Cornelia de lange syndrome

Define Cornelia de Lange syndrome

Cornelia de Lange syndrome (CdLS) is a congenital rare syndrome appear due to genetic disorders. The primary characteristic of this syndrome is delayed physical development during fetal growth and continues to after birth. In other word, it can be described as a prenatal and postnatal growth retardation.

The signs and symptoms are associated with distinct physical appearance, including craniofacial (head and facial) abnormalities, defective upper limb (hands and arms) development; and mild to severe cognitive impairment due to mental retardation. The symptomatic variation seems with case to case. (1,2)

Cornelia de Lange Syndrome image

Sign and symptoms

The typical sign and symptoms of Cornelia de Lange syndrome is distinct, but some features are considered as secondary features. Therefore, the appeared signs and symptoms are divided into two categories, which include primary characteristics and secondary characteristics, though all the below mentioned sign and symptoms may not be prominent in every case.

Primary characteristics of CdLS

Depending upon the genetic differences, the primary characteristics occur, which include:

Overall growth of a infants

The infant born by CdLS usually has low birth weight, that approximately 5 lbs. or 1oz., but this is not a fixed for every case, and it varies within a range of 1 lb., 2 oz. to 10 lbs. The length of the child is also low and calculated mean birth length is around 18 inches. The provided value can help to indicate that CdLS cause growth retardation during  fetal development in the womb. The head size of the infant is also small, which is termed as microcephaly.

Cornelia de lange syndrome

Delayed mental development

The children with CdLS typically has delayed mental development and cause mild to severe intellectual incapacitance. The common features  include Learning disabilities, language delays, but some individual can have borderline of standard intelligence.

Gastro esophageal Reflux Disease (GERD)

Vast majority of the CdLS patient (almost 85%) complains discomfort after ingestion of food, like heartburn due to the high possibility of GERD. The unpleasant effect also has a negative impact on  behavior.

Behavioral Issues

Different types of annoying behaviors, which may cause self hurting issues like head-banging or  hand-biting are often associated. Repetitive compulsive behavior,  Obsessive Compulsive Disorder, Attention Deficit Hyperactivity Disorder, Anxiety and Attention Deficit Disorder are also noticeable with patients having  CdLS syndrome.

Secondary Characteristics of CdLS

Typical  facial appearance

Along with microcephaly, a peculiar vertically extended groove present between the upper lip and nose, a stumpy nasal bridge; upturned nostrils; and a obtrude upper jaw. In addition, distinctive facial defects may consist of skinny, downturned lips; ears are low-sited; vaulted, prominent eyebrows that raise jointly diagonally from the bottom of the nose; an oddly short hairline on the forehead and the backside of the neck; and atypical twisted, elongated eyelashes and cleft palate or high-arched palate.

Limb distinction

The typical distinction of limb is also associated with CdLS patients, for them, which include small sized hands and feet with curved little finger (clinodactyl), incompletely united the second and third toes,  abnormal positioning of the thumbs. Associated hand abnormalities may be single sided or both sided. Foot size is smaller than the normal size. Other than these, rarely missing of fingers, forearms  or hands are noticed.

Other System Abnormalities

Other included abnormal features include inflamed eyelid, drooping eyelids, myopia (nearsightedness), involuntary rapid eye movement etc. (2,3,4)

Cornelia De Lange Syndrome Causes

The Cornelia de Lange syndrome is a genetic disorder. The responsible genes associated with CdLS are NIPBL gene on chromosome 5 and the SMC1L1 gene on the X chromosome. In most of the cases, almost half of the incidence is related to the abnormal mutation NIPBL gene, though a very few cases are associated with the abnormal mutation of SMC1L1 gene. Other involved gene yet to discover.

The mutagenic abnormality of the involved gene may carry forward from either of the parental source or new genetic alteration also cause the onset of CdLS. (2)

Diagnosis

An ultrasound imaging system may help to assume the presence of Cornelia de Lange syndrome (CdLS) during fetal growth. The waves of the ultrasounds form an image, which can detect growth retardation, deformities of limb, facial abnormalities and/or defective organ formation.

