Restless legs syndrome, a condition that is often difficult to pinpoint

Restless legs syndrome is a very common nervous disorder, affecting mostly women, and sometimes difficult to diagnose.

On Europe 1, Nathalie Patte-Karsenti, neurologist in the Parkinson's unit at the Rothschild Foundation hospital in Paris, explains how to treat it.

Legs that are tingling, itching or burning ... Restless legs syndrome (RLS) is a neurological pathology that is not serious, but particularly disabling.

It is often difficult for the patient to stay still, and in some cases a train or car trip, as well as watching a movie or a show, is simply unthinkable.

RLS concerns nearly 10% of the French population, and 2.5% of those affected suffer from it on a daily basis.

And this disease mainly affects women.

RLS is characterized by an overwhelming urge to move one's legs, an urge more or less associated with unpleasant sensations, of varying intensity, from tingling, discomfort, feeling of heat, to pain.

"These symptoms appear at rest, generally in the evening, and are relieved by movement", indicates at the microphone of

Sans Rendez-vous

, the health program of Europe 1, Nathalie Patte-Karsenti, neurologist in the Parkinson's unit of the Rothschild Foundation hospital in Paris.

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Why is it a sleep disorder?

RLS is considered a sleep disorder because the symptoms almost systematically impact the patient's sleep.

"In almost 80% of cases, periodic movements of the legs, generally small jolts, disturb the night", specifies Nathalie Patte-Karsenti.

The patient wakes up several times, sometimes very briefly, without even realizing it, which however affects the quality of his sleep.

"In the morning, people wake up as if they haven't slept, although they don't always remember waking up several times during the night."

In the more severe forms, the arms can also be affected by a symptom of impatience.

How is restless legs syndrome diagnosed?

"It is a clinical diagnosis and interrogation", specifies our specialist, that is to say that there is no specific medical examination to diagnose this problem, even if certain examinations can be carried out, such as an electromyogram , in order to identify any associated pathologies.

The diagnosis can be long, "because the feelings of the patients are not always clearly expressed", notes Nathalie Patte-Karsenti.

"RLS should be distinguished from a problem of heavy legs, associated with a venous syndrome, although a venous problem can increase the symptoms of RLS," she notes.

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What are the causes ?

No cause has yet been clearly identified, even if this pathology has been known since the 17th century.

"But there are a few leads, in particular that of iron", slips our neurologist.

Indeed, RLS can be associated with a lack of modulation of this element in the body, without necessarily it being anemia.

The lack of iron would also explain the importance of the prevalence rate of this disorder in women, "more often deficient than men by their menstrual cycles", points Nathalie Patte-Karsenti. 

The lack of dopamine is often singled out.

But there can also be a genetic predisposition.

"With an affected parent, the risk of developing RLS is multiplied by two, and by three to four if it is a brother or a sister," says our neurologist.

Certain illnesses can also be accompanied by RLS: neuropathy, linked to diabetes or excessive alcohol consumption, as well as kidney failure or Parkinson's disease.

"Conversely, restless legs syndrome is not a precursor to Parkinson's disease", insists Nathalie Patte-Karenti.

Finally, several drugs can worsen an already present RLS, such as certain neuroleptics and antidepressants.

However, there is no question of eliminating the patient's treatment, but rather of finding a substitute molecule.

How do you treat it?

The treatment begins with hygieno-dietetic advice, in particular to compensate for a lack of iron.

"We will avoid, for example, consuming a lot of green tea, which removes iron," explains our specialist.

The patient is also invited to remove stimulants at the end of the day, such as coffee or alcohol.

Finally, we will stop any sporting activity after 3 p.m., to protect ourselves from a restless night.

Drugs which act on dopamine, called dopamine agonists, and similar to those used in Parkinson's disease, may be prescribed.

"They are taken in very small doses, and give very good results, but there can be certain side effects, in particular addiction problems", indicates Nathalie Patte-Karenti.

Certain antiepileptics and morphine derivatives make it possible to circumvent this risk of addiction and act just as effectively.

"The goal is to give the patient a treatment strategy, which he can manage on his own depending on the pain and the severity of the symptoms."

Finally, for those who experience bedtime anxiety, hypnosis can be of great help, and allow them to re-associate sleep with a time of comfort and rest.