Calling Doctors: Question

SefacHotRodder · Oct 15, 2005

Recently, i've been getting these weierd "spasms" in my legs. Its wierd, my muscles sorta just twitch. It happens usually when my legs are straight out like when i'm watching tv in bed or resting my legs on a table or even lying down going to bed. Its getting to the point where i have to keep moving my legs every minute or so. Does anyone know what this could be? It doesn't happen any other time, just when my legs are completely straight out and flat.

Thanks

Chris

gougoul · Oct 15, 2005

I have it as well. Started in the legs (upper part), and went to the stage where i had it everywhere, really just everywhere, basically, it was similar to the "writers cramp" in the eye, just everywhere. Also had some "Needles" twitching etc etc (have it since more than 8-10 years, but it's going away now).
Made big exams, and nothing came out.
Make sure it's not just happening on one side, as this could be bad news.
Otherwise, try taking some calcium/magnesium for a while (months). Also, do you sleep enough ? Do you have it more when you're stressed ?
How did it start ?

Sometimes, this is also related to mitochondria. There is something you can try, it's L-carnitin...maybe it could work. Also do exercice a lot, even if it's bad, it makes the thing much better.

gougoul · Oct 15, 2005

By the way, is it rythmic (does it like a heartbeat), or is it only once ?

One is called Myoclonus, the other myokiny....(not sure about spelling in english, ermm)...These are different.

Sfumato · Oct 15, 2005

Try more potassium in diet.
Sleep leg twitching is different, a form of sleep apnea.

SefacHotRodder · Oct 15, 2005

I have it as well. Started in the legs (upper part), and went to the stage where i had it everywhere, really just everywhere, basically, it was similar to the "writers cramp" in the eye, just everywhere. Also had some "Needles" twitching etc etc (have it since more than 8-10 years, but it's going away now).
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Oh man...

Make sure it's not just happening on one side, as this could be bad news.
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bad? As far as i can remember, it only happens on my right leg

Otherwise, try taking some calcium/magnesium for a while (months).
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Thanks

Also, do you sleep enough ?
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Definatley not

Do you have it more when you're stressed ?
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I don't really get stressed

How did it start ?
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I have no idea

There is something you can try, it's L-carnitin...maybe it could work. Also do exercice a lot, even if it's bad, it makes the thing much better.
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Thanks

By the way, is it rythmic (does it like a heartbeat), or is it only once ?
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Umm. Its sorta a rythmic thing. It happens and then it sorta "spasis" (sp?) a few times

One is called Myoclonus, the other myokiny....(not sure about spelling in english, ermm)...These are different.
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Thanks. I'll look into it

Try more potassium in diet.
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Thanks

Its actually happening now. I'm sitting at my desk and my leg is resting on the floor and my "gastronemius" muscle (at least, thats what i think it is based off a google image search for leg muscles) is twitching. It stops for about half a minute and starts again. The twitching lasts about 15-30 secs

EDIT: Now that i'm thinking about this, i'm noticing it more. Its happening in my back too and in my "underarm" area. AND, its only happening on my right side

^@#& · Oct 15, 2005

this might sound stupid but are your boxers (or whatever underwear you happen to wear) tight at the bottom? It could have something to do with that..

luke9583 · Oct 15, 2005

I cramp up when my Ca is down.

SefacHotRodder · Oct 15, 2005

ferrari355fi said:

this might sound stupid but are your boxers (or whatever underwear you happen to wear) tight at the bottom? It could have something to do with that..
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NO

luke9583 said:

I cramp up when my Ca is down.
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These don't feel like cramps but i'll look into it.

UroTrash · Oct 15, 2005

People always feel compelled to say something about electrolytes when a patient has that complaint...take potassium, eat bananas, take tonic water, blah blah blah.

The truth is it is a little muscle twitch that is harmless and happens to everybody occasionally and has nothing to do with electrolyte deficiencies.

