GOOD article. I (persoanally) use opinrole at noon and evening meals .05 and 2 of .5mg ropinrole along with two gabipintyin 300 mg CAPSULES at night.Please check with a movement Neurologist.. This i a very serous problem with very few knowedgeable physicians who really understnd meds for it. Google and study. The Medical field is light years behind in actual physical movements at day. They call it RLS but that discrition is for night time thinking about it. Feel left out. Read from this form.