Restless legs syndrome

Last reviewed: 1 Sep 2022
Last updated: 13 Mar 2019

Summary

Definition

History and exam

Key diagnostic factors

  • presence of risk factors
  • dysaesthesias
  • evening symptoms
  • relieving factors (movement, stretching, massage)
  • location in lower extremities, less commonly upper extremities and torso
More key diagnostic factors

Other diagnostic factors

  • alcohol use
  • caffeine use
Other diagnostic factors

Risk factors

  • conditions associated with iron deficiency
  • pregnancy
  • family history of RLS
  • use of antidepressants, antihistamines, and metoclopramide
  • increased age
  • female sex
  • smoking
  • obesity
  • diabetes mellitus
More risk factors

Diagnostic investigations

1st investigations to order

  • clinical diagnosis
More 1st investigations to order

Investigations to consider

  • serum ferritin
More investigations to consider

Treatment algorithm

ACUTE

primary RLS

secondary RLS

Contributors

Authors

Nitun Verma, MD, MBA

Sleep Physician

AC Wellness

Cupertino

CA

Disclosures

NV declares that he has no competing interests.

Clete A. Kushida, MD, PhD, RPSGT

Acting Medical Director

Stanford Sleep Medicine Center

Director

Stanford Center for Human Sleep Research

Associate Professor

Stanford University Medical Center

Stanford Sleep Medicine Center

Redwood City

CA

Disclosures

CAK has received research grant support from XenoPort, the manufacturer of gabapentin enacarbil, and is an author of a number of references cited in this topic.

Peer reviewers

Magdolna Hornyak, MD

Associate Professor

Interdisciplinary Pain Center and Department for Psychiatry and Psychotherapy

University Medical Center Freiburg

Freiburg

Germany

Disclosures

MH declares that she has no competing interests.

Teofilo Lee-Chiong, MD

Professor of Medicine

Head of Division of Sleep Medicine

Department of Medicine

National Jewish Health

Denver

CO

Disclosures

TLC declares that he has no competing interests.

  • Differentials

    • Periodic limb movement disorder (PLMD)
    • Akathisia
    • Peripheral neuropathy
    More Differentials
  • Guidelines

    • Evidence-based and consensus clinical practice guidelines for the iron treatment of restless legs syndrome/Willis-Ekbom disease in adults and children
    • Treatment of restless legs syndrome in adults
    More Guidelines
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