It is harmless and meaningless, ignore it.

*The above is for entertainment value only and is not intended as medical blah blah blah.

SefacHotRodder · Oct 15, 2005

Harmless? I can't watch tv without having to change my position every 5 minutes.

"The truth is it is a little muscle twitch that is harmless and happens to everybody occasionally ..."

Occasionally caught my eye in this one. Define occasionally. Every 30 seconds? I doubt it.

vvvmd · Oct 15, 2005

Muscle fasciculation or twitches are usually harmless and very common. The ones that happen in eyelids are the most common and are meaningless. Sometimes they can occur in other muscle groups and can be very annoying. Lack of sleep or stress can make them worse. Unless they are associated with other symptoms like loss of strength or muscle mass they usually mean nothing.

Sfumato · Oct 15, 2005

Restless leg syndrome is indeed a clinical diagnosis, usually in sleep, but occ. seen in awake. I am not well versed in adult RLS, but it is seen.

http://www.ninds.nih.gov/disorders/restless_legs/detail_restless_legs.htm

Anecdotally, my father-in-law recently had similar problem, I told him to try more potassium. Seemed to work. Who knows why.
Besides, dic-doc dunno nuttin' about the other 2 legs.

HTH

SefacHotRodder · Oct 15, 2005

Thanks. It could be my lack of sleep. I get about 6-7 hours a night.

FarmerDave · Oct 15, 2005

Sfumato said:

Besides, dic-doc dunno nuttin' about the other 2 legs.
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QUACKFIGHT!

Sfumato · Oct 15, 2005

FarmerDave said:

QUACKFIGHT!

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whart · Oct 16, 2005

Could this be a syndrome, which will eventually be recognized as a basis for preferred treatment?

I used to get these in my legs as a teenager, and just attributed it to 'growing pains.'

When our exotic cat was still a kitten, and was in the bloom of growth, we would wake up in the morning sometimes and he would seem noticeably bigger.

His legs twitched, too.

gougoul · Oct 16, 2005

vvvmd said:

Muscle fasciculation or twitches are usually harmless and very common. The ones that happen in eyelids are the most common and are meaningless. Sometimes they can occur in other muscle groups and can be very annoying. Lack of sleep or stress can make them worse. Unless they are associated with other symptoms like loss of strength or muscle mass they usually mean nothing.
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Yeah, this is fully right. I went to 2 different neurologists, had quite painful exams (a 40 cms needle in the legs etc) just to hear the muscle response to electric stimulation. It least you can hear the twitching....how cool.
But useless.
Frankly, i would first try out to sleep more, do some exercice, every day (if it's in the legs, walk a lot), and start with calcium/magnesium. It helped a lot with me.

SefacHotRodder · Oct 16, 2005

^ Thanks

Boudewijn · Oct 16, 2005

If you are on a normal diet there is no need to take additional elements. Fasciculations they are, usually harmless but when persistent I would consult a neurologist.

SefacHotRodder · Oct 16, 2005

Thanks Boudewijn

I want to make clear that these don't happen when i'm using my legs (walking, driving etc) but when i'm sitting or lying down.

M512 · Oct 16, 2005

Threads like this drive me nuts. There is way too much erroneous advice. Unless you're an anomoly, then your diet is not perfect. Everyone should supplement with a high quality multi-nutritional.

There could be many reasons for your problem. While it is likely "nothing serious" as in massive health problems will result, you do not know that for sure. Your problem could be nutrition related, circulation related, etc, etc. "Don't worry about it" is simply an irresponsible approach. There can be many causes for what you are describing, but the internet is not a valid medium for diagnosing a problem. Leave that to the professionals. The key is to find a good physician. Remember that MD's are like Champion F1 drivers.... Good ones are far and few between. You may need to go to 10 physicians before you find a good one that does more than; "go home and rest, it's nothing to worry about..." or "take these samples and see what happens".

You may also want to good DO that specializes in MMI.

Sfumato · Oct 16, 2005

Sleep medicine in kids is part of what I do.
The website linked is a nice summary of RLS. I had to look it up as adult medicine is different. So, read it and decide. Site is NIH site, not some good houskeeping dreck
It isn't just fasciculations.

National Institute of Neurological Disorders and Stroke said:

What is restless legs?
Restless legs syndrome (RLS) is a neurological disorder characterized by unpleasant sensations in the legs and an uncontrollable urge to move when at rest in an effort to relieve these feelings. RLS sensations are often described by people as burning, creeping, tugging, or like insects crawling inside the legs. Often called paresthesias (abnormal sensations) or dysesthesias (unpleasant abnormal sensations), the sensations range in severity from uncomfortable to irritating to painful.
The most distinctive or unusual aspect of the condition is that lying down and trying to relax activates the symptoms. As a result, most people with RLS have difficulty falling asleep and staying asleep. Left untreated, the condition causes exhaustion and daytime fatigue. Many people with RLS report that their job, personal relations, and activities of daily living are strongly affected as a result of their exhaustion. They are often unable to concentrate, have impaired memory, or fail to accomplish daily tasks.
Some researchers estimate that RLS affects as many as 12 million Americans. However, others estimate a much higher occurrence because RLS is thought to be underdiagnosed and, in some cases, misdiagnosed. Some people with RLS will not seek medical attention, believing that they will not be taken seriously, that their symptoms are too mild, or that their condition is not treatable. Some physicians wrongly attribute the symptoms to nervousness, insomnia, stress, arthritis, muscle cramps, or aging.
RLS occurs in both genders, although the incidence may be slightly higher in women. Although the syndrome may begin at any age, even as early as infancy, most patients who are severely affected are middle-aged or older. In addition, the severity of the disorder appears to increase with age. Older patients experience symptoms more frequently and for longer periods of time.
More than 80 percent of people with RLS also experience a more common condition known as periodic limb movement disorder (PLMD). PLMD is characterized by involuntary leg twitching or jerking movements during sleep that typically occur every 10 to 60 seconds, sometimes throughout the night. The symptoms cause repeated awakening and severely disrupted sleep. Unlike RLS, the movements caused by PLMD are involuntary-people have no control over them. Although many patients with RLS also develop PLMD, most people with PLMD do not experience RLS. Like RLS, the cause of PLMD is unknown.

What are common signs and symptoms of restless legs?
As described above, people with RLS feel uncomfortable sensations in their legs, especially when sitting or lying down, accompanied by an irresistible urge to move about. These sensations usually occur deep inside the leg, between the knee and ankle; more rarely, they occur in the feet, thighs, arms, and hands. Although the sensations can occur on just one side of the body, they most often affect both sides.
Because moving the legs (or other affected parts of the body) relieves the discomfort, people with RLS often keep their legs in motion to minimize or prevent the sensations. They may pace the floor, constantly move their legs while sitting, and toss and turn in bed.
Most people find the symptoms to be less noticeable during the day and more pronounced in the evening or at night, especially during the onset of sleep. For many people, the symptoms disappear by early morning, allowing for more refreshing sleep at that time. Other triggering situations are periods of inactivity such as long car trips, sitting in a movie theater, long-distance flights, immobilization in a cast, or relaxation exercises.
The symptoms of RLS vary in severity and duration from person to person. Mild RLS occurs episodically, with only mild disruption of sleep onset, and causes little distress. In moderately severe cases, symptoms occur only once or twice a week but result in significant delay of sleep onset, with some disruption of daytime function. In severe cases of RLS, the symptoms occur more than twice a week and result in burdensome interruption of sleep and impairment of daytime function.
Symptoms may begin at any stage of life, although the disorder is more common with increasing age. Sometimes people will experience spontaneous improvement over a period of weeks or months. Although rare, spontaneous improvement over a period of years also can occur. If these improvements occur, it is usually during the early stages of the disorder. In general, however, symptoms become more severe over time.
People who have both RLS and an associated condition tend to develop more severe symptoms rapidly. In contrast, those whose RLS is not related to any other medical condition and whose onset is at an early age show a very slow progression of the disorder and many years may pass before symptoms occur regularly.

What causes restless legs syndrome?
In most cases, the cause of RLS is unknown (referred to as idiopathic). A family history of the condition is seen in approximately 50 percent of such cases, suggesting a genetic form of the disorder. People with familial RLS tend to be younger when symptoms start and have a slower progression of the condition.
In other cases, RLS appears to be related to the following factors or conditions, although researchers do not yet know if these factors actually cause RLS.
People with low iron levels or anemia may be prone to developing RLS. Once iron levels or anemia is corrected, patients may see a reduction in symptoms.
Chronic diseases such as kidney failure, diabetes, Parkinson's disease, and peripheral neuropathy are associated with RLS. Treating the underlying condition often provides relief from RLS symptoms.
Some pregnant women experience RLS, especially in their last trimester. For most of these women, symptoms usually disappear within 4 weeks after delivery.
Certain medications-such as antinausea drugs (prochlorperazine or metoclopramide), antiseizure drugs (phenytoin or droperidol), antipsychotic drugs (haloperidol or phenothiazine derivatives), and some cold and allergy medications-may aggravate symptoms. Patients can talk with their physicians about the possibility of changing medications.
Researchers also have found that caffeine, alcohol, and tobacco may aggravate or trigger symptoms in patients who are predisposed to develop RLS. Some studies have shown that a reduction or complete elimination of such substances may relieve symptoms, although it remains unclear whether elimination of such substances can prevent RLS symptoms from occurring at all.

How is restless legs syndrome diagnosed?
Currently, there is no single diagnostic test for RLS. The disorder is diagnosed clinically by evaluating the patient's history and symptoms. Despite a clear description of clinical features, the condition is often misdiagnosed or underdiagnosed. In 1995, the International Restless Legs Syndrome Study Group identified four basic criteria for diagnosing RLS: (1) a desire to move the limbs, often associated with paresthesias or dysesthesias, (2) symptoms that are worse or present only during rest and are partially or temporarily relieved by activity, (3) motor restlessness, and (4) nocturnal worsening of symptoms. Although about 80 percent of those with RLS also experience PLMD, it is not necessary for a diagnosis of RLS. In more severe cases, patients may experience dyskinesia (uncontrolled, often continuous movements) while awake, and some experience symptoms in one or both of their arms as well as their legs. Most people with RLS have sleep disturbances, largely because of the limb discomfort and jerking. The result is excessive daytime sleepiness and fatigue.
Despite these efforts to establish standard criteria, the clinical diagnosis of RLS is difficult to make. Physicians must rely largely on patients' descriptions of symptoms and information from their medical history, including past medical problems, family history, and current medications. Patients may be asked about frequency, duration, and intensity of symptoms as well as their tendency toward daytime sleep patterns and sleepiness, disturbance of sleep, or daytime function. If a patient's history is suggestive of RLS, laboratory tests may be performed to rule out other conditions and support the diagnosis of RLS. Blood tests to exclude anemia, decreased iron stores, diabetes, and renal dysfunction should be performed. Electromyography and nerve conduction studies may also be recommended to measure electrical activity in muscles and nerves, and Doppler sonography may be used to evaluate muscle activity in the legs. Such tests can document any accompanying damage or disease in nerves and nerve roots (such as peripheral neuropathy and radiculopathy) or other leg-related movement disorders. Negative results from tests may indicate that the diagnosis is RLS. In some cases, sleep studies such as polysomnography (a test that records the patient's brain waves, heartbeat, and breathing during an entire night) are undertaken to identify the presence of PLMD.
The diagnosis is especially difficult with children because the physician relies heavily on the patient's explanations of symptoms, which, given the nature of the symptoms of RLS, can be difficult for a child to describe. The syndrome can sometimes be misdiagnosed as "growing pains" or attention deficit disorder.

