Summary

• Restless legs syndrome is characterised by uncomfortable sensations in the legs.
• It gets worse during periods of inactivity or rest or while sitting or lying down.
• There is often a positive family history of the disorder.
• The sensations are described as: pulling, drawing, crawling, wormy, boring, tingling, pins and needles and prickly.
• It is a life-long condition for which there is no cure.

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Description
Restless legs syndrome is characterised by uncomfortable sensations in the legs, which are worse during periods of inactivity or rest or while sitting or lying down. There is often a positive family history of the disorder.

Individuals affected with the disorder describe the sensations as pulling, drawing, crawling, wormy, boring, tingling, pins and needles, prickly, and sometimes painful sensations that are usually accompanied by an overwhelming urge to move the legs.

Sudden muscle jerks may also occur. Movement provides temporary relief from the discomfort. In rare cases, the arms may also be affected.

Symptoms may interfere with sleep onset (sleep onset insomnia). Research suggests that restless legs syndrome is related to periodic limb movement disorder (PLMD), another more common motor disorder, which causes interrupted sleep.

The symptoms often exhibit circadian rhythmicity in their peak occurrence during awakening hours.

Prognosis
Symptoms may gradually worsen with age, and their most disabling feature is the sleep onset insomnia they cause, which can be severe.

Treatment

• Treatment is symptomatic.
• Massage and application of cold compresses may provide temporary relief.
• Certain medications are effective in relieving the symptoms.
• Research suggests correction of iron deficiency may improve symptoms for some patients.

Reviewed by Dr Andrew Rose-Innes, MD, Department of Neurology, Yale University School of Medicine, New Haven.

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