Cause for concern

As the cause of RLS remains unclear there are hundreds of information sites in the internet, there are hundreds of individual accounts of “cure”, there are many claims to remedies. Many of these claims and information are unfounded, non-scientific and at times could be dangerous to health.

There have many scientific meetings in 2007-2008 which dealt with RLS and the associated disorder of PLM (periodic leg movement: a condition when the leg jerks either as you are about to doze of or when you are asleep). The most exciting discovery is that there appears to be more pointers towards a genetic basis to this condition with the independent discovery of three genes that may be related to RLS. It must be emphasised however, that as yet there are NO specific genetic tests that are available for RLS. These discoveries suggest potential genes that may be responsible for development of RLS in some and much work is needed in future. Firstly Winkelmann and colleagues described a gene called MEIS1 (on chromosome 2) associated with RLS and this gene tends to be involved in development of limbs. Thereafter, Stefansson and colleagues described another gene called BTBD9 (on chromosome 6). Finally, Winkelmann and colleagues also described another gene involved in the action of an enzyme nNOS. Potential implications of these discoveries are huge and in future this may open up new ways of identifying and treating RLS.

From the treatment point of view, drugs licensed specifically for treatment of RLS are pramipexole and ropinirole (marketed specifically for RLS as Adartrel). Both are useful but not all patients respond to these. Rotigotine, a skin patch that works by being applied once a day, has also been licensed for RLS. Like the other two, this is also a dopamine agonist drug and also is used primarily in Parkinson’s disease. IT IS WORTH NOTING HOWEVER, THAT USING THESE DRUGS IN RLS DOES NOT MEAN THAT THERE IS ANY RISK OF DEVELOPING PARKINSON’S DISEASE.

K Ray Chaudhuri