Nocturnal myoclonus; RLS; Akathisia
Restless leg syndrome is a disorder in which there is an urge or need to move the legs to stop unpleasant sensations.
Restless leg syndrome (RLS) occurs most often in middle-aged and older adults. Stress makes it worse. The cause is not known in most patients.
RLS may occur more often in patients with:
A form of RLS may be passed down in families. This may be a factor when symptoms start at a younger age. The abnormal gene has not yet been identified.
RLS leads to sensations in the lower legs that make you uncomfortable unless you move your legs. These sensations:
You will feel an irresistible urge to walk or move your legs, which almost always relieves the discomfort.
Most patients have rhythmic leg movements during sleep hours, called periodic limb movement disorder (PLMD).
All of these symptoms often disturb sleep. Symptoms can make it difficult to sit during air or car travel, or through classes or meetings.
Note: Symptoms may be worse during stress or emotional upset.
There is no specific examination for restless leg syndrome. The health care provider will not usually find any abnormalities, unless you also have peripheral nerve disease. Blood tests (CBC and serum ferritin) may be done to rule out iron deficiency anemia, which in rare cases can occur with restless leg syndrome.
Examination and testing may be used to rule out other disorders with similar symptoms.
There is no known cure for restless leg syndrome.
Treatment is aimed at reducing stress and helping the muscles relax. The following techniques may help:
Low doses of pramipexole or ropinirole (Requip) can be very effective at controlling symptoms in some people.
If your sleep is severely disrupted, your health care provider may prescribe medications such as Sinemet (an anti-Parkinson's medication), gabapentin and pregabalin, or tranquilizers such as clonazepam. However, these medications may cause daytime sleepiness.
Patients with iron deficiency will receive iron supplements.
Low doses of narcotics may sometimes relieve symptoms of restless leg syndrome.
Restless leg syndrome is not dangerous or life-threatening, and it is not a sign of a serious disorder. However, it can be uncomfortable and disrupt your sleep.
Insomnia may occur.
Call for an appointment with your health care provider if:
Techniques to promote muscle relaxation and stress reduction may reduce the incidence of restless leg syndrome in people prone to the condition.
Bayard M, Avonda T, Wadzinski J. Restless legs syndrome. Am Fam Physician. 2008;78(2):235-240.
Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier; 2007.
Kushida CA. Clinical presentation, diagnosis, and quality of life issues in restless legs syndrome. Am J Med. 2007;120:S4-S12.
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