About Restless Legs Syndrome (RLS)
Restless legs syndrome (RLS) is a sensorimotor disorder that is defined by the presence of the following four essential clinical criteria:
|1.||An urge to move legs or other body parts accompanied or caused by unpleasant sensations;|
|2.||The urge to move or unpleasant sensations increase or worsen during rest or inactivity;|
|3.||The urge to move or unpleasant sensations are partially or totally relieved by movement;|
|4.||The urge to move or unpleasant sensations are worse at night or occur only at night.|
Supportive clinical features
There are several supportive clinical features that can help resolve any diagnostic uncertainty, these are:
Positive family history; positive response to dopaminergic therapy; coexisting periodic leg movements (PLM) while awake or asleep.
There are significant clinical features that have been identified to as being associated with RLS, these are follows:
The clinical course of RLS is generally chronic and often progressive; Neurological examination is normal in the idiopathic or familial forms of RLS, but may show evidence of an associated peripheral neuropathy or radiculopathy in the older age onset, more rapidly progressive non-familial form; Sleep disturbance is a common complaint.
RLS symptoms often have an important negative impact on a activities of daily living due to the sleep disruption that they cause and the inability to keep still which causes difficulties in working, travelling and social activities.
The lifetime prevalance of RLS in European studies ranges between 3-10% (3-6). The prevalance of RLS in the South-East of Europe is somewhat lower: 3,2% in Turkey (7), and 3,9% in Central Greece (8). Among those with RLS in the general population, between 35,4-66% have moderate to severe symptoms (3,5,8-10).
RLS may be secondary to or exacerbated by a number of conditions that include iron deficiency, pregnancy, end-stage renal disease (ESRD), diabetes and rheumatoid arthritis, or with neurological disorders such as peripheral neuropathy, radiculopathy, spinal disorders and various forms of spinocerebellar ataxia.
Algorithms for the diagnosis and treatment of restless legs syndrome in primary care
To facilitate the evaluation of RLS severity and to monitor treatment efficacy a simple sleep diary can be used.
Click here to download a diary template.
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2. Hening WA, Walters AS, Allen RP, Montplaisir J, Myers A, Ferini-Strambi L. Impact, diagnosis and treatment of restless legs syndrome (RLS) in a primary care population: the REST (RLS epidemiology, symptoms, and treatment) primary care study. Sleep Med 2004;5(3):237-246.
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8. Hadjigeorgiou GM, Stefanidis I, Dardiotis E, Aggellakis K, Sakkas GK, Xiromerisiou G, et al. Low RLS prevalence and awareness in central Greece: an epidemiological survey. Eur J Neurol 2007;14(11):1275-1280.
9. Ulfberg J, Björvatn B, Leissner L, Gyring J, Karlsborg M, Regeur L, et al. Comorbidity in restless legs syndrome among a sample of Swedish adults. Sleep Med 2007;8(7-8):768-772.
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