Brief Answer:
I would explain as follows:

Detailed Answer:
Hello!

Welcome and thank you for asking on HCM!

Regarding your concern, I would explain that restless leg syndrome can start at any age, but it is more common in elderly patients, as it is associated with other commorbidities (diabetes, amyloidosis, vitamin B12 deficiency, folate and magnesium deficiency, neurodegenerative disorders, etc.).

Nevertheless, it can start since at the age of 20. Sometimes no cause is found for such disorder. It is a primary central nervous system disorder.

You should know that 25-75 % of young patients with this disorder, usually have a positive family history for restless leg syndrome.

Does your husband have anyone in the family with this disorder?

As all his blood tests have resulted normal (besides cholesterol levels), many of secondary causes have been excluded.

I would recommend consulting with a neurologist and get the proper treatment for this disorder based on his tolerance (dopaminergic drugs, benzodiazepines, antiepileptics,etc.).

Regarding his cholesterol levels, I would like to have some more information on his blood lipid profile, in order to give a more professional opinion on his cardio-vasculary risk related to his cholesterol levels.

Some lifestyle modifications would help reduce the cholesterol levels:

-reduce saturated fat and sugar and eat more food rich in omega 3 fatty acids (fish oil, fish, olive oil, nuts, etc.)
-perform a lot of physical activity
- reduce weight if he is overweight.

If his cholesterol levels are two high, treatment with statins may be considered (simvastatin, atorvastatin, etc.).

Hope you will find this answer helpful!

Kind regards,

Dr. Iliri

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Brief Answer:
I would explain as follows:

Detailed Answer:
Hello again!

Thank you for the additional information.

You should know that there are specific clinical criteria for the diagnosis of Restless Leg syndrome, which are:


1- An urge to move the legs that is usually accompanied by or occurs in response to uncomfortable and unpleasant sensations in the legs, characterized by all of the following: (1) the urge to move the legs begins or worsens during periods of rest or inactivity; (2) the urge is partially or totally relieved by movement; and (3) the urge to move legs is worse in the evening or at night than during the day or occurs only in the evening or at night
2-Symptoms occur at least 3 times per week and have persisted for at least 3 months
3-Symptoms cause significant distress or impairment in social, occupational, educational, academic, behavioral or other areas of functioning
4-The symptoms cannot be attributed to another mental disorder or medical condition (e.g., leg edema, arthritis, leg cramps) or behavioral condition (e.g. positional discomfort, habitual foot tapping)
5-The disturbance cannot be explained by the effects of a drug of abuse or medication

All these criteria should be fulfilled in order to confirm the diagnosis. There is no specific lab test to confirm the diagnosis, because it is a clinical diagnosis.

From the other hand the fact that his symptoms improve by magnesium, could be a sign of magnesium deficiency. As I already mentioned before, magnesium deficiency can lead to restleg leg syndrome.

I would recommend performing magnesium plasma levels and some other tests to exclude possible nerve or vessel disorders, which could lead to this symptomatology:

- A Doppler ultrasound of the leg vessels
- A nerve conduction study to exclude possible peripheral neuropathy
- A backbone X ray study to exclude possible herniated disk or spinal canal stenosis, which could mimic this clinical scenario. A spinal MRI may be needed if suspicions of this disorder are raised.

You should discuss with your doctor on the above issues.

Hope to have been helpful!

Best wishes,

Dr. Iliri

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