September 2009, Volume 59, Issue 9

Student's Corner

On the Move: Restless Legs Syndrome

Madam, Restless Legs Syndrome (RLS) is a sensorimotor disorder that is characterized by often vexing and bothersome sensations in the limbs. These sensations are particularly accentuated at rest and bedtime.1 Data from the Western world show a high prevalence of this disorder with up to 15% of the general population being affected.2 Data from the Asian world is scarce. The few studies that exist show a lower prevalence in the Asian population as compared to the West.3,4 
RLS may be idiopathic, familial, associated with renal failure, iron deficiency, or pregnancy. It is conjectured to be related to abnormal storage and usage of iron in the body; this in turn modifies the functioning of dopaminergic circuits in the body through influence on co-enzymes involved in the production process of dopamine. Abnormal levels of calcium may also have a role in RLS.1 
RLS may be analogous to allergic rhinitis or common headaches in being an apparently benign condition. However, it can have a significant impact on the quality of life of the patients as allergic rhinitis or common headaches; sometimes to the point of incapacitation. Sleep architecture and axis; the integrity of which is undoubtedly sine qua none for daily functioning, can be significantly impaired by RLS.5 
This syndrome has not been well characterized in Pakistan. Only one study has been conducted regarding RLS in Pakistan with the study population being pregnant females.6 
More research should be conducted in areas of sleep medicine and movement disorders such as RLS. Because of its "silent" but potentially detrimental impact on the quality of life of individuals, RLS warrants wider recognition and awareness among physicians who may be under-diagnosing or under-treating this entity. 
Taimur Saleem 
Medical College, The Aga Khan University, Karachi, Pakistan.

References

1.Agarwal P, Griffith A. Restless legs syndrome: a unique case and essentials of diagnosis and treatment. Medscape J Med 2008; 10: 296. 
2.Thorpy MJ. New pardigms in the treatment of restless legs syndrome. Neurology 2005; 64: S28-S33 
3.Rangarajan S, Rangarajan S, D'Souza GA. Restless legs syndrome in an Indian urban population. Sleep Med 2007; 9: 88-93. 
4.Kumar VG, Bhatia M, Tripathi M, Srivastava AK, Jain S. Restless legs syndrome: diagnosis and treatment. J Assoc Physicians India 2003; 51: 782-3. 
5.Santos B, Oliveira AS, Canhão C, Teixeira J, Dias AR, Pinto P, et al. Restless legs syndrome. Acta Med Port 2008; 21: 359-66. 
6.Sikandar R, Khealani BA, Wasay M. Predictors of restless legs syndrome in pregnancy: A hospital based cross sectional survey from Pakistan. Sleep Med 2008.  doi:10.1016/j.sleep.2008.06.011.
 

Journal of the Pakistan Medical Association has agreed to receive and publish manuscripts in accordance with the principles of the following committees: