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Restless Legs Syndrome

Denise Sharon, MD, PhD, FAASM and John R. Burk, MD, FACP Reviewed 06/2019
 


BASICS

DESCRIPTION

  • Sensorimotor disorder consisting of a strong, nearly irresistible urge to move the limbs (1)[A]

  • The urge usually affects the legs at least initially but may involve arms or other body...

DIAGNOSIS

  • Clinical, depends on history, often “difficult to describe”

  • All criteria must be met for RLS diagnosis (2)[C]:

    • An urge to move the legs, usually accompanied by or thought to be caused by uncom...

TREATMENT

GENERAL MEASURES

  • If iron deficient, supplement (4)[C]:

    • 325 mg FeSO4 TID combined with vitamin C

    • Repletion requires months till serum ferritin >75 ng/mL and transferrin saturation >16%.

  • Dai...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

Patient Monitoring

  • At 1- to 2-week intervals until stable and then annually

  • If taking iron, reassess iron stores, at least ferritin.

  • If status changes, assess for au...

REFERENCES

1
Allen RP, Picchietti DL, Garcia-Borreguero D, et al. Restless legs syndrome/Willis-Ekbom disease diagnostic criteria: updated International Restless Legs Syndrome Study Group (IRLSSG) cons...

ADDITIONAL READING

  • Garcia-Borreguero D, Cano-Pumarega I. New concepts in the management of restless legs syndrome. BMJ.  2017;356:j104. [View Abstract on OvidMedline]

  • Sharon D, Allen RP, Martinez-...

CODES

ICD10

G25.81 Restless legs syndrome 

ICD9

333.94 Restless legs syndrome (RLS) 

SNOMED

32914008 Restless legs (disorder) 

CLINICAL PEARLS

  • Insomnia is often a symptom of RLS.

  • RLS is associated with depression, anxiety ADHD.

  • Antidepressants, antipsychotics, antiemetics, and antihistamines can trigger or exacerbate RLS.

  • RLS sy...

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