Involuntary Limb Movements

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People with RLS can exhibit spontaneous, involuntary movements of

their body. These movements are called " dyskinesias " . They can involve

any part of the body but are commonest in the upper and lower

extremities. They are part of the recognized diagnostic criteria for

RLS, not mandatory but not unusual. Dyskinesias can also be

drug-induced and are often seen in patients taking drugs

(neuroleptics) with dopamine antagonistic effects as well as drugs

having dopamine agonistic effects. Sinemet, Parlodel, Permax, Mirapex

and Requip can all cause dyskinesias, especially in Parkinsonian

dosages. They do NOT usually cause dyskinesias in the dosages used for

RLS. The muscular movements are frequently bizarre and repetitive.

They typically are not spastic like those seen in the dystonias.

People with PLMD have involuntary muscular contractions while they are

sleeping, " periodic limb movements of sleep. " They can also have

similar movements while awake. These are called DWA (dyskinesias while

awake). DWA describes the movements in a person with PLMD with no

symptoms of RLS. Otherwise, the two types of dyskinesia are

essentially the same. They are NOT the same as the voluntary movements

used to try and relieve the sensory symptoms of RLS (paresthesias,

creepy-crawlies).

Dr. Levin