The confirmation can be notable about the presence CdLS is possible after the birth of the infant by performing a thorough clinical evaluation and detection of typical physical features. The different scientific literature described that a confirmed diagnosis of the presence of Cornelia de Lange syndrome can be reported  after receiving the distinct facial features with the association of  limb abnormalities, before and after birth growth retardation, and intellectual retardation. Mild symptomatic features can cause confusion of the CdLS diagnosis and often difficult to provide conclusive result.

In confirmatory test, molecular genetic testing is performed in the NIPBL and SMC1L1 and finding of abnormal genetic mutations validate the detected physical abnormality is related to CdLS. This test usually recommended for mild characteristic features.

If a precise NIPBL or SMC1L1 gene mutation has been detected, then in the prenatal stage diagnosis of CdLs is possible. (2,4)

Treatment

Depending upon the notable symptomatic approach, a treatment plan is prepared by the clinical experts. In the Cornelia de Lange syndrome, multiple organ deformity is involved, therefore a team of expert clinicians needs to provide a proper therapeutic approach to the affected child. The included specialists are pediatricians; surgeons; geneticists; orthopedists; orthopedic surgeons; plastic surgeon; gastroenterologists, urologists, otolaryngologists (specialist of the ears, nose, and throat); pediatric cardiologists; dentist; speech pathologists; audiologists (specialists who assess and treat hearing problems); eye specialists; physical and occupational therapists; and/or other health care givers.

Any involvement of cardiac problems, GI tract defect, audibility complications, and/or propensity towards respiratory infections need early detection and prompt medical care to reduce the complications. The interventions include pharmacological, surgical depending upon the site and type of abnormality. For example, child susceptible towards respiratory infection can need to treat with antibiotic therapy, episodes of convulsion can be controlled by anticonvulsive therapy, whereas abnormality in heart or limb abnormality may rectify by surgical intervention.

Other supportive therapeutic approaches like hearing aids may recommend and provide a beneficial effect for  hearing impairment. Remedial education, speech therapy, vocational training,  and/or other medical and/or social services also provide positive outcomes for CdLS.

Genetic counseling is suggested for affected persons and their family members. (2)

References

  1. Cornelia de Lange syndrome, (2016); Genetic Home References; Retrieve from: https://ghr.nlm.nih.gov/condition/cornelia-de-lange-syndrome
  2. Cornelia de Lange Syndrome; National Organization for rare diseases; http://rarediseases.org/rare-diseases/cornelia-de-lange-syndrome/
  3. Characteristics of CdLS; CdLS foundation; http://www.cdlsusa.org/what-is-cdls/characteristics-of-cdls.htm
  4. Matthew A Deardorff, Sarah E Noon, andIan D Krantz, (2016); Cornelia de Lange Syndrome; http://www.ncbi.nlm.nih.gov/books/NBK1104/

Budd Chiari Syndrome

What is Budd Chiari Syndrome?

Budd Chiari syndrome is a rare disease produced by thrombotic or non-thrombotic hepatic venous outflow blockage. Dr. Budd explained the disease in 1845, and Dr. Chiari gave additional information regarding the primary pathologic explanation of the liver condition in 1899. The three main characteristics of Budd Chiari syndrome are enlargement of the liver, ascites, and sudden pain in the abdomen.

The majority of patients who have this syndrome usually also have the following underlying conditions:

  1. thrombotic diathesis
  2. polycythemia vera
  3. paroxysmal nocturnal hemoglobinuria
  4. pregnancy and use of birth control pills
  5. tumors
  6. chronic inflammatory diseases
  7. clotting disorders
  8. infections

Signs & Symptoms

The majority of the patients who have Budd Chiari syndrome have the three chief manifestations:

  1. Ascites – abdomen becomes distended because of the fluid accumulation in the abdominal cavity
  2. Pain in the abdomen – sudden in onset, accompanied by nausea and vomiting
  3. Hepatomegaly – enlargement of the liver, blood can flow toward the liver, but not away from it

The accumulation of blood inside the liver can destroy the liver cells. This may subsequently lead to jaundice or yellowish discoloration of the eyes and skin and problems in the kidney.

