RