Seizure vs. RLS

[1Ginge1]

I have not seen anything about seizures and RLS. Could be I missed it but this hit me last night. Most of the strong meds for RLS are opioids and what were they first used for? Seizures. Now when your legs get moving on their own have you ever thought that they were going through seizures? So is there a relation in the brain to the nerves that cause both? There is a reason that these Seizure meds also stop the legs from twitching.

[Hidden]

Hi, firstly, no offense meant. Simply to be informative.

It's not quite accurate to say most of the meds for RLS are opioids. They were first used as painkillers and narcotics long before RLS was first described. Although, opioids were the first meds used for RLS.

Seizures is a vague term which can be used to describe a variety of conditions The word is usually associated with epilepsy. The sterotypical image perhaps is the classic tonic-clonic convulsions experienced by some sufferers. There are other forms of epilepsy however which dont't always manifest as convulsions e.g. as in "petit mal" seizures.

However, I have myself noticed the comparison between the epileptic seizures I have observed in others and the twitching-jerking symptoms I have experienced myself due to my RLS.

There are several differfences however -

The movements you see in a tonic-clonic convulsion are not the same as the involuntary movements seen in RLS.

In RLS, you don't stop breathing.

In RLS you don't lose consciousness.

In RLS you don't fall over.

What is interesting is that some meds used for RLS, i.e. the gabapentioids are primarily anti-convulsants also used for some forms of epilepsy. However, this is becasue on both cases they inhibit the overexcitability of nerves.

[1Ginge1 in reply to Hidden]

Great answer and I shouldn't have said "most". Always gets me in trouble. smile I have a diabetic child that had peti mal and grand mal seizures. Requip says it for Parkinsons tremors. I'm thinking that the neurologic issues involved in all three that we are talking about must have some connection. The brain doesn't know the names put on the different contortions that medical people are using. So many of those jerky (seizure) movements must be coming from the same cerebral area. Which is why these meds work to some degree on all of them. OK my dear, you're turn. ha

[Hidden in reply to 1Ginge1]

I see, a challenge.

The areas that are involved in the epilepsies are different to the areas that are involved in Parkinson's (PD) or RLS.

However, the connection between RLS and PD is dopamine.

In RLS there is a dysfunction of dopamine receptors and can be too much dopamine.

In PD there is a lack of dopamine.

Dopamine in relation to RLS has an inhibitory effect, so when there is a dysfunction nerves become overexcitable.

Dopamine agonists (e.g. requip), stimulate dopamine receptor sites thus treating both RLS and PD.

I don't believe dopamine is involved in epilepsy, but seizures can occur because nerves are overexcitable.

Another factor in nerve excitability generally is the balance between the neurotransmitters GABA and glutamate. GABA has an inhibitory effect calming things down, glutamate.has an excitatory effect.

One of the features of RLS alongside the motor symptoms is hyperarousal due to nerve overecitability. This is caused by an excess of glutamate over GABA. Glutamate is the most common neurotransmitter there is.

Gabapentinoids boost GABA levels and limit glutamate levels, thus can be used for both epilepsy and RLS. (But not PD).

This is the connection between RLS and epilepsy.

It's not entirely clear why opioids work for RLS. Opioids do increase dopamine levels in some areas of the brain and that might be an explanation. The most notable area of the brain that this happens is in the so called "pleasure" area of the brain. Anything that increases dopamine in this area causes pleasure and can lead to the behaviour that led to the increase to be repeated, again and again.

This leads to addiction.

This was, I believe first discovered in rats. Rats were trained to press a lever. When they pressed the lever they were given an electrical stimulation in their pleasure area . It was found that rats treated this way would press the lever anything up to 4000 times a minute and carry on til they dropped dead from exhaustion.

Unfortunately giving drugs to stimulate dopamine receptors (e.g. agonists) or raise dopamine levels is indisciminate, i.e. they don't just boost dopamine in areas of the brain where it's needed, they do it all over. It's like putting you in plaster all over for a broken leg.

This is the problem with allopathic medicine.

This can also lead to addictive behaviour, known as an Impulse Control Disorder (ICD). One of the complications of Requip!

Another thing of note about dopamine is that it is thought that people with schizophrenia have higher levels of dopamine. Reducing dopamine levels can relieve symptoms of schizophrenia.

The first drugs used to treat schizophrenia were sedating antihistamines which work by reducing dopamine levels. Unfortunately the side effects of these drugs are Parkinsonic and RLS like symptoms.

Sedating antihistamines also make RLS worse because of this.

On the other hand, levodopa and dopamine agonists can cause schizophrenic type symptoms e.g. hallucinations.

Which means, if you mess with nature, it can mess you back.

[1Ginge1 in reply to Hidden]

And THAT dear RLS friends is why we are privileged to have Manerva in our midst. Is your background in medical OR just a really good researcher?

[lorrinet]

I've had RLS for around 50 years. Several other family members have it also (though milder than me), including, I'm sorry to say, both my children. I have a brother with Epilepsy, and another brother who had seizures as a child but 'grew out of it'. A nephew had epilepsy until adolescense, then later he developed RLS and PLM (the RLS is manageable but the PLM caused his long-suffering and bruised wife to sleep in another room). I have often wondered if there could be a connection between epilepsy and RLS, especially since I was prescribed an epilepsy drug (Tegretol) for 'these awful nerves runing up and down my limbs when I go to bed' (I'd never heard of RLS then, I just thought I was going mad), but the drug stopped working after about five years.

[1Ginge1 in reply to lorrinet]

I put out the question a week or so ago about the same nerves being serviced in the brain that control nerve stimulation could all be related. Including the nerves in the lower back. Gabapentin is also for epilepsy and Requip is for Parkinson's. Go figure. I say a definite connection.

[lorrinet in reply to 1Ginge1]

I believe it's likely, though I've never managed to make any GP even consider the possibility. They're just not interested.