Restless legs syndrome

Restless legs syndrome has probably been known for over three centuries but remains underdiagnosed. Recent advances in pathophysiology and new treatment options for the symptoms may not be widely appreciated. The syndrome has a prevalence of 10-15% in white adults, with some preponderance in women.1 Although it is widely believed to occur in middle aged or elderly people, it also affects children and adolescents.2 In over a third of patients symptoms start before the age of 10 years, although in most the disorder is not diagnosed until middle or late adult life.^w1 One study has even asked whether “growing pains”—in a subgroup of children—may be a manifestation of this syndrome.3

The syndrome is characterised by unpleasant, “creepy crawly” sensations in the lower limbs, which occur at rest, mainly in the evenings when the person is seated or at night in bed, and are temporarily relieved by moving the legs. These cause the patient to move the legs relentlessly usually by pacing about in an attempt to gain relief. The International Restless Legs Syndrome Study Group has suggested four criteria for diagnosis: the desire to move the extremities, often associated with paraesthesiae or dysaesthesiae; motor restlessness; aggravation of symptoms by rest and at least temporary relief by activity; and worsening of symptoms in the evening or night.4

Restless legs syndrome is commonly …