Restless Legs Syndrome

Abstract

Restless legs syndrome is characterized by unpleasant, deep-seated paresthesias in the legs and sometimes the arms. These sensations occur at rest and are relieved by movement. Sleep disturbance is common. Many patients also have periodic movements of sleep. Mild symptoms of restless legs occur in up to 5% of the population. Restless legs syndrome is idiopathic in most patients, but it may be the presenting feature of iron deficiency and is also common in uremia, pregnancy, diabetes mellitus, rheumatoid arthritis, and polyneuropathy. Treatment of the underlying cause, when possible, usually relieves the symptoms. For patients with severe symptoms, levodopa, bromocriptine mesylate, opioids, carbamazepine, clonazepam, and clonidine hydrochloride have proved to be effective.

Restless Legs Syndrome

“…52 Although the adverse eect of caeine and alcohol on RLS is well known, medications such as lithium, neuroleptics and others have a similar eect. An extensive list of conditions associated with RLS-PLMS is reported by O'Keee 11 and others. 19,53 Neurological and laboratory ®ndings…”

“…4,9,10 The incidence of RLS in pregnancy, usually in the second half of gestation, can be as high as 11% to 27%. 5,11,12 The symptoms often appear initially during pregnancy and after delivery may disappear for many years. 1,4 The onset of idiopathic RLS begins at any age, even in infancy and early childhood.…”

“…Some patients report an urge or inner feeling of restlessness without any clear precipitating sensations, while others report an indescribable uncomfortable feeling in their extremities or merely a need to move the limbs. 11,14,19 The paresthesias aect primarily the legs, especially the calves, and may be bilateral or unilateral. About 20% to 30% of patients experience similar sensations in the arms but rarely in the trunk or elsewhere in the body.…”

“…36,37 Other medical conditions in which symptoms of RLS are observed are diabetes, chronic respiratory insuciency, post-gastrectomy states, Sjoegren's syndrome, hypothyroidism, porphyria and carcinoma among many others. 1,11,38 Familial amyloidosis resulting in peripheral neuropathy has also been thought to be associated. 39 Neurological disorders in which RLS is frequently observed include chronic myelopathy; diabetic, alcoholic, and chronic idiopathic polyneuropathy; Parkinson's disease and REM behavior disorders.…”

“…39 Neurological disorders in which RLS is frequently observed include chronic myelopathy; diabetic, alcoholic, and chronic idiopathic polyneuropathy; Parkinson's disease and REM behavior disorders. 5,11 In a group of patients evaluated for polyneuropathy, 5% had symptoms of RLS. These patients had mild predominantly sensory polyneuropathy.…”