Summary
Definition
History and exam
Key diagnostic factors
- urge to move the legs
- dysesthesias
- evening or night symptoms
- relieving factors (movement, stretching, massage)
- location in lower extremities, less commonly upper extremities and torso
Other diagnostic factors
- alcohol use
- caffeine use
- female sex
Risk factors
- conditions associated with iron deficiency
- pregnancy
- family history of RLS
- use of antidepressants, antihistamines, and metoclopramide
- female sex
- increased age
- obesity
- diabetes mellitus
- Parkinson disease
- multiple sclerosis
- peripheral neuropathy
Diagnostic tests
1st tests to order
- clinical diagnosis
- iron studies
Treatment algorithm
intermittent RLS: nonpregnant
intermittent RLS: pregnant
chronic persistent RLS: nonpregnant
chronic persistent RLS: pregnant
refractory RLS: nonpregnant
refractory RLS: pregnant
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.
K Ray Chaudhuri, MD, FRCP, DSc, FEAN
Professor of Movement Disorders and Neuroscience and Clinical Director
Parkinson Foundation International Centre of Excellence
King's College Hospital and King's College
Campus Research Director and Assistant Medical Director
King's College Hospital NHS Foundation Trust
London
UK
Disclosures
KRC declares that he has no competing interests.
Brian Koo, MD
Associate Professor of Neurology
Yale University
New Haven
CT
Disclosures
BK declares that he has no competing interests.
Differentials
- Periodic limb movement disorder (PLMD)
- Akathisia
- Peripheral neuropathy
More DifferentialsGuidelines
- International classification of sleep disorders, 3rd edition, text revision (ICSD-3-TR)
- Management of restless legs syndrome: an updated algorithm
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