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(Chest. 2006;130:1596-1604.)
© 2006 American College of Chest Physicians

Restless Legs Syndrome*

A Clinical Update

Charlene E. Gamaldo, MD and Christopher J. Earley, MB, BCh, PhD

* From the Department of Neurology, Johns Hopkins School of Medicine, Baltimore, MD.

Correspondence to: Charlene E. Gamaldo, MD, Neurology and Sleep Medicine, Johns Hopkins University, Asthma and Allergy Bldg 1B75, 5501 Hopkins Bayview Circle, Baltimore, MD 21224; e-mail cgamald1{at}jhmi.edu

Abstract

Restless legs syndrome (RLS) is a common and often disabling sensorimotor disorder. Epidemiologic studies suggest that RLS is an underrecognized and undertreated disorder affecting both children and adults. The diagnosis is based primarily on the following four essential criteria: (1) an urge to move, usually associated with paresthesias, (2) onset or exacerbation of symptoms at rest, (3) relief of symptoms with movement, and (4) symptoms manifesting in a circadian pattern. Supplemental workup including polysomnography, iron profile, and/or neuropathy screen can provide support for the diagnosis and aid in the treatment strategy. Behavioral techniques, dopaminergic agents, opiates, benzodiazepines, and antiepileptics all have potential value in treating this disorder. Dopaminergic agents continue to be the most effective RLS treatment. However, due to their potential long-term side effects, these agents should not be considered the sole treatment of choice. In the end, the therapeutic plan should be individualized to suit each patient’s presentation and needs.

Key Words: diagnosis • Parkinson disease • restless legs syndrome • treatment






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