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Restless Leg Syndrome After Stroke: Causes, Symptoms and Treatment

woman with restless leg syndrome fidgeting in bed

Restless leg syndrome after stroke can lead to insomnia and affect your quality of life. Therefore, treatment is often desirable for many patients. But where do you start?

You’re about to learn the causes, symptoms, and treatment for restless leg syndrome after stroke. Let’s dig in.

What is Restless Leg Syndrome?

The most classic symptom of restless leg syndrome after stroke is the overwhelming desire to move your legs, as the name implies.

Restless leg syndrome (RLS), also known as Willis-Ekbom Disease, can cause unpleasant sensation in the legs coupled with an urge to move them.

This may result in sleepless nights which snowball into other secondary effects from stroke, like daytime sleepiness and chronic fatigue.

The cause of RLS is unknown in most cases. Surprisingly, RLS impacts about 10% of Americans regardless of a stroke diagnosis, according to the National Institute of Neurological Disorders.

Though it can occur at any age, RLS is often experienced more severely in middle age or later. Additionally, women are twice more likely than men to have RLS.

The Basal Ganglia & Restless Leg Syndrome After Stroke

While the cause for restless leg syndrome is a mystery, many studies suggest that symptoms associated with RLS emerge within a few days following stroke.

Newer research is also looking at the relationship between RLS and stroke in which damage to the basal ganglia may be responsible for RLS-associated symptoms.

The basal ganglia is a cluster of neurons located deep in the cerebral cortex. It plays an essential role in helping the brain select which muscles to move.

It regulates a balance between the agonist muscles (muscles that initiate movement) and antagonist muscles (muscles that inhibit movement).

If a stroke damages part of the basal ganglia, its ability to keep this balance is disrupted and can cause conflicting muscle movement at the same time, resulting in twitching movements.

Other Causes of Restless Leg Syndrome After Stroke

Restless leg syndrome and stroke share similar risk factors such as smoking, high blood pressure, high cholesterol, diabetes, and obesity.

Obesity can cause a disruption in the dopamine pathways in the brain, which can also contribute to RLS symptoms.

Other potential causes of RLS include:

  • Sleep deprivation
  • Genetic predisposition
  • Environmental triggers
  • Low levels of iron in the brain
  • Medications taken to treat conditions such as allergies
  • Nausea
  • Depression
  • Psychosis

Caffeine or alcohol consumption can also trigger or intensify symptoms.

Restless leg syndrome can also result from another health condition, like peripheral neuropathy, diabetes, or kidney failure.

In these cases, treating the main conditions may resolve RLS symptoms.

Symptoms of Restless Leg Syndrome

Common symptoms of restless leg syndrome include:

  • A desire to move legs especially when sitting still or lying in bed
  • Abnormal leg sensations (e.g., tingling, crawling or pulling)
  • Worsened symptoms at rest and later on in the day

In the case of mild restless leg syndrome, these symptoms may not occur every night and can mistakenly be attributed to restlessness, anxiety, or stress.

More severe cases of RLS can make it difficult to enjoy and engage in the simplest activities such sitting on a plane for a long period of time or sitting through a movie.

Treatment for Restless Leg Syndrome

There are several options available to help treat the symptoms of restless leg syndrome after stroke.

The best way to treat RLS is to treat the symptoms, according to the National Institute of Neurological Disorders and Stroke.

Moving your legs, or walking around may provide some temporary relief.

Also, in the case of an underlying medical condition, such as iron deficiency anemia or diabetes, appropriately treating the original condition can provide relief towards this RLS.

Other treatment options include:

Lifestyle changes

  • Reduce or eliminate intake of caffeine, alcohol, and tobacco
  • Strive for a regular sleep schedule
  • Get some exercise everyday
  • Massage or stretch your leg muscles in the evening
  • Soak in a hot bath before bed
  • Use a heating pad or ice pack when experiencing symptoms
  • Arrange activities that require prolonged sitting earlier in the day rather than letter
  • Take a look at your diet to make sure you are getting enough essential vitamins and nutrients
  • Consider increasing options with vitamin C to increase your iron absorption


  • Iron supplements may be helpful if you have iron deficiency.
  • Magnesium supplements or magnesium oil have been shown to help improve restless leg syndrome

Before adding supplements to your diet, it’s important to consult your physician or nutritionist.


  • Dopaminergic agents can help decrease motion in your legs
  • Narcotics such as opioids can decrease pain and strange sensation and help you relax
  • Sleep aids and muscle relaxants such as benzodiazepines can help you relax and sleep better

Though there is no cure for restless leg syndrome, managing the symptoms will definitely provide relief.

For treatment options, it is best to consult your doctors to see what treatment and/or medications would be appropriate for you!

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