CASE DISCUSSION A 50-years old female Para 5+0 presents with a history of unpleasant feeling in the feet, calves

and thighs, which is often felt as a crawling or creeping sensation and an overwhelming, irresistable urge to move the legs. On further enquiry she reports that the symptoms are triggered by stress, smoking, taking caffeine alcohol. The symptoms typically begin after she had been lying down or sitting for an extended period of time. In the past medical history she reports that she used to develop similar symptoms during her pregnancy particularly during the last trimester; and, the symptoms used to disappear within four weeks of giving birth a. What is the most likely diagnosis? b. What is known about the cause of this condition? c. How would you manage this patient?

ANSWERS a. Restless leg syndrome due to Magnesium and vitamin B deficiency b. RLS is a condition that affects the legs. It starts with a sudden, unpleasant sensation deep inside one or both legs. This is accompanied by an irresistible urge to move the legs to stop the unpleasant feeling. RLS is a common condition and is estimated to affect one in 10 people. It can occur at any age, even in children, but is more common as people get older. It affects more women than men.
c. The Magnesium deficiency tenses leg muscles and causes the urge to move them. The

burning creeping crawling sensation is due to a Vitamin B deficiency neuropathy (nerve disease). Estrogen Dominance causes the Magnesium Deficiency and Vitamin B deficiency. Chemical estrogens (xenoestrogens) absorbed mainly through the skin cause Estrogen Dominance and cause a Magnesium Deficiency and Vitamin B deficiency. After the age of 35, many of the menstrual cycles (anovulatory cycles) do NOT produce progesterone. This can also contribute to Estrogen Dominance. d. Giving the patient Progesterone, Magnesium, Vitamin B and avoiding Chemical Estrogens (xenoestrogens) .