Monday, October 4, 2010

The Jimmy Legs

Know someone whose legs/ankles/feet move constantly when they're supposed to be relaxed, ie. watching TV?  Kramer (of Seinfeld fame - the January 16, 1997, episode) made "the jimmy legs" famous to a generation of tube watchers when his girlfriend of the moment, Emily, was so afflicted.  (Apparently George's mother, Estelle, had the "jimmy arms" according to Frank, for those keeping track!)  But unbeknownst to many it is an actual medical condition called Restless Legs Syndrome (RLS).  (Distinct, by the way, from myoclonus, a more serious thrashing about while asleep.)  Primary RLS is idiopathic (no known cause) and usually begins before age 40, with both a slow onset and a propensity to disappear for months or even years.  However, it often gets worse with age.  Secondary RLS usually has a sudden onset and may be daily right from the beginning.  It (usually) occurs after age 40 and (usually) is associated with specific medical conditions or drugs.  The former include iron deficiency (just over 20% of all cases), varicose veins, venous reflux, folate deficiency, and a dozen others including rheumatoid arthritis.  The medications exacerbating RLS, or causing it secondarily, include some dopaminergic anti-emetics, certain antihistamines in over-the-counter cold medications, and older antidepressants.  Treatment of the aforesaid disease or stopping the offending medication often eliminates Secondary RLS.  Aren't you glad you asked?  You didn't ask?  Oh well.