El Síndrome de Piernas Inquietas (SPI) es un trastorno frecuente y crónico. Consiste en un impulso irrefrenable de mover las piernas asociado a sensaciones desagradables, no dolorosas, a menudo descritas como hormigueo, o pinchazos, por ejemplo. Éstas se exacerban con el reposo, mientras que con el movimiento se produce una sensación de alivio. La etiología de este trastorno es desconocida, si bien se esgrimen como posibles causas la insuficiencia de hierro cerebral y las alteraciones en la neurotransmisión de dopamina.
Según explica la Asociación Española de Síndrome de Piernas Inquietas (AESPI), aproximadamente el 80% de las personas con esta patología realizan movimientos periódicos de las extremidades durante el sueño. Se trata de unas sacudidas que se producen con una frecuencia de 20 a 30 segundos durante la noche y, por lo general, causando continuas interrupciones del sueño.
Una de las mayores quejas de los pacientes de SPI es cómo se ve mermada su calidad de vida, ante la privación crónica del sueño, provocando cansancio, insomnio muchas veces, e incluso una disminución en la capacidad de concentración durante el día, además de afectar a su estado de ánimo.
CARACTERÍSTICAS DE LA ENFERMEDAD
En una entrevista con Infosalus, la doctora Pilar Rubio, del servicio de Neurofisiología Clínica del Hospital Universitari i Politècnic La Fe de Valencia, señala que el SPI puede presentarse a cualquier edad, tanto en la infancia como en la edad adulta; si bien advierte de que éste predomina a partir de la tercera o cuarta década de la vida, y su frecuencia se incrementa conforme aumenta la edad.
“El trastorno puede presentarse de forma espontánea o bien asociarse a otras patologías entre las que cabe destacar el déficit de hierro o la insuficiencia renal terminal. También se ha relacionado con procesos como diabetes mellitus, trastornos reumatológicos, así como afecciones neurológicas, entre ellas la enfermedad de Parkinson. En afecciones gastrointestinales como la celiaquía y la enfermedad de Crohn, también ha sido descrita dicha asociación”, añade la experta.
A su vez, indica que los síntomas de piernas inquietas pueden desencadenarse por el uso de algunos fármacos como los antidepresivos. Además, durante el embarazo, y muy especialmente durante los últimos meses, hasta un 20% de las mujeres desarrollan el SPI. Después del parto, a menudo los síntomas desaparecen. No obstante, existe una relación clara entre el número de embarazos y las posibilidades de desarrollar SPI crónico.
Por otro lado, Rubio precisa que se trata de un trastorno que puede aparecer espontáneamente, aunque un 40% de pacientes tienen una historia familiar positiva de piernas inquietas, “es decir tiene un factor hereditario siendo el patrón de herencia autosómico dominante”.
El diagnóstico se realiza con una adecuada historia clínica, añade la especialista. No se precisan estudios especiales, salvo que se sospeche una asociación a otros trastornos del sueño, como los movimientos periódicos de piernas. “En ese caso el diagnóstico se haría con polisomnograma”, apostilla.
Sobre el tratamiento, la experta del equipo de Neurofisiología Clínica del Hospital La Fe de Valencia apunta que es sintomático y personalizado. “Actualmente se dispone de una amplia gama de fármacos desde hierro asociado a vitamina C, fármacos dopaminérgicos, gabapentina, benzodiacepinas, entre otros que mejoran la sintomatología”, asegura.
CONSEJOS PARA SOBRELLEVARLO
Por todo ello, desde la AESPI aconsejan para sobrellevar la enfermedad, aparte del tratamiento farmacológico:
1.- Mantener horarios regulares de sueño, acostándose y levantándose a la misma hora, y a poder ser tener un entorno de sueño tranquilo y cómodo.
2.- Evitar el consumo de sustancias excitantes, tipo cafeína, y alcohol, y sobre todo por la tarde-noche.
3.- Realizar ejercicio suave, no extenuante, por la tarde como estiramientos, o relajación, por ejemplo, así como masajes suaves en las piernas asociado a baños calientes- fríos.
4.-Evitar ciertos fármacos que pueden empeorar los síntomas (antihistamínicos, algunos sedantes que bloquean la dopamina, y ciertos antidepresivos)
5.- Hablar abiertamente sobre el SPI con los familiares y amigos.
6.- No luchar contra el cuadro. Si se intenta suprimir la necesidad de moverse puede que los síntomas empeoren aún más. Un buen programa de ejercicios puede ayudar al organismo a enfrentarse mejor con la enfermedad. El ejercicio regular puede mantener la flexibilidad, propiciar una buena postura, conservar los músculos fuertes y las articulaciones ágiles.
7.- Escriba un diario del sueño. Tenga un registro de los medicamentos y estrategias que le ayudan o alivian en su batalla contra el SPI y compártala con su médico.
8.- Póngase más alto. Puede encontrarse más cómodo si eleva el escritorio o las estanterías a una altura que le permita estar de pie mientras trabaja o lee.
9.- Ocupe la mente. Si la mantiene activa puede que los síntomas del SPI disminuyan.
10.- Comience y acabe el día con estiramientos. Las terapias complementarias pueden ayudar física y emocionalmente con el SPI. Tales como el yoga, el tai chi, la musicoterapia y la acupuntura. De hecho, algunas se ofrecen dentro del proceso de rehabilitación del SPI.
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