Restless Legs Syndrome
Casey Parker, MD, and Heidi James, MD
Background
- Affects 10%-15% of population
- Varies in severity and duration
- Diagnostic criteria
- Uncomfortable and unpleasant sensations in legs
- Urge to move legs when inactive or resting
- Symptoms partially or totally resolve during movement
- Symptoms worse in evening and night
- Not due to another condition
- Causes
- Anemia
- End-stage renal failure
- Pregnancy
- Peripheral neuropathy/lumbar radiculopathy
- Medications
- Antidepressants (selective serotonin reuptake inhibitors, serotonin and norepinephrine reuptake inhibitors)
- Dopamine antagonists (metoclopramide)
Clinical Findings
- History and physical
- Lab tests to rule out above causes
Management
- Remove triggers
- Non-pharmacological
- Avoid caffeine, nicotine, alcohol
- Stretching
- Heat or cold packs on legs
- Massage
- Distraction (eg, reading, puzzles)
- Pharmacological
- Dopaminergic agents
- L-dopa
- May cause symptom augmentation
- Direct dopamine agonists
- Benzodiazepines
- Opiates
- Anticonvulsants