Causes

Usually Budd Chiari syndrome was brought about by a blood disorder, for instance polycythemia vera or Sickle cell disease. Furthermore, it can also be brought about by the use of birth control pills, pregnancy, liver cancer, liver trauma, infection, and autoimmune diseases.

The causes or underlying conditions that can cause Budd Chiari Syndrome are the following:

  1. hepatic vein thrombosis
  2. hepatic vein compression caused by a tumor
  3. pregnancy and the use of birth control pills
  4. infection
  5. blood disorders
  6. congenital venous webs
  7. inferior vena caval narrowing

Diagnosis

The most common diagnostic tests to confirm Budd Chiari Syndrome are the following:

  1. MRI or Magnetic Resonance Imaging
  2. Ultrasound
  3. Liver biopsy

The liver cells taken from the liver biopsy will be examined under the microscope to confirm the disease. The fluid that had accumulated in the abdomen can also be collected for confirmatory testing.

The common manifestations of Budd Chiari Syndrome, which is Hepatomegaly, ascites and abdominal pain are not confirmatory for the diagnosis because it is also the symptoms of a lot of liver disorders.

It is really necessary that the patient undergo many diagnostic tests to help the doctor come out with the correct diagnosis.

Treatment

If there is no treatment provided, Budd Chiari Syndrome can seriously injure the liver.

Here are the following treatments for Budd Chiari Syndrome:

  1. Drugs that can dissolve blood clots or lessen new blood clot formation can be prescribed.
  2. Low sodium intake can regulate the growth of ascites.
  3. Special surgeries can alleviate the blockage of blood in the liver.
  4. A liver transplant can be a last resort if the liver is severely injured.

Pictures

budd chiari syndrome pictures

Abdominal distension (ascites) in Budd chiari syndrome

budd chiari syndrome pictures

Picture of Engorged veins in Budd chiari syndrome

budd chiari syndrome images

Churg-Strauss Syndrome

What is Churg-Strauss Syndrome?

Churg-Strauss syndrome is a health problem characterized by swelling of the blood vessels. This swelling can impede blood circulation to essential body organs and at times may lead to irreversible damage. The most usual manifestation of Churg-Strauss syndrome is asthma. However, it can also result to different problems scaling from allergic rhinitis, skin rash and gastrointestinal bleeding, to terrible pain and lack of sensation in your hands and feet. The broad variety of symptoms and their likeness to manifestations of other diseases make it more difficult for doctors to diagnose Churg-Strauss syndrome. Churg-Strauss syndrome is uncommon and has unknown cure at present. However, your physician can typically assist you in managing symptoms by means of steroids and other immunosuppressant medications.

Symptoms & Signs

Churg-Strauss is an extremely unpredictable disorder. Several patients manifest merely minor symptoms, while some suffer major or critical problems. Presently, there are three stages of Churg-Strauss syndrome, everyone having its individual manifestations, although not everybody will undergo the entire three stages or in the similar arrangement. This is particularly correct as soon as the illness is diagnoses and managed earlier than the most severe injury happens.

churg strauss syndrome pictures

Pictures of symptoms of churg strauss syndrome (allergic, vasculitic stage)

Churg-Strauss stages comprises of:

Allergic stage

This is more often than not the initial stage of Churg-Strauss syndrome. It’s characterized by some allergic reactions, involving:

Asthma – The most usual manifestation of Churg-Strauss syndrome, asthma forms on standard three to nine years prior to the appearance of other signs and symptoms. In patients who have Churg-Strauss syndrome who previously suffer from asthma, symptoms typically grow to be bad and might necessitate steroids for regulation. Some people have what is called as late-onset asthma. Having asthma, even later on in life, doesn’t essentially signify that you obtain Churg-Strauss syndrome, nevertheless, Churg-Strauss happens hardly ever as a result of asthma.

