A loved one  has been diagnosed with a pretty rare collection of
symptoms called "restless  leg."

He has a history of underactive thyroid (now he takes pills of
ground sheep thyroid glaand), lower back pain & herniated disk,
prolonged mental and physical stress (career as a RADAR operator in the
Vietnam, 1969-70; other similar jobs) during his late 20s-mid
30s.  

The condition does not appear to be life-threatening, but it is
making life difficult during a time when he must be a
responsible leader of a fairly-large business.  It appears to
be getting progressively worse.

As he feels drowsy and wants to sleep--just as that threshold
between consciousness and unconsciousness is being crossed--his
limbs start to move in spasms.  Not small tremors, entire
movements. These lasts until he awakenss himself more
completely--or falls asleep in exhaustion with only 2-3 hours
of sleep  ahead of him.

A number of things have been tried without much success.
That musle relaxants do not work leads us to believe that it is
a deep-seated neurological problem--perhaps a con{*filter*} one
(his mother recalls that he was a baby who "banged his head").
Out of desperation (and in the face of my severe cautions)--he
found a doctor who would prescribe him  l-dopa.

L-dopa, as i recall, alleviates Parkinsonian symptoms.  But
also, a tolerance is rapidly built against the drug such that
severe side effects soon begin to outweigh the  effectiveness.

Has anyone heard of these symptoms?

Has anyone heardd of using L-dopa for illnesses not as severe
as Parkinson's or substantia nigra drug abuse damage?

What are this man's options?  He is an otherwise healthy and
content man in his early 50s with no intention of "slowing down,"
anytime soon.

                                jon

It's actually fairly common.  The best treatment for it is Sinemet
(levodopa/carbidopa) 25/100 one before bed.  Clonazepam and opiates also
work although a little less reliably.  Some patients can control the
symptoms nicely with vitamin E supplements.  There is a tendency in some
patients for the medication to become less effective over time.  When
that happens I just switch them to one of the others, then back again
later.

David Nye, MD * Neurology Dept., Midelfort Clinic, Eau Claire, Wisconsin
Men ought to know that from nothing else but the brain come joy,
despondency and lamentation,...wisdom and knowledge -- Hippocrates

Hi,

Did your friend (or relative) get a prescription for Magnesium
pills ? If no, he should ask for one. Restless legs is a
condition often admirably cured by Magnesium prescription. I
would be careful using L-dopa though.

Frank

--

: Hi,

: Did your friend (or relative) get a prescription for Magnesium
: pills ? If no, he should ask for one. Restless legs is a
: condition often admirably cured by Magnesium prescription. I
: would be careful using L-dopa though.

Does this have to be a prescription or will OTC vitamins work?

They don't require a prescription (nor will most insurance cover it with
a prescription).

Why?  For this indication it's probably safer than aspirin.

David Nye, MD * Neurology Dept., Midelfort Clinic, Eau Claire, Wisconsin
This is patently absurd; but whoever wishes to become a philosopher
must learn not to be frightened by absurdities. -- Bertrand Russell

: : Hi,

: : Did your friend (or relative) get a prescription for Magnesium
: : pills ? If no, he should ask for one. Restless legs is a
: : condition often admirably cured by Magnesium prescription. I
: : would be careful using L-dopa though.

: Does this have to be a prescription or will OTC vitamins work?

Chuck:

Also, has your friend ever tried sleeping on his back with his legs
elevated by an 8-inch pillow? (I've had back surgery and have never slept
better than I do now -- I also sleep with a pillow under my left shoulder
to reduce stretching of my chest cartilage.) At any rate, with your
friend's herniated disk problems, it may be that his leg twitches may be
due in part to his sleeping posture.

Several people had posted truly excellent suggestions on sleeping
positions earlier, these including sleeping with a pillow between one's
knees (if one is sleeping on one's side), perhaps sleeping with a pillow
under one's waist to help ensure a straight spine, etc. (One person said
that she sleeps on her back with a huge pillow under her legs and a
kitty-cat sitting on her tummy. I think the cat is optional, however. But
this woman said that she also underwent back surgery and is sleeping very
well now as a result of her sleep posture.)

I am not a physician, but perhaps these suggestions may prove useful.
--
Yours,

Caleb Burns, Portland, Oregon

Complaining of chronic fatigue, and {*filter*} tests showing normal, I did a
sleep study.  Spent a night with about 30 wires connected to me monitoring
I guess everything.  The suspected problem was perhaps I had sleep apnea (sp).
But I don't, what I have is "nocturnal myoclonus", also know as
"periodic movement in sleep"  (yes PMS :-).  It seems as though about every
minute during my sleep my legs spasm slightly.  The effect is as if someone
were standing by you and shacking your shoulder, arousing you slighlty
from your sleep.  Anyway the Dr. has prescribed a pill, sedative, taken
before bedtime.  (Don't have name of medication with me, something like
 "nocturus") Been on the medication about 2 months now, it works.

Now to the "restless leg" thing.  I say my Dr. yesterday and asked him if
what I have is also know as restless legs.  He said no, restless legs is a
condition of the "daytime'.  What I have occurs only at knight.  HOWEVER,
he said that "restless legs" is a very good indicator that there is also
"nocturnal myoclonus" also at night.  Thus causing sleep/fatigue problems.
So, special pillows, etc will lilkely not help.  I asked Dr about treatment
of nocturnal myoclonus with magnesium, vit E, etc.  He said perhaps, also
quinine (sp) is also used for treatment.  He said go ahead and try it.
Meanwhile I'm taking the sleeping pills.  It is wonderful to be awake
during the day !!!!!  I only wish I'd found this four years ago.

I'll be happy to discuss any of this with anyone.  Post or email me.
Regards - Tom Graham

d
--
Tom Graham                               Unocal Corporate Information Services
Phone: (714)693-5808                     5460 E. La Palma Ave.