29A. Restless-legs syndrome

Restless legs syndrome (RLS) is a waking sensorimotor disorder characterised by a complaint of a strong, nearly irresistible urge to move the legs, especially during the night, potentially impairing sleep.

Most cases are familial, but it can also be secondary to:

• Iron deficiency
• Uraemia
• Radiculopathy
• Neuropathy
• Drugs (antipsychotics, antihistamines)

Clinical features

Unpleasant sensations in the legs are present, which give a strong urge to move them. The symptoms are worse at rest, alleviated with movement, predominant in the evening or night, and usually affect sleep.

Diagnosis and evaluation

Primary restless legs syndrome is a diagnosis of exclusion, and so it’s important to exclude secondary causes.

Treatment

In case of secondary RLS, the underlying disorder must be treated.

Non-pharmacological treatment, like proper sleep hygiene and avoidance of triggers (certain drugs, coffee) is important. If insufficient, dopamine agonists or antiepileptics like gabapentin or pregabalin can be used.