Treatment does not cure the periodic limb movement disorder (PLMD) but relieves the symptoms. Firstly, the patient has to avoid certain products, such as:
- Caffeine because it worsens PLMD symptoms
- Caffeine-containing products, such as chocolate, coffee, tea, soft drinks, and antidepressants, can intensify PLMD
Medications commonly used to treat PLMD include:
- Benzodiazepines: Benzodiazepines are sedatives that suppress muscle contractions. Klonopin (clonazepam) is useful in reducing the total number of periodic limb movements per hour.
- Dopaminergic agents: It increases the level of a brain chemical called dopamine, thus regulating muscle movements. Sinemet (levodopa/carbidopa) are some of the examples of Dopaminergic agents.
- Anticonvulsant agents: The medications are useful to reduce contractions in some people. Neurontin (gabapentin) is most widely used for treating PLMD.
- GABA agonists: These agents inhibit neurotransmitters that excite muscle contractions. Lioresal (baclofen) helps in the relaxation of muscle contractions.
What is periodic limb movement disorder?
Periodic limb movement disorder (PLMD) is a sleep disorder characterized by jerky movements of the legs when a person is asleep. It is a sleep disorder that disrupts sleep and leads to daytime drowsiness. PLMD is often associated with restless leg syndrome, but they both are completely different. PLMD can occur at any age; however, it is more common in middle-aged and older people.
Who is at risk of getting periodic limb movement disorder?
Patients associated with the following factors are at an increased risk of getting PLMD:
- Sleep apnea/snoring (It’s a sleep disorder that causes you to stop breathing while sleeping)
- Cataplexy (It is characterized by problems, such as slurred speech or total body collapse)
- Narcolepsy (a chronic sleep disorder characterized by excessive daytime sleepiness, sleep paralysis, hallucinations, and loss of muscle control)
- Diabetes mellitus
- Anemia
- Spinal cord injury
- Iron deficiency
- Dopaminergic medications
- Uremia (high levels of urea in the blood)
- Benzodiazepine withdrawal
- Barbiturate withdrawal
- Drug dependency
- Antipsychotic medication
Also, poor sleep hygiene and excessive alcohol can contribute to PLMD.
What are the symptoms of periodic limb movement disorder?
Poor sleep and daytime sleepiness are the most common symptoms of PLMD. Most of the patients are unaware of their repetitive leg movements unless informed by their partners.
Typical characteristics of leg movements include:
- Bending of the knee, ankle, and big toe joints as a part of the movements
- Movements that range from slight to strenuous wild kicking and thrashing
- Movements last for about 2 seconds
- Rhythmic and repetitive movements occurring every 20-40 seconds
SLIDESHOW
The 14 Most Common Causes of Fatigue See SlideshowHow does a physician diagnose periodic limb movement disorder?
The physician performs a physical examination and may enquire about your medical history and sleep history. Tests to identify PLMD include:
- Polysomnogram is a sleep study that requires you to stay at a sleep center overnight
- Multiple sleep latency tests (MSLT) measure your daytime sleepiness
- Laboratory tests, such as thyroid-stimulating hormone (TSH) level, may be performed
- Radiologic tests, such as CT scan or MRI, is done to identify obstruction sites
How to prevent periodic limb movement disorder?
Some lifestyle changes that may be useful to manage the symptoms include:
- Refraining from caffeine, alcohol, and nicotine
- Having small meals throughout the day rather than heavy meals at once
- Maintaining a sleep schedule
- Exercising daily for 20 to 30 minutes
- Taking power naps (15 to 20 minutes) during the day
References
https://www.webmd.com/sleep-disorders/periodic-limb-movement-disorder#:~:text=Benzodiazepines%3A%20These%20drugs%20suppress%20muscle,used%20drug%20to%20treat%20PLMD.
https://emedicine.medscape.com/article/1188558-overview#a5
https://my.clevelandclinic.org/health/diseases/14177-periodic-limb-movement-disorder-plmd-in-adults/management-and-treatment
https://emedicine.medscape.com/article/1188558-overview#a5
https://my.clevelandclinic.org/health/diseases/14177-periodic-limb-movement-disorder-plmd-in-adults/management-and-treatment
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