How is restless legs syndrome treated?
Although movement brings relief to those with RLS, it is generally only temporary. However, RLS can be controlled by finding any possible underlying disorder. Often, treating the associated medical condition, such as peripheral neuropathy or diabetes, will alleviate many symptoms. For patients with idiopathic RLS, treatment is directed toward relieving symptoms.
For those with mild to moderate symptoms, prevention is key, and many physicians suggest certain lifestyle changes and activities to reduce or eliminate symptoms. Decreased use of caffeine, alcohol, and tobacco may provide some relief. Physicians may suggest that certain individuals take supplements to correct deficiencies in iron, folate, and magnesium. Studies also have shown that maintaining a regular sleep pattern can reduce symptoms. Some individuals, finding that RLS symptoms are minimized in the early morning, change their sleep patterns. Others have found that a program of regular moderate exercise helps them sleep better; on the other hand, excessive exercise has been reported by some patients to aggravate RLS symptoms. Taking a hot bath, massaging the legs, or using a heating pad or ice pack can help relieve symptoms in some patients. Although many patients find some relief with such measures, rarely do these efforts completely eliminate symptoms
Physicians also may suggest a variety of medications to treat RLS. Generally, physicians choose from dopaminergics, benzodiazepines (central nervous system depressants), opioids, and anticonvulsants. Dopaminergic agents, largely used to treat Parkinson's disease, have been shown to reduce RLS symptoms and PLMD and are considered the initial treatment of choice. Good short-term results of treatment with levodopa plus carbidopa have been reported, although most patients eventually will develop augmentation, meaning that symptoms are reduced at night but begin to develop earlier in the day than usual. Dopamine agonists such as pergolide mesylate, pramipexole, and ropinirole hydrochloride may be effective in some patients and are less likely to cause augmentation.
Benzodiazepines (such as clonazepam and diazepam) may be prescribed for patients who have mild or intermittent symptoms. These drugs help patients obtain a more restful sleep but they do not fully alleviate RLS symptoms and can cause daytime sleepiness. Because these depressants also may induce or aggravate sleep apnea in some cases, they should not be used in people with this condition.
For more severe symptoms, opioids such as codeine, propoxyphene, or oxycodone may be prescribed for their ability to induce relaxation and diminish pain. Side effects include dizziness, nausea, vomiting, and the risk of addiction.
Anticonvulsants such as carbamazepine and gabapentin are also useful for some patients, as they decrease the sensory disturbances (creeping and crawling sensations). Dizziness, fatigue, and sleepiness are among the possible side effects.
Unfortunately, no one drug is effective for everyone with RLS. What may be helpful to one individual may actually worsen symptoms for another. In addition, medications taken regularly may lose their effect, making it necessary to change medications periodically.

What is the prognosis of people with restless legs?
RLS is generally a lifelong condition for which there is no cure. Symptoms may gradually worsen with age, though more slowly for those with the idiopathic form of RLS than for patients who also suffer from an associated medical condition. Nevertheless, current therapies can control the disorder, minimizing symptoms and increasing periods of restful sleep. In addition, some patients have remissions, periods in which symptoms decrease or disappear for days, weeks, or months, although symptoms usually eventually reappear. A diagnosis of RLS does not indicate the onset of another neurological disease.

