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Restless legs syndrome

Restless legs syndrome, or RLS, is a neurological disorder characterized by unpleasant sensations in the legs and an uncontrollable urge to move when at rest in an effort to relieve these feelings. RLS sensations are often described by people as burning, creeping, tugging, or like insects crawling inside the legs. The most distinctive aspect of the condition is that lying down and trying to relax activates the symptoms. As a result, most people with RLS have difficulty falling asleep and staying asleep.

Symptoms 

  • Uncomfortable sensations in the legs, especially when sitting or lying down, accompanied by an irresistible urge to move about.
  • Exhaustion and daytime fatigue.
  • Inability to concentrate and to accomplish daily tasks
  • Impaired memory

RLS occurs in both genders, although the incidence may be slightly higher in women. Although the syndrome may begin at any age, even as early as infancy, most patients who are severely affected are middle-aged or older. In addition, the severity of the disorder appears to increase with age. Older patients experience symptoms more frequently and for longer periods of time.

Diagnosis 

Currently, there is no single diagnostic test for RLS. The disorder is diagnosed clinically by evaluating the patient's history and symptoms. Physicians must rely largely on patients' descriptions of symptoms and information from their medical history, including past medical problems, family history, and current medications. Patients may be asked about frequency, duration, and intensity of symptoms as well as their tendency toward daytime sleep patterns and sleepiness, disturbance of sleep, or daytime function. The diagnosis is especially difficult with children because the physician relies heavily on the patient's explanations of symptoms, which, given the nature of the symptoms of RLS, can be difficult for a child to describe. The syndrome can sometimes be misdiagnosed as "growing pains" or attention deficit disorder.

Treatment 

RLS can be controlled by finding and treating the underlying associated medical condition, such as peripheral neuropathy or diabetes. For patients with idiopathic RLS, treatment is directed toward relieving symptoms. Studies also have shown that maintaining a regular sleep pattern can reduce symptoms. Some individuals, finding that RLS symptoms are minimized in the early morning, change their sleep patterns. Others have found that a program of regular moderate exercise helps them sleep better; on the other hand, excessive exercise has been reported by some patients to aggravate RLS symptoms. Taking a hot bath, massaging the legs, or using a heating pad or ice pack can help relieve symptoms in some patients. Physicians also may suggest a variety of medications to treat RLS, including dopaminergics, benzodiazepines (central nervous system depressants), opioids, and anticonvulsants. Unfortunately, no one drug is effective for everyone with RLS.

Treatment of Restless Legs Syndrome at Hopkins Children’s

Restless Legs Syndrome is diagnosed and treated by physicians and clinical staff at the Johns Hopkins Pediatric Sleep Center. For an evaluation at the sleep clinic at the Johns Hopkins Children’s Center, or for a sleep study at the sleep laboratory at the Mt. Washington Pediatric Hospital, please call 410-955-2035.


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