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other sleeping partner might experience disruption of their own sleep by the movements. Sometimes they relocate to

another bed because of them.

The usual course of RLS is that the condition is present for life, and can worsen over time. RLS and PLMS are among

those conditions described as due to a "chemical imbalance" in the brain. The abnormality does not show up on MRI

scans, CT scans, electroencephalograms (EEGs), spinal taps or blood tests.

Although no cure yet exists, treatment can reduce symptoms and improve function. While medications are the mainstay

of treatment, many patients find that physical maneuvers improve their symptoms, like rubbing their legs or periodically

getting up and walking around.

Choice of medication depends on what else is going on with the patient. In some cases the RLS is due to another

condition in need of its own treatment, like iron deficiency, anemia, diabetes, nerve damage or advanced kidney disease.

Pregnancy can also induce RLS, though in this situation the symptoms usually resolve after the woman delivers.

The most common form of RLS occurs without evidence of a second, underlying condition, except for a possible genetic

link to relatives with RLS. In these patients drugs that boost dopamine--one of the brain's chemical transmitters--are the

first choice. These are the same drugs used in Parkinson's disease, another condition in which dopamine is in short

supply. However, for the most part, the two diseases are otherwise unrelated.

Dopamine-blocking drugs--comprising most of the anti-nausea and anti-psychotic medications--can have the unintended

consequence of worsening symptoms. For example, in the author's practice, a young woman with RLS went to an

emergency room because of a migraine attack. She received an intravenous dose of the dopamine-blocker

promethazine (brand name Phenergan) and this made her legs acutely restless and uncomfortable. In another case, an

elderly woman with memory loss and agitation received risperidone (Risperdal) and this caused RLS symptoms that had

not been present previously.

Certain drugs that also serve as anticonvulsants, like gabapentin (Neurontin) and clonazepam (Klonopin), can help.

Painkillers also work, and probably do so by interacting with a specific set of painkiller receptors in the brain, rather than

just dulling symptoms. However, because treatment is generally needed over a long period of time, painkillers are not the

usual treatments of first choice.

This essay only brushes the surface of this fascinating condition. To learn more, visit the website of the aptly named

We Move organization.

(C) 2005 by Gary Cordingley

Gary Cordingley, MD, PhD, is a clinical neurologist, teacher and researcher. For more health-related articles see his

website at: http://www.cordingleyneurology.com

intravenous klonopin Information

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RLS and PLMS might look like alphabet soup, but to millions of people with restless legs

syndrome and periodic leg movements of sleep, they spell misery.

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