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Restless legs syndrome and day procedures

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To the Editor: This letter encourages timely preoperative recognition of restless legs syndrome (RLS), for patient wellbeing, as well as for practical management of incidental procedures. RLS is a neurological disorder found in many older patients of either sex and in those with a variety of conditions including iron deficiency, pregnancy, uraemia, diabetes and rheumatoid arthritis. It may also affect patients with other neurological disorders such as peripheral neuropathy.1

Affected persons have spontaneous, recurring, unpleasant leg paraesthesia, which they may find difficult to describe. Patients know that these discomforts are about to climax into sudden involuntary movement of the limb or limbs. RLS occurs mainly in the late afternoon and evening, especially when patients are seated or supine. Sleep may be disturbed. The anticipated movement can be overcome by voluntary activation of the limb or limbs, by bearing weight or by pacing.2 RLS is believed to arise from abnormalities in brain neurotransmitters that regulate automatic movements.

Dopamine receptor agonist medications can suppress the attacks but not cure them.1

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