Nocturnal myoclonus, or Rapid Leg Movement Syndrome or Periodic limb movement disorder, is common to late middle-aged and elderly patients.
This condition is characterized by periodic episodes of recurring and highly stereotyped limb movements that occur during sleep.
The disorder consists of sensations in the lower legs that make the person uncomfortable unless the legs are moved. The sensations usually occur shortly after going to bed but may also occur during the daytime.
Same type of movements can occur in the upper limbs. The movements are often linked with a partial arousal or awakening; however, the patient is usually unaware of the limb movements or the frequent sleep disturbance.
There is an irresistible urge to move the legs or walk to ease the discomfort, resulting in periodic events of leg movements during early sleep stages. The symptoms may last for 1 hour or longer.
The patient may experience a history of frequent nocturnal awakenings and unrefreshing sleep. Patients unaware of the sleep interruptions may have symptoms of excessive sleepiness. It is probable that the nature of the patient’s complaint is affected by the frequency of the movement as well as the connected awakenings.
Anxiety and depression can also be produced with the nocturnal myoclonus. While the natural history of this disorder in not known, it appears to increase in frequency with advancing age.
It appears to be uncommon in children and advances with advancing age to become a common finding in up to 34 percent of patients over the age of 60 years. This disorder can accompany narcolepsy and sleep apnea.
Variety of other medical conditions, such as chronic uremia and other metabolic disorders can evoke nocturnal myoclonus.
Nocturnal myoclonus can be worsen by the taking medications like tricyclic antidepressants and monoamine oxidase inhibitors, as also by the withdrawal from variety of drugs, such as anticonvulsants, benzodiazepines, barbiturates, and other hypnotic agents.
Nocturnal Myoclonus Signs And Symptoms:
People with nocturnal myoclonus experiences unusual sensations that usually occur in the legs but sometimes are present in the arms and trunk. The sensations:
- Cause jerking movements of the legs when the person is sleeping and occasionally when the person is awake
- Cause an irresistible urge to move the legs
- Can occasionally cause restless movements of the feet or toes in the evening, when a person is sitting or lying down
- Occur when the person is inactive and usually get worse at night
- Can make falling asleep difficult and can awaken the person from sleep
- Contribute to weariness and sleepiness during the day, since the person is not getting a good night's sleep
- Are described as burning, itching, crawling, pulling, or tugging but are rarely painful
- Are relieved by leg movements
Nocturnal myoclonus is common in individuals who are under lot of stress, pregnant women, people with certain diseases such as rheumatoid arthritis, chronic renal failure, Parkinson's disease, and diabetes
Nocturnal Myoclonus Diagnosis:
The first step in diagnosing nocturnal myoclonus is a complete history and physical examination. Often, a person will need tests to rule out other problems such as nerve disease and pain that results from poor circulation to the leg muscles.
Nocturnal Myoclonus Treatment:
Nocturnal myoclonus treatment begins with correction of any underlying disease or condition. For instance, anemia is corrected by giving iron or folic acid supplements. The physician will work with the person to treat other disorders such as rheumatoid arthritis, poor circulation to the legs, and diabetes.
The intensity of the symptoms of nocturnal myoclonus can be reduced with changing the lifestyle. A balanced diet supplemented with vitamins and iron need to be followed. You should avoid food and drinks containing caffeine, such as coffee, tea, and chocolate. Moderate exercise can contribute to better sleep habits.