Thursday, September 4, 2008
I saw two patients today who were grateful that their restless legs were better and they were able to sleep. RLS (restless leg syndrome) or periodic limb movement disorder is commonly seen in my Lyme practice. Sleep apnea and RLS are the two most common disorders diagnosed in sleep labs. Sleep clinics say RLS is frequently related to iron deficiency and low ferritin levels. In my practice it is related to Lyme disease. The afflicted persons limbs, especially legs move around in a jerking fashion interfering with sleep. It is a type of movement disorder. It is related to Parkinson's disease and responds to the same medicines. Drugs like Mirapex which increases dopamine activity in the brain are effective. Neuroborreliosis seems to cause a mix of conditions related to abnormal neurotransmitter activity. Rocephin's efficacy, is in part, thought to be due to its mitigating effect on glutamine, another neurotransmitter. Many patients develop a host of psychiatric symptoms which improve when neurotransmitters are "tweeked" including: serotonin, norepinephrine, GABA, glutamine, dopamine and possibly others. The cause is unclear. Is it infection of glial cells, supporting brain cells, neurotoxins, inflammation or other issues? Another day: another piece of the puzzle.