Allergic rhinitis – This involves your nose’ mucous membranes, resulting to runny nose, sneezing and irritation.

Sinusitis – You may suffer from pain in the facial area and have nasal polyps, which are soft, non-cancerous lumps that brought about by inflammation for a long period of time.

Eosinophilic stage

An eosinophil is a kind of white blood cell that facilitates protection from particular infections. Usually, eosinophils comprises only an insignificant percentage of white blood cells, although in Churg-Strauss syndrome, unusually these cells are elevated medically termed as hypereosinophilia. Hypereosinophilia can lead to severe damage. Signs and symptoms of hypereosinophilia will be based on which area of your body is involved. The most targeted areas are your lungs and digestive tract. Hypereosinophilia can signify a quantity of allergic reactions and doesn’t essentially denote that you will have Churg-Strauss syndrome. Generally speaking, signs and symptoms of the hypereosinophilia stage may involve:

  1. Fever
  2. Loss of weight
  3. Asthma
  4. Tiredness
  5. Sweating at night
  6. Cough
  7. Pain in the abdomen
  8. Abdominal bleeding

This stage can continue in months or years, and your manifestations may vanish sometimes, simply to come back afterward. You might also suffer symptoms of hypereosinophilia and systemic vasculitis, the third stage of this disorder, all at once.

Vasculitic stage

The characteristic sign of this stage is massive blood vessel swelling medically termed as vasculitis. Through thinning blood vessels, swelling lessens blood circulation to essential organs all over the body, together with your skin, heart, peripheral nervous system, muscles, bones and digestive tract. Seldom, your kidneys might also be involved. Throughout this stage, you may experience being sick and have unintentional weight loss, inflamed lymph nodes, feebleness and exhaustion. Based on which areas are involved, you may also suffer from:

  1. Rash or sores in the skin
  2. Joint pains and inflammation
  3. Intense pain, loss of sensation and tingling in your hands and feet medically known as peripheral neuropathy
  4. Intense abdominal pain
  5. Diarrhea, nausea and vomiting
  6. Difficulty of breathing from asthma or congestive heart failure
  7. Coughing up of blood
  8. Chest pain
  9. Irregularities in your heart rhythm
  10. Blood in your urine

It is recommended to consult your doctor any time you manifest signs and symptoms familiar to Churg-Strauss syndrome. Churg-Strauss syndrome is uncommon, and it’s more possible that these manifestations have some other origin. However, it’s significant that your physician assess them.

Treatment

At present, the cure for Churg-Strauss syndrome remains unknown. Although specific drugs may aid even patients with grave symptoms attain remission. An excellent result and a decreased chance of complications from both the disorder and its management are greatly possible when Churg-Strauss syndrome is confirmed and managed ahead of time. Drugs indicated to manage Churg-Strauss syndrome involve:

Corticosteroids

Prednisone is the most usually given drug for Churg-Strauss syndrome. Your physician might give a high dose of corticosteroids or an increase in your present dose of corticosteroids to get hold of your symptoms as quickly as possible. However, since high doses of corticosteroids might lead to severe side-effects, such as bone thinning, elevated blood sugar, cataracts and infections, your physician will reduce the dose slowly until you are getting the minimum quantity that will maintain your disorder under management.

Other immunosuppressive drugs

Indicated for people with minor symptoms, a corticosteroid alone may be sufficient. Some people may need one more immunosuppressive drug, such as Cytoxan, Imuran or methotrexate, to decrease the body’s immune response even more. Since these medications damage your body’s capability to battle off infection and might lead to other grave side-effects, your disorder will be personally observed while you’re having them.

Intravenous immunoglobulin or IVIg

The infusion is given per month. IVIg is the most gentle of the medications prescribed for Churg-Strauss syndrome. The most usual side-effects are flu-like manifestations that normally persist just a day or so. IVIg has two most important disadvantages, on the other hand, it’s very costly, and it isn’t generally successful. IVIg isn’t regarded as an initial management for Churg-Strauss syndrome, however, research have revealed that it can be useful for patients who don’t react to other drugs. Even though pharmacologic management can alleviate symptoms of Churg-Strauss syndrome and propel the disorder toward remission, relapses are still frequent.

