My latest post was about Restless Leg Syndrome (RLS), a disorder in which patients experience uncomfortable twitches and prickly feelings in the legs.
About 80% of RLS patients also experience periodic limb movements. Patients with periodic limb movement disorder (PLMD) complain of insomnia and frequent awakenings during the night, sometimes due to excessive leg jerking. They also kick during their sleep.
I am going to go a little deeper into PLMD in this post. PLMD patients typically display periodic contractions of the tibialis anterior (shown in the picture below), a muscle in the leg that plays a role in the dorsiflexion of the toes and ankle. Dorsiflexion is the action of moving the foot in an upward direction. For this reason, PLMD patients also sometimes experience periodic dorsiflexion, which causes a leg jerk or a kick.
PLMD also affects the quality of life in general. For instance, many patients cannot travel in airplanes or drive for long distances in cars. They also cannot sit and enjoy movies because they constantly need to be walking around to alleviate the tingling sensation in their legs.
Having this condition has caused many people to make drastic lifestyle changes. Some people have quit their jobs due to amount of discomfort they felt. Additionally, one patient suffered from this condition as a child. He was excluded and humiliated by the way he was treated, and he eventually entered a period of depression.
PLMD tortures patients during the day as well as during the night. During sleep, the patient is usually not aware of the leg jerks. He is, however, aware of waking up frequently. Thus, his sleep is fragmented. For this reason, PLMD can cause excessive daytime sleepiness. It is also a problem to bed partners in that they complain of the patient being very restless and kicking frequently.
This speaks to the seriousness of this condition. PLMD is one of the causes of sleep disorders like insomnia and can force patients to reconsider their lifestyle altogether.
More to come soon!
Source: Reite, Martin, Michael P. Weissberg, and John Ruddy. Clinical manual for the evaluation and treatment of sleep disorders. Washington, DC: American Psychiatric Pub., 2009. Print.
How does a person develop this condition? Also, does insomnia exacerbate these symptoms?
ReplyDeleteThe exact cause of PLMD is unknown, but there are many things that can contribute to it. For instance, certain medications such as antidepressants can exacerbate symptoms. Additionally, chronic diseases, like peripheral neuropathy, diabetes, and iron deficiency, can also cause PLMD. Some of these are the same as the causes of RLS (see previous post).
DeleteThis condition actually is a contributing factor to sleep disorders like insomnia and excessive daytime sleepiness. The jerking of the legs results in interrupted sleep, which causes these disorders. Great question!
The patient's quality of life really suffers with this disease. Are there any known treatments of PLMD? Are doctors able to do anything to improve the situation, or does the patient just have to learn to deal with it?
ReplyDeleteHey Avani! That's a great question! From watching Dr. Qureshi treat PLMD patients, I know that normally they wouldn't treat unless it causes problems like excessive daytime sleepiness or really fragmented sleep. When PLMD causes these problems, they use medications to improve symptoms. There are various medications used to decrease muscle contractions.
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