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How To Rule Out A RLS?
Question: I have been drawing complete blanks for the past week. Sometimes Im not even sure what my eyes are seeing. I have to sit and touch my dog over and over again when I bring him in just to ensure that he is really there. I will see him going to the bathroom, but there is another part of my mind that just cant conclude exactly what I am seeing. At work yesterday, I was givin a very important direction, and within 5 min completely forgot what had been said, and guessed wrong. It couldve been a fatal mistake. I just recently went up on my repinerol for RLS. My dr moved me up to 6mg per day, even though I read everywhere that for my condition that I shiuldnt be taking more than 4 mg. This is starting to really scare me and I dont trust my dr enough to go to her with this.
Brief Answer:
Need neurological examination
Detailed Answer:
Good afternoon. I am happy to provide some insight into your problem.
I am in full agreement that the AMOUNT of medication you've been prescribed is well beyond what the average dosing is in patients who have TRUE SYMPTOMS OF RLS. This medication can and does produce alterations in cognitive function and can block proper processing of information to lead to unusual and/or bizarre types of behavior.
I would recommend that you be reviewed by a NEUROLOGIST to begin with for the diagnosis of RLS. This diagnosis is not common in an otherwise healthy 29 year old young lady such as yourself. It is much more common to find RLS like symptoms in patients with some type of metabolic disorder such as severe anemia, diabetes, etc. Therefore, a qualified neurologist will likely wish to perform an examination on you for your complaints after taking a good history to find out what patterns if any accompany your problem. You may then, be sent for either metabolic and/or head imaging studies to rule out any and all neurologically based entities that need to be eliminated.
If RLS is truly the diagnosis and there are no metabolic issues that need to be addressed such as iron deficiency, zinc deficiency, vitamin D/TSH/B12/folate deficiencies, or FT4 excess then, you should not such high amounts to make a therapeutic difference and the increased dosing could be exhibiting side effects as you describe.
If you do have true RLS I find in my patients that Pramipexole (Mirapex) tends to be a much better tolerated medication which can be more tightly titrated and controlled in case of side effects and so I always use that as a first line drug as opposed to ropinirole.
The other option available to your doctor would be to perform a sleep study to see if in fact you suffer from something called PLMS (periodic leg movement syndrome). Though this is not the same as RLS.....it is often the case that people with PLMS will also have the clinical story that fits RLS.
Bottom line....I would likely get off the ropinirole and clear up the brain fog then, I'd look for an appointment with a neurologist with a good general knowledge of this sort of parasomnia or get a sleep disorder specialist to re-evaluate what's going on then, embark upon a definitive treatment plan.
If I've adequately answered your questions could you do me a huge favor by CLOSING THE QUERY and being sure to include some fine words of feedback along with a 5 STAR rating if you feel my suggestions have helped? Again, many thanks for posing your questions and please let me know how things turn out.
Do not forget to contact me in the future at: www.bit.ly/drdariushsaghafi for additional questions, comments, or concerns having to do with this topic or others.
This query has utilized a total of 15 minutes of professional time in research, review, and synthesis for the purpose of formulating a return statement.
Need neurological examination
Detailed Answer:
Good afternoon. I am happy to provide some insight into your problem.
I am in full agreement that the AMOUNT of medication you've been prescribed is well beyond what the average dosing is in patients who have TRUE SYMPTOMS OF RLS. This medication can and does produce alterations in cognitive function and can block proper processing of information to lead to unusual and/or bizarre types of behavior.
I would recommend that you be reviewed by a NEUROLOGIST to begin with for the diagnosis of RLS. This diagnosis is not common in an otherwise healthy 29 year old young lady such as yourself. It is much more common to find RLS like symptoms in patients with some type of metabolic disorder such as severe anemia, diabetes, etc. Therefore, a qualified neurologist will likely wish to perform an examination on you for your complaints after taking a good history to find out what patterns if any accompany your problem. You may then, be sent for either metabolic and/or head imaging studies to rule out any and all neurologically based entities that need to be eliminated.
If RLS is truly the diagnosis and there are no metabolic issues that need to be addressed such as iron deficiency, zinc deficiency, vitamin D/TSH/B12/folate deficiencies, or FT4 excess then, you should not such high amounts to make a therapeutic difference and the increased dosing could be exhibiting side effects as you describe.
If you do have true RLS I find in my patients that Pramipexole (Mirapex) tends to be a much better tolerated medication which can be more tightly titrated and controlled in case of side effects and so I always use that as a first line drug as opposed to ropinirole.
The other option available to your doctor would be to perform a sleep study to see if in fact you suffer from something called PLMS (periodic leg movement syndrome). Though this is not the same as RLS.....it is often the case that people with PLMS will also have the clinical story that fits RLS.
Bottom line....I would likely get off the ropinirole and clear up the brain fog then, I'd look for an appointment with a neurologist with a good general knowledge of this sort of parasomnia or get a sleep disorder specialist to re-evaluate what's going on then, embark upon a definitive treatment plan.
If I've adequately answered your questions could you do me a huge favor by CLOSING THE QUERY and being sure to include some fine words of feedback along with a 5 STAR rating if you feel my suggestions have helped? Again, many thanks for posing your questions and please let me know how things turn out.
Do not forget to contact me in the future at: www.bit.ly/drdariushsaghafi for additional questions, comments, or concerns having to do with this topic or others.
This query has utilized a total of 15 minutes of professional time in research, review, and synthesis for the purpose of formulating a return statement.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Answered by
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