Introduction

Restless legs syndrome (RLS) is an unsettling and poorly understood movement disorder affecting 3% to 15% of the general population. RLS can affect both children and adults. Although effective treatments are available, the condition frequently remains undiagnosed.

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Symptoms of RLS. The core symptom of RLS is an irresistible urge to move the legs (medically known as akathisia). It is sometimes described as a sense of unease and weariness in the lower leg that is aggravated by rest and relieved by movement. Specific characteristics of RLS include the following:

• Patients have described their RLS symptoms as "pulling, searing, drawing, tingling, bubbling, or crawling" beneath the skin, usually in the calf area, causing an irresistible urge to move the legs. These sensations can occur not only in the lower legs, but they can also affect the thighs, feet, and even the upper body. In fact, a small 2000 study suggested that nearly half of patients may experience RLS-type symptoms in the arms. Furthermore, restless arms may be the first symptom of RLS in some people.
• About 80% of patients with RLS also experience semi-rhythmic movements called periodic limb movement disorder, or PLMD.
• Itching and pain, particularly aching pain, may be present.
• Patients experience symptoms when the legs are at rest and they feel most comfortable. (Conversely, movement brings relief.) Symptoms occur most often at night when lying down or sometimes during the day while sitting.
• Episodes of RLS most often occur between 10:00 PM and 4:00 AM at night, being at their worst right after midnight. They typically occur at 30 to 60 second intervals. They usually ebb by morning, although as the condition progresses, people may begin to experience symptoms during the day. They are always worse at night, however.
• At night the unpleasant sensations and the resulting uncontrollable urge to move the legs can often disturb sleep. Ignoring the need to move the legs usually only builds up tension until they jerk uncontrollably. If patients experience them during the day, they usually feel compelled to move his or her legs in order to relieve the symptoms, making it difficult to sit during air or car travel or through classes or meetings.