Restless Leg Syndrome As A Marker For Unsuspected Chronic Lyme Disease
By Virginia T. Sherr, MD (2002)
Objectives: Restless Legs Syndrome is characterized by a torturous sense of needing to move the reclining leg--a feeling that can not be denied by the sufferer. As it was more clearly understood that RLS is mediated by many neurologically related abnormalities, it was thought RLS might be provoked by the presence of known or unsuspected neuroborreliosis. A study was undertaken in and from an eastern Pennsylvania private psychiatric office to ascertain the likelihood of a Lyme/RLS connection in that area, highly endemic for infected deer ticks.
Method: Psychiatric patients who had been found to have previously unsuspected tick-borne diseases, primarily Lyme disease, were interviewed to ascertain the possibility of co-existent RLS. At the same time, a survey of the membership of an unrelated, local support group for known RLS sufferers was undertaken with the goal of locating people who were previously diagnosed or as yet possibly undiagnosed victims of chronic Lyme disease.
Results: Of the 66 chronically Lyme-infected psychiatric office outpatients, 20% described typical symptoms of Restless Legs Syndrome. They acknowledged RLS symptoms as causing excruciating distress to them. Some of these patients also had a related condition, Periodic Limb Movement Disorder, which is characterized by a jerking of the legs (or arms) during sleep. None was receiving usual dopamine agonist medications for treatment of RLS.
The situation in the totally unrelated RLS support group was different but also suggestive. In a survey of 150 members, approximately one third of whom responded, 50% described chronic non-RLS multi-system physical symptoms for which they could get no diagnosis after consulting multiple specialists. Of the 7 people who so far have allowed Western Blot and PCR testing, 5 tested positive for Lyme and, to some degree, other associated tick-borne infections. One other person apparently has lupus. There were 3 others who had past histories of treated LD.
The 5 RLS support group members who tested positive were relieved at the new diagnoses of chronic Lyme disease. Of the four of them to date who have allowed treatment for their infections, all have experienced reduction in their RLS, two no longer needing therapy other than iron supplements and antimicrobial medications.
In the psychiatric outpatient group, all the patients who underwent treatment for chronic Lyme disease lost their RLS and PLMD symptoms with the advent of appropriate antimicrobial medications and sans dopaminergics.
Conclusions: Experience with two unrelated sets of people--Lyme victims in treatment for emotional/cognitive problems and a cluster within a RLS support group indicates a likely role for Lyme disease as a causation of RLS.