Restless legs syndrome

1. Big picture

Restless legs syndrome (RLS) is the most frequent sleep-related movement disorder. It causes an unpleasant urge to move the legs, usually in the evening or at night, especially during rest. Movement gives temporary relief.

The key exam sentence:

Restless legs syndrome is a clinical diagnosis based on an urge to move the legs, worse at rest, relieved by movement, and maximal in the evening or night.

The most important exam trap:

RLS is often secondary, so always look for iron deficiency, pregnancy, renal failure/uremia, polyneuropathy, radiculopathy, Parkinson disease, and provoking drugs.

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2. Definition

Restless legs syndrome is a neurological sensorimotor disorder characterized by:

• unpleasant sensations in the legs;
• irresistible urge to move;
• worsening during rest or inactivity;
• relief by movement;
• evening or night predominance;
• sleep-onset insomnia or sleep fragmentation.

It is also called:

• Ekbom syndrome;
• “Elvis legs” in some older lecture wording.

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3. Classification