What research is being done?
Within the Federal Government, the National Institute of Neurological Disorders and Stroke (NINDS), one of the National Institutes of Health, has primary responsibility for conducting and supporting research on RLS. The goal of this research is to increase scientific understanding of RLS, find improved methods of diagnosing and treating the syndrome, and discover ways to prevent it.
NINDS-supported researchers are investigating the possible role of dopamine function in RLS. Dopamine is a chemical messenger responsible for transmitting signals between one area of the brain, the substantia nigra, and the next relay station of the brain, the corpus striatum, to produce smooth, purposeful muscle activity. Researchers suspect that impaired transmission of dopamine signals may play a role in RLS. Additional research should provide new information about how RLS occurs and may help investigators identify more successful treatment options.
The NINDS sponsored a workshop on dopamine in 1999 to help plan a course for future research on disorders such as RLS and recommend ways to advance and encourage research in this field. Participants' recommendations for further research included the development of an animal model of RLS; additional genetic, epidemiologic, and pathophysiologic investigations of RLS; efforts to define genetic and non-genetic forms of RLS; establishment of a brain tissue bank to aid investigators; continuing investigations on dopamine and RLS; and studies of PLMD as it relates to RLS.
Research on pallidotomy, a surgical procedure in which a portion of the brain called the globus pallidus is lesioned, may contribute to a greater understanding of the pathophysiology of RLS and may lead to a possible treatment. A recent study by NINDS-funded researchers showed that a patient with RLS and Parkinson's disease benefited from a pallidotomy and obtained relief from the limb discomfort caused by RLS. Additional research must be conducted to duplicate these results in other patients and to learn whether pallidotomy would be effective in RLS patients who do not also have Parkinson's disease.
In other related research, NINDS scientists are conducting studies with patients to better understand the physiological mechanisms of PLMD associated with RLS.

Where can I get more information?
Restless Legs Syndrome Foundation
819 Second Street, SW
Rochester, MN 55902-2985
[email protected]
http://www.rls.org
Tel: 507-287-6465
Fax: 507-287-6312
National Sleep Foundation
1522 K Street NW
Suite 500
Washington, DC 20005
[email protected]
http://www.sleepfoundation.org
Tel: 202-347-3471 (no public calls please)
Fax: 202-347-3472
WE MOVE (Worldwide Education & Awareness for Movement Disorders)
204 West 84th Street
New York, NY 10024
[email protected]
http://www.wemove.org
Tel: 212-875-8312
Fax: 212-875-8389
National Organization for Rare Disorders (NORD)
P.O. Box 1968
(55 Kenosia Avenue)
Danbury, CT 06813-1968
[email protected]
http://www.rarediseases.org
Tel: 203-744-0100 Voice Mail 800-999-NORD (6673)
Fax: 203-798-2291
"Restless Legs Syndrome Fact Sheet", NINDS. Publication date April 2001.
NIH Publication No. 01-4847
Prepared by:
Office of Communications and Public Liaison
National Institute of Neurological Disorders and Stroke
National Institutes of Health
Bethesda, MD 20892
NINDS health-related material is provided for information purposes only and does not necessarily represent endorsement by or an official position of the National Institute of Neurological Disorders and Stroke or any other Federal agency. Advice on the treatment or care of an individual patient should be obtained through consultation with a physician who has examined that patient or is familiar with that patient's medical history.
All NINDS-prepared information is in the public domain and may be freely copied. Credit to the NINDS or the NIH is appreciated.

Last updated October 13, 2005
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SefacHotRodder · Oct 16, 2005

^ Thanks. Thats definatley what i have . I will certainly be looking into this.

Thanks guys

UroTrash · Oct 16, 2005

He describes fasciculations, not Restless Leg Syndrome. Common and harmless.

I believe Boudewijn and Victor both agree with me.

Remember Chris is 17 years old.

SefacHotRodder · Oct 16, 2005

UroTrash said:

He describes fasciculations, not Restless Leg Syndrome. Common and harmless.
Click to expand...

But its annying and does affect what i do. It does make a difference when i do stuff. I can't watch tv without moving all the time and its annoying as hell when i'm just sitting somewhere doing something (like right now)

UroTrash said:

Remember Chris is 17 years old.
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18 in 3 weeks

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