Prognosis

Churg-Strauss syndrome is a grave disorder that can be life-threatening. Not treated it is tremendously hazardous and jeopardizes the organs that are involved. With forceful management and close observing it might be calmed and remission is likely.

Tumor Lysis Syndrome

What is Tumor Lysis Syndrome?

Tumor lysis syndrome is a serious metabolic crisis often linked among particular forms of tumors. Dilutions of electrolytes inside the cell, vary from electrolytes outside the cell. In tumor lysis syndrome, tumor cells break apart, liberating their insides into the blood vessel. It will lead to a hazardous modification in the usual equilibrium of fluid and electrolytes—the amounts of potassium, phosphate and uric acid are increased, whereas calcium levels are reduced. The alterations happen in a very rapid manner and may possibly be so fast that instant fatality can occur.

Symptoms & Signs

Initially patients are asymptomatic or they do not manifest any symptoms, however, as the syndrome progresses it will lead into the following symptoms:

Tumor lysis syndrome pathophysiology, symptoms picture

Picture of Tumor lysis syndrome pathophysiology and symptoms

  1. Heartbeat irregularities
  2. Damage to mental ability
  3. Loss of awareness
  4. Difficulty of breathing
  5. Elevated blood potassium and uric acid levels shown in the laboratory tests
  6. Decreased blood calcium levels also shown in the laboratory tests

Treatment

Treatment is intended at preventive and palliative care, with the primary objectives to avoid kidney impairment and serious electrolyte problems. Patients who are vulnerable obtain treatment on a hospital to permit critical monitoring by hospital staff. The patients must have access to a dependable intravenous line always. Before starting treatment, a patient’s fluid levels and electrolyte status are cautiously calculated and examined. If the results came out and there are irregularities, the doctors may consider holding the treatment for a while, although this is not all the time a choice.

Laboratory examinations are completed regularly to check serum calcium, potassium, phosphate, magnesium and uric acid levels. A normal hospital procedure may need blood be removed for these examinations every two to six hours throughout two to three days. Subsequent are preventions and treatment plans for every major electrolyte problems like hyperuricemia, hyperkalemia, hyperphosphatemia, and hypocalcemia.

Hyperuricemia

Hyperuricemia is defined as an irregular elevation of serum uric acid levels that may possibly result to acute renal failure. There are a number of ways available to avoid renal impairment lie forceful hydration for instance. Also, drugs labeled as diuretics, for example furosemide or acetazolamide, are prescribed to aid increase urine excretion when needed.

Prophylactic allopurinol can also be prescribed to patients vulnerable for tumor lysis syndrome. One dose of 600 mg can be prescribed the day prior to treatment, followed by 300 mg once daily for the rest of treatment. Allopurinol is helpful since it stops the uric acid formation.

Hyperkalemia

Hyperkalemia is defined as an irregular elevation of serum potassium levels that may possibly result to hazardous irregularities in heart beats, heart attack, and muscle weakness. Regular checking with electrocardiography is suggested in patients vulnerable for tumor lysis syndrome in order that changes in the electrical movement of the heart can be detected ahead of time. Foods rich in potassium can also be limited to avoid by now high levels from elevating. Every now and then, drugs like Kayexalate are prescribed to facilitate reduction of serum potassium levels.

Hyperphosphatemia

Hyperphosphatemia is defined as an irregular elevation of serum phosphate levels that may possibly result to neuromuscular irritation and deteriorate kidney function. Cancer cells can have up to four times as much phosphate as non-malignant cells. Patients having acute tumor lysis syndrome can be taught to lessen their food intake of phosphate. Additionally, they can be prescribed drugs that attach to phosphate, thus preventing its intestinal absorption.

Hypocalcemia 

Hypocalcemia is defined as an irregular reduction in serum calcium levels that may possibly result to tetany, muscle cramps, and seizures. A calcium supplement can be prescribed.

