Restless legs syndrome

Abstract

Restless legs syndrome (RLS), also known as Willis-Ekbom disease (WED), is a common movement disorder characterised by an uncontrollable urge to move because of uncomfortable, sometimes painful sensations in the legs with a diurnal variation and a release with movement. The pathophysiology is only partially known and a genetic component together with dopaminergic and brain iron dysregulation plays an important role. Secondary causes for RLS need to be excluded. Treatment depends on the severity and frequency of RLS symptoms, comprises non-pharmacological (eg lifestyle changes) and pharmacological interventions (eg dopaminergic medication, alpha-2-delta calcium channel ligands, opioids) and relieves symptoms only. Augmentation is the main complication of long-term dopaminergic treatment of RLS. This article will provide a clinically useful overview of RLS with provision of diagnostic criteria, differential diagnoses, possible investigations and different treatment strategies with their associated complications. Definition and diagnostic criteriaRestless legs syndrome (RLS), also known as Willis-Ekbom disease (WED), is a common neurological movement disorder characterised by an uncontrollable urge to move (mainly the legs).1 Diagnosis of RLS is based primarily on the patient's history and on a neurological examination to exclude differential diagnoses. The diagnosis can be made if all of the following five criteria are met (International RLS Study Group (IRLSSG) diagnostic criteria): 2 1 A need to move the legs usually accompanied or caused by uncomfortable, unpleasant sensations in the legs. 2 Symptoms are exclusively present or worsen during times of inactivity/rest. 3 Partial or total relief of symptoms by movement, such as walking or stretching, at least as long as the activity continues. 4 Symptoms are generally worse or exclusively occur in the evening or during the night. ABSTRACT Restless legs syndrome5 The occurrence of the fi rst four essential criteria must not be solely accounted for as symptoms primary to another medical or a behavioural condition.A single standard question for rapid screening of RLS has been validated by the IRLSSG, 3 which is: 'when you try to relax in the evening or sleep at night, do you ever have unpleasant, restless feelings in your legs that can be relieved by walking or movement?' This question can be used to effectively screen large patient groups as it has 100% sensitivity and 96.8% specificity for the diagnosis of RLS. However, the final diagnosis should always be confirmed by matching the patient's history and symptoms with the IRLSSG diagnostic criteria, accompanied by an exclusion of secondary conditions. Aetiology and differential diagnosesThe aetiology of RLS can be categorised as primary (idiopathic) or secondary. The majority of cases are primary Key pointsRestless legs syndrome (RLS) is a common neurological movement disorder, characterised by an uncontrollable urge to move the legs combined with an uncomfortable sensation in the legs.Diagnosis of RLS is mainly base...

Sleeplessness and health

“…Restless Legs Syndrome: Restless legs syndrome (RLS) is a common neurological movement disorder, characterised by an unmanageable urge to move the legs combined with a painful sensation in the legs. RLS is also called as Willis-Ekbom disease (WED) [21].…”

“…Walking and stretching, massaging the affected limbs, bathing in hot or cold water, relaxation exercises will help in RLS treatments. Pharmacological treatment are carried out through medications like Ropinirole, Pramipexole, Clonazepam Levodopa, Pregabalin and Tramadol [21].…”

The prevalence of Restless Legs Syndrome/Willis-ekbom disease (RLS/WED) in the third trimester of pregnancy: a systematic review

“…If RLS symptoms are mild or trivial, changes in the lifestyle such as regular exercise may be beneficial. Massaging the legs or soaking them in water may also be alleviating [19]. However, when RLS is severe, pharmacotherapy may be indicated.…”

The effects of vibration and massage on severity of symptoms of restless leg syndrome and sleep quality in hemodialysis patients; a randomized cross-over clinical trial

“…Treatment depends on the severity and frequency of the symptoms. Mild forms of this syndrome may be managed by changing the life style and the severe forms may be treated by pharmaceutical therapy (11). Considering the numerous medicines used for treatment and the unexpected complications of these drugs in the patients, the provision of non-pharmaceutical treatment methods for these patients seems mandatory.…”