RESTLESS LEGS SYNDROME
The following discussion is for general informational purposes only and is not meant to provide the reader with specific medical advice. Please consult with your personal physician, or with a neurologist, for specific advice, guidance and information regarding your particular circumstances.
Restless legs syndrome (RLS) is a neurologic condition characterized by an urge to move that occurs or worsens at rest and is relieved by activity. The symptoms characteristically occur during the evening and at night. Patients complain of difficulty falling asleep or waking up shortly after falling asleep due to discomfort in the legs. Patients often find themselves vigorously flexing, extending, and rubbing the legs together for relief. RLS can occur in the setting of other medical conditions such as iron deficiency, uremia, and peripheral neuropathy. RLS can also run in families, with more than 50% of patients reporting relatives with similar symptoms. Despite the name, similar symptoms can occur in the arms in some cases. RLS is thought to occur due to a deficiency of dopamine in certain parts of the brain.
The essential features included in the diagnostic criteria for restless legs syndrome are as follows:
1. The patient experiences and urge to move the legs that is accompanied or caused by unpleasant sensations in the legs.
2. The unpleasant sensations or urge to move increases while at rest
3. The unpleasant sensations or urge to move is partially or completely relieved by movement
4. The unpleasant sensations or urge to move is characteristically worse in the evening
There is no specific test to diagnose RLS. The diagnosis is made when the above criteria are present. Further work up can include labs looking for anemia, iron deficiency, and neurodiagnostic testing to screen for the presence of a neuropathy.
Treatment is usually aimed at correcting the underlying cause. Iron supplementation, correction of uremia, and treating a neuropathy, if present, can be useful. Also, medications designed to increase the amount of dopamine available in the brain can also be useful.