Dialysis

Dialysis is a process utilized to control electrolyte problems by means of diffusion and ultrafiltration of fluid. Hemodialysis is a process that eliminates waste products via the human’s blood. Dialysis can otherwise be executed via the peritoneum called peritoneal dialysis. Since peritoneal dialysis does not clean up phosphate and urate as proficiently, and since it is not possible in patients with abdominal growths, hemodialysis is the ideal process. A physician who focuses in nephrology will normally inspect a vulnerable patient prior to cancer management, to get ready for the option of dialysis. In several cases, dialysis begins as a precautionary measure, both prior to or throughout cancer treatment.

Locked-in syndrome

What is Locked-in Syndrome?

Locked-in syndrome is an uncommon neurological problem described as full paralysis of voluntary muscles in the entire area of the body with the exception of eye movement that the individual can still control. It may possibly the consequence of brain injury, circulatory system diseases, diseases that tear down the myelin sheath covering the nerve cells, or drug overdose. Patients with locked-in syndrome are aware and are still capable of thinking and reasoning, but incapable of speaking or moving. The problem will lead individuals to turn out to be absolutely mute and paralyzed. Communication may be doable with blinking and eye movements.

Having a locked-in syndrome is really difficult for the individual and with his or her family. Especially that the patient will become bed ridden and will be incapable of speaking. Despite the problem the family should just have to take into consideration that the individual is still aware of his or her surrounding and can still think and reason. He or she may communicate using blinking and eye movements. In some cases, numerous therapies shows that function can still be slowly regained.

Signs & Symptoms

Symptoms of locked-in syndrome include the following:

Locked-in syndrome pictures

Picture of voluntary muscle dysfunction in Locked-in syndrome

  1. Full incapability for voluntary muscle control except eye movements and blinking
  2. The patient can still think, reason and remain conscious and aware
  3. Usual sleep and wake cycles are preserved
  4. Not capable of speaking
  5. Paralysis of lower extremities, lower cranial nerves and voluntary muscles

Due to the following symptoms of locked-in syndrome the patient required full care in a hospital or in a home setting.

Causes

The common causes of locked-in syndrome are the following:

  1. Traumatic brain injuries caused by stroke, severe head injury or ruptured aneurysm
  2. Diseases that tear down the myelin sheath surrounding the nerves, drug toxicity
  3. Any neurologic problem that can involve the ventral pons in the brain, which is the one responsible for voluntary muscle control

Treatment

As of now there is no known cure or surgery for locked-in syndrome. The management for the problem is only supportive care. They are taken care of critical care specialists, doctors of neurology, and physiatrists. They can also be supported by

  1. physical therapists
  2. occupational therapists
  3. speech and language therapists and
  4. psychotherapists.

Prognosis

The prognosis for locked-in syndrome is poor because there is no known cure and no standard treatment. In some cases therapy can help patients to regain their function. Despite the general poor prognosis there are still cases of locked-in syndrome who have regained impressive improvement of function with the help of new technologies like augmentative communication technology.

Now that there are new hopes for locked-in syndrome, families of the patients should not give up and maybe sometime in the future therapy could really help majority of the patients for their improvement and slowly return to their productive life.

Restless Leg Syndrome

What is Restless Leg Syndrome?

This condition is a problem of the leg wherein there is an uncomfortable feeling such as pain the leg area whenever the patient is at rest such as sitting down or even lying in bed. This is a neurological disorder affecting the legs but sometimes, other parts of the body are also affected like the torso or trunk, and the arms.

The RLS is also called as the Willis-Ekbom disease where the patient will associate the discomfort as something that can’t be scratched or a tickle that cannot be stopped. More than that, the restless leg syndrome is intensified when the person is at rest like reading a book, studying and even during sleep.

According to the studies, women have higher tendencies of developing the problem than men. And the symptoms develop gradually peaking when the person is about 50 years old, the symptoms become worse at nighttime causing the, to have an abnormal sleeping pattern.

