Typical case of restless legs syndrome

  The patient is a 62-year-old female from Tianmen, Hubei. More than 10 years ago, the patient began to experience discomfort in both lower extremities around 1:00 a.m. It is difficult to name the discomfort, and it is unbearable to pat, rub and press the legs, or get out of bed and walk around, or apply cool oil externally, or take painkillers or cold medicine to reduce the discomfort in the legs and continue to sleep. Initially, the attacks were intermittent and occurred mostly in winter every year.  In the second half of 2007, the patient’s condition recurred, with discomfort in both lower extremities every night just before going to sleep, accompanied by trembling in both lower extremities, distress, chest tightness, patting, rubbing, applying medicine, applying heat to both lower extremities, etc. did not improve, and had to get out of bed and keep walking in order to reduce the discomfort, and went to major hospitals in Shenzhen for many times, and was diagnosed as “restless leg syndrome”. He was diagnosed as “restless legs syndrome” and was treated with carbamazepine, dextran, alprazolam, cipro, methyldopa, bromocriptine, etc. The discomfort in the legs could be reduced, but the improvement in sleep was not obvious.  In July 2011, the patient’s symptoms worsened and he stayed awake all night. Every time he was about to fall asleep, he experienced unbearable discomfort in both lower extremities, and both lower extremities trembled involuntarily and beat on the bed with loud tapping sounds, and his family members were also woken up by the tapping sounds in other rooms. The patient’s sleep was seriously affected, and his family was frightened by the tapping sound and worried. He went to the hospital again and took more than 10 kinds of medications but could not control the trembling of both lower limbs.  In August 2011, the patient came to our department for inpatient treatment. After treatment with Western medicine such as Pramipexole and Chinese medicine to relieve liver depression and nourish the heart and calm the mind, together with acupuncture and Chinese medicine foot bath, the trembling of both lower limbs was basically controlled by the third day. At the time of discharge, the patient could sleep naturally and had good sleep quality, with no discomfort and tremors in both lower limbs. After discharge, the patient continued to adhere to the treatment and gradually reduced the dosage after a full course of treatment. The patient was followed up in the outpatient clinic, and no recurrence of the disease was seen at the follow-up visit before the Spring Festival in 2012, and he slept well, and is currently under maintenance treatment with only small doses of medication.