RLS as a vascular problem (In Dread of Night)

[Guest guest]

Hello Everybody,

Is Dr. Meadows right when he says that RLS is a vascular problem ? Is his

statement wrong ?

BOTH !! (in my humble opinion)

30-40 years ago, It was not usual to differentiate between leg cramps, RLS,

PLMS, legs jerking due to medicaments,...

Even today, many MDs are still mixing up these different afflictions.

In order to give you an example, I copied/pasted the following texts from

the Archives of internal Medicine at:

http://www.ama-assn.org/sci-pubs/journals/archive/inte/vol_156/no_20/letter_

3.htm

" I agree with O'Keeffe's therapeutic recommendations,..... On the other

hand, a useful pharmacological approach for the treatment of RLS, which is

not described by O'Keeffe, is the use of orphenadrine citrate. Although no

randomized controlled trials have been reported, observational studies in my

experience and in that of others have shown orphenadrine to be extremely

effective and safe in controlling the symptoms of RLS and periodic movments

of sleep.[3] [4] [5]

H. Neustadt, MD, MACR

Louisville, Ky "

The reply of O'keeffe is obtainable on line at:

http://www.ama-assn.org/sci-pubs/journals/archive/inte/vol_156/no_20/letter_

5.htm

" Neustadt suggests the use of ophenadrine citrate in patients with RLS. I

have no personal experience with this agent. However, although Popkin[1]

reported good results with ophenadrine citrate in an open study, many of the

patients in his report had nocturnal cramps rather than true RLS. Further

studies are necessary before this drug can be recommended for patients with

RLS.

Shaun T. O'Keeffe, MB, MRCPI

Liverpool, England "

As you can read it, even in specialized publications, authors may have used

misdiagnosed patients for their studies!

By discussing with a few acquaintances who suffer from these affliction,

reading publications and by this Cybergroup, I am convinced that some " RLS "

patients could be helped by Dr.Meadows's exercices because their " RLS " have

a vascular origin. But clearly, many others will not respond because they

have RLS (sensu stricto) and there is nowadays plenty of evidence that this

affliction is due to a deficience in a neuroendocrine regulation.

One important problem is that the word " RLS " is often used sensu lato (even

in this Group) for all possible disconfort in the legs, but should be

normally used only sensu stricto for symptoms according to the current

internationally recognized definition (see http://www.rls.org).

Those who have a vascular/blood circulation origin of " RLS " will most

probably respond to vasodilatator agents and to the specific exercises of

Dr. Meadows.

Those who have nocturnal muscle cramps will most probably respond to

Magnesium salts and muscle relaxants.

Those who have only idiopathic RLS sensu stricto will most probably respond

to low doses of opioids or dopamine agonists (with more side effects).

Those having peripheral neuropathy will use pain killers.

And those who have a blend of different afflictions will respond less

efficiently to one specific medic. :-(

Many thanks to Don in Albuquerque who spent his time in writing a summary

review of " In Dread of Night " .

A good night wish you

Bernard + Mireille, Switzerland

[Guest guest]

Bernard,

You also sound suspiciously knowledgeable! Your theory about both ideas

regarding the origin and subsequent treatment of rls is a philosophy

that has a lot of merit. Often we seem to want to polarize our ideas,

when in fact the truth may be somewhere in the middle. Your " global "

thinking(which tends to alleviate my suspicions!),is,imho, a welcome

and necessary component to the ultimate solving of this mystery called

rls.

ne, 59, Lawrenceville, NJ

--- Bernard Jenni Bjenni@...> wrote:

>

>

> Hello Everybody,

>

> Is Dr. Meadows right when he says that RLS is a

> vascular problem ? Is his

> statement wrong ?

>

> BOTH !! (in my humble opinion)

>

> 30-40 years ago, It was not usual to differentiate

> between leg cramps, RLS,

> PLMS, legs jerking due to medicaments,...

>

> Even today, many MDs are still mixing up these

> different afflictions.

>

> In order to give you an example, I copied/pasted the

> following texts from

> the Archives of internal Medicine at:

>

http://www.ama-assn.org/sci-pubs/journals/archive/inte/vol_156/no_20/letter_

> 3.htm

>

> " I agree with O'Keeffe's therapeutic

> recommendations,..... On the other

> hand, a useful pharmacological approach for the

> treatment of RLS, which is

> not described by O'Keeffe, is the use of

> orphenadrine citrate. Although no

> randomized controlled trials have been reported,

> observational studies in my

> experience and in that of others have shown

> orphenadrine to be extremely

> effective and safe in controlling the symptoms of

> RLS and periodic movments

> of sleep.[3] [4] [5]

> H. Neustadt, MD, MACR

> Louisville, Ky "

>

> The reply of O'keeffe is obtainable on line at:

>

http://www.ama-assn.org/sci-pubs/journals/archive/inte/vol_156/no_20/letter_

> 5.htm

>

> " Neustadt suggests the use of ophenadrine citrate in

> patients with RLS. I

> have no personal experience with this agent.

> However, although Popkin[1]

> reported good results with ophenadrine citrate in an

> open study, many of the

> patients in his report had nocturnal cramps rather

> than true RLS. Further

> studies are necessary before this drug can be

> recommended for patients with

> RLS.

> Shaun T. O'Keeffe, MB, MRCPI

> Liverpool, England "

>

>

> As you can read it, even in specialized

> publications, authors may have used

> misdiagnosed patients for their studies!

>

> By discussing with a few acquaintances who suffer

> from these affliction,

> reading publications and by this Cybergroup, I am

> convinced that some " RLS "

> patients could be helped by Dr.Meadows's exercices

> because their " RLS " have

> a vascular origin. But clearly, many others will not

> respond because they

> have RLS (sensu stricto) and there is nowadays

> plenty of evidence that this

> affliction is due to a deficience in a

> neuroendocrine regulation.

>

> One important problem is that the word " RLS " is

> often used sensu lato (even

> in this Group) for all possible disconfort in the

> legs, but should be

> normally used only sensu stricto for symptoms

> according to the current

> internationally recognized definition (see

> http://www.rls.org).

>

> Those who have a vascular/blood circulation origin

> of " RLS " will most

> probably respond to vasodilatator agents and to the

> specific exercises of

> Dr. Meadows.

> Those who have nocturnal muscle cramps will most

> probably respond to

> Magnesium salts and muscle relaxants.

> Those who have only idiopathic RLS sensu stricto

> will most probably respond

> to low doses of opioids or dopamine agonists (with

> more side effects).

> Those having peripheral neuropathy will use pain

> killers.

> And those who have a blend of different afflictions

> will respond less

> efficiently to one specific medic. :-(

>

>

>

> Many thanks to Don in Albuquerque who spent his time

> in writing a summary

> review of " In Dread of Night " .

>

>

> A good night wish you

> Bernard + Mireille, Switzerland

>

>

>

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