Restless Leg Syndrome pictures

Picture view to show restless leg syndrome

Symptoms & Signs

With RLS, the problem is diagnosed 10 to 20 years after because at a younger age, the pain is generic and it is not worse. But during middle adulthood, more signs and symptoms are experienced like:

  1. Unpleasant sensations wherein patients would describe it as either: cramping, creeping, tense, pulling, uncomfortable, itchy, burning, gnawing, aching, tingling and others
  2. The pain escalades when the patient is resting or about to rest
  3. Then it worsens during nighttime
  4. The pain will be relieved if certain movements are done like jogging, walking, pacing, or whatever movements that offers relief
  5. Twitching of the legs during night time
  6. Disturbed sleeping pattern

Apart from that, by 2003, the NIH or National Institutes of Health made concise criteria on how to diagnose the problem with the symptoms presented like:

  1. Activity improvement where patients will find relief if they keep on moving
  2. Having the urge to move the limbs without sensation or with sensation
  3. It gets worse while at rest
  4. Worsening at night disrupting the circadian rhyth

Causes & Risk factors

There are 2 kinds of restless leg syndrome: the primary and secondary restless leg syndrome. In primary RLS, the cause is idiopathic or unknown. In secondary RLS however, there are underlying medical problems that causes the RLS

  1. Lack of iron or iron deficiency is said to be a cause of RLS. Iron is linked with the problem or at some point, it worsens the RLS
  2. Peripheral neuropathy. With this problem, the nerves in the arms and legs are damaged causing the lack of oxygen supply in the area then results to painful sensation, numbness and tingling sensation.
  3. Abnormalities in the neurotransmitters like dopamine are also likely to cause restless leg syndrome. These neurotransmitters help in regulating the muscle contraction or movements.
  4. Medications may also worsen the RLS like antiemtic drugs, antipsychotic drugs, anticonvulsants, anti-depressants, and even sudden withdrawal of benzodiazepines.

Treatment

As soon as restless leg syndrome is diagnosed, it is important to know the cause of the problem and address it right away. There are medications that can be taken in order to avoid worsening the problems like:

A. Opioids

These are narcotics which should be given at a small dose since it can be addicting. Opioids are analgesics of higher dose that helps relieve the uncomfortable feeling. Some opioids include codeine, oxycodone, etc.

B. Parkinson’s disease medications

The Parkinson’s disease medications are given in patients with RLS because it reduces their extra movements. Parkinson’s disease drugs such as carbidopa and levodopa increases the level of dopamine, one of the neurotransmitters in the brain that also causes the restless leg syndrome. Most of the time, the drug taken by patients with RLS are a combination of carbidopa and levodopa and patients are expected to feel mild side effects like nausea and fatigue.

C. Sleeping pills and muscle relaxants

These are prescribed since RLS has the tendency to disrupt the circarian rhythm which dictates the sleeping pattern of an individual. These drugs include clonazepam, eszopiclone, ramelteon, etc.

D. Epileptic drugs

Sometimes, drugs for epilepsy like gabapentin are prescribed to reduce abnormal twitching for patients with restless leg syndrome.

Home Remedies

Aside from the medications prescribed by the doctor, there are home remedies that need to be done in order to give relief from RLS. These include:

  1. Massage and warm bath are suggested in order to relax the muscles especially the legs. Aside from massage, there are also other relaxation methods like doing yoga, meditation especially at night before going to bed.
  2. Pain relievers are also suggested like NSAIDS to address simple discomforts and relieve muscle twitching sensations
  3. Having warm, clean and good sleep hygiene may promote sleep at night. As much as possible, it is important to have a cool and quite place and a comfortable bed to relax and entice sleep. Having a warm shower is also suggested to have good nights sleep.
  4. Application of warm and cold packs in alternate is helpful to reduce sensation of the limbs.
  5. Vices should be cut like drinking alcohol and smoking. These aggravate the symptoms of RLS especially when there is peripheral neuropathy.
  6. Cutting on caffeine or caffeinated drinks may reduce the restlessness felt by the patient.