<p>Restless arms syndrome: prevalence, impact, and management strategies</p>

Abstract

This literature review focuses on restless arms syndrome (RAS), an upper limb variant of restless legs syndrome (RLS). RLS, also known as Willis-Ekbom disease, is a frequently occurring neurological disorder characterized by an irresistible urge to move the lower limbs often accompanied by unpleasant sensations in the legs, worsened at rest and in the evening, improved by movement. Extension of leg restlessness to the upper limbs is frequently reported in typical patients who had RLS only in the legs and usually occurs later in the course of RLS, restlessness remaining most invalidating in the lower limbs. In RAS, the arms are predominantly affected with little or no involvement of the legs. Cases of restless shoulders syndrome or periodic arm movements without arm restlessness were not considered. A total of 9 articles with 10 cases were included and analyzed for the adherence to the five essential diagnostic criteria of the International RLS Study Group (IRLSSG) classification, as well as for the additional supportive features. All of the reported cases were classified as having definite RAS. The clinical history and disease evolution of two previously reported patients were completed and updated. Overall, the clinical picture of RAS does not differ from that of RLS, except for the symptoms localization on the upper limbs. Underlying mechanisms of the spread of RLS to upper limb restlessness and of RAS remain unknown. Whether RAS is a phenotypic variant of RLS or a separate entity needs further investigations. RAS likely remains underdiagnosed and according to IRLSSG diagnostic criteria RAS should be considered when RLS-like symptoms are present in one or both arms, especially when they have a circadian pattern and are improved by movement and dopaminergic therapy. Clinicians should be aware of this rare condition, especially as treatment using dopaminergic agonists proves to be very efficient.

Motivation States for Physical Activity and Sedentary Behavior: Desire, Urge, Wanting, and Craving

“…Urges to move, most cited in work on Restless Legs Syndrome, are highly specific in this context to muscular movement but are clearly gauged as a negative tension. Patients with Restless Leg Syndrome, other variants such as Restless Arm or Mouth Syndrome, and Tourette's Syndrome report pressing, involuntary and bothersome urges to move and/or stretch that are often temporarily suppressed but eventually released (Cavanna and Nani, 2013;Jung et al, 2017;Ruppert, 2019). Appetence is highly specific to movement, but neutral in feeling in the same sense that appetite may be either present or lacking but distinct from the pangs of hunger (Ferreira et al, 2006).…”

Measurement of Motivation States for Physical Activity and Sedentary Behavior: Development and Validation of the CRAVE Scale

“…A preponderance of information about desires for movement exists in clinical and psychiatric studies. Urges to move, especially at night, are a defining characteristic of Restless Leg Syndrome, which may affect other parts of the body as well ( Garcia-Borreguero et al, 2011 ; Jung et al, 2017 ; Ruppert, 2019 ). Exercise dependence/addiction is a “craving for leisure-time physical activity, resulting in uncontrollable excessive exercise behavior” and showing a variety of physical and psychological symptoms ( Hausenblas and Downs, 2002 ).…”

Suspected Agomelatine-induced restless legs syndrome: a case report

“…Patients with RLS usually seek treatment due to insomnia and daytime sleepiness. Despite the name, longer duration or inadequate treatment is associated with involvement of the arms and other parts of the body [ 6 ]. Periodic Limb Movements of Sleep (PLMS) are common in patients with RLS, manifesting as involuntary contractions of the limbs and torso while awake and during sleep which differentiates it from the voluntary movements in RLS.…”