Restless legs syndrome (RLS) and nighttime leg cramping etiologies have always been poorly understood. An abstract presented at VIVA Physicians, a not-for-profit organization dedicated to advancing the field of vascular medicine and intervention through education and research, by Swar Shah, MD, noted many patients with chronic superficial venous insufficiency/varicose veins have had presenting symptoms of RLS and nighttime leg cramping/Charley horses. It was also noted that many of these patients presented with abnormal reflux of the lateral subdermic venous plexus (LSP) and superficial veins on the lateral thigh and calf typically not evaluated in most settings. It was hypothesized that there is an association between these leg symptoms and this poorly understood lateral subdermic venous plexus.
A total of 510 patients were evaluated for a correlation between RLS/nighttime leg cramping with reflux in the LSP. In patients with either symptom, 83% and 89%, respectively, had an abnormal lateral subdermic venous plexus on ultrasound. Of patients with both symptoms, 91% had an abnormal LSP on ultrasound. A total of 242 symptomatic patients underwent ultrasound-guided foam sclerotherapy of the LSP and up to 92% were symptom-free at 1 year.

The lateral subdermic venous plexus appears to play a key role in RLS and nighttime cramping and should be added to the comprehensive venous ultrasound, the authors say, especially for patients presenting with these symptoms. What’s more, treatment for this is simple and effective and can be life-changing for many of these patients.