HeadWise HeadWise: Volume 6, Issue 3 | Page 21

Restless leg syndrome (RLS), or Willis-Ekborm disease, is a neurological condition characterized by a sense of discomfort/urge to move one’s leg prior to resting or falling asleep in the evening. The discomfort of RLS is alleviated by moving the limb. Often, patients who suffer from RLS complain of a range of abnormal sensations in the limb, describing the feeling as “creepy-crawly,” “ants crawling,” “jittery,” “burning,” “pain,” or “shock-like.” The exact neurological mechanism for RLS is unknown. In fact, patients can have the disease as a primary condition but the syndrome can be caused by a variety of physiological or pathological conditions that range from pregnancy and low iron levels, to kidney diseases, spinal cord diseases, or even Parkinson’s disease. The diagnosis of restless leg syndrome is made clinically. In 2012, the International Restless Leg Syndrome Study Group established a set of criteria to help clinicians con- firm the diagnosis. Numerous studies have shown a connection between migraine headaches and restless leg syndrome. In a 2010 Taiwanese study of 772 migraineurs, 11.4% experienced RLS. In a study of 31,370 women in Germany, 24,513 subjects denied any migraine attacks and of those women, 2,749 had RLS. This compared to 6,857 women who re- ported migraine, and of those subjects, 996 complained of RLS. These researchers concluded that migraine is associ- ated with an increase likelihood of having RLS. A similar relationship has been demonstrated in men and children in studies lead by Harvard University and University of Vienna. Interestingly, migraine is not the only headache that is associated with RLS. A study of 77,520 patients in Taiwan, with and without tension-type headache, suggests that there is an increased risk for RLS in tension-type headache patients as well. Age appears to play a role. In a population-based study of 2695 Koreans, patients with migraine in their 20s and 40s tend to have a higher risk of RLS than patients older than 49. The caveat though, is that this data did not cap- ture the likelihood of secondary causes for RLS in older populations because of the population’s comorbidities (other illnesses) and/or concurrent medication use. It is an open question whether the characteristics of one’s migraine attack influences the risk for getting RLS. The data are mixed when it comes to whether migraine with aura confers a higher risk of RLS. In a Turkish study involving 204 patients, migraine with aura confers higher risk for having RLS. In a study done in Madrid with 94 patients, however, migraine without aura seems to have a higher correlation. Regardless, the frequency of headaches does not seem to correlate with whether one is at risk for RLS. Patients who have less than 15 days of headaches or those who have more are both at risk. In contrast, those who are ex-migraineurs do not seem to be at higher risk for RLS. www.headaches.org | National Headache Foundation 21