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Thursday, December 12, 2013
Parkinson's & restless leg syndrome
Got RLS in 1998 followed by peripheral neuropathy in 1999. Present treatment is Limbitrol DS. My current neurologist says Amitrip/CDP (generic) assists the nerves in recovering or assists the communication between them. Second opinion neurologist does not believe this and recommends Lyrica. He also says PN does not lead to Parkinsons but RLS may. My father got Parkinsons late in life. How do I distinguish risks from RLS from PN?
The majority of cases of restless legs syndrome (RLS) are idiopathic (no identifiable cause). However, there are certain medical conditions that can predispose someone to developing RLS.
Some of the more common conditions that increase risk of RLS include:
- varicose veins
- iron deficiency anemia
- rheumatoid arthritis
- peripheral neuropathy
- kidney disease
- and Parkinson's disease
People with Parkinson's disease (PD) can often experience symptoms of restless leg syndrome, but there is no evidence to suggest that RLS causes PD. With regards to peripheral neuropathy, the symptoms of RLS may be an early manifestation prior to finding the actual etiology of the peripheral neuropathy.
In addition, certain medications can cause or exacerbate symptoms of RLS. These include certain anti-nausea, anti-seizure, antipsychotic, and cold/allergy drugs. Other agents that can also aggravate symptoms of RLS include caffeine, alcohol, and tobacco. Often, the elimination of these such agents may help alleviate RLS symptoms.
There are a far greater number of potential risks and causes for peripheral neuropathy. Given the multitude of causes, a person experiencing symptoms of peripheral neuropathy should seek medical attention for an individualized evaluation. There is no evidence to support that peripheral neuropathy causes or leads to Parkinson's disease. However, as discussed above peripheral neuropathy can increase risk of developing symptoms of RLS. Some of the more common causes of peripheral neuropathy include:
- Systemic or metabolic disorders:
- Diabetes (diabetic neuropathy)
- Vitamin deficiencies (vitamin B12)
- Excessive alcohol use (alcoholic neuropathy)
- Kidney disease (Uremia)
- Infectious or inflammatory conditions:
- HIV or AIDS
- Guillain-Barre syndrome
- Lyme disease
- Polyarteritis nodosa
- Rheumatoid arthritis
- Sjogren syndrome
- Exposure to toxic compounds:
- Sniffing glue or other toxic compounds
- Nitrous oxide
- Industrial agents -- especially solvents
- Heavy metals (lead, arsenic, mercury, etc.)
- Prolonged exposure to certain medications:
- Heart or blood pressure medications:
- Cholesterol lowering mediations:
- Cancer fighting medications:
- Medications to fight infections:
- Other medications:
- Decreased oxygen and blood flow
- Trauma or prolonged exposure to cold temperature
Hopefully, this answer helps you identify certain risks associated with both peripheral neuropathy and RLS.
Punit Agrawal, DO
Assistant Professor of Neurology
College of Medicine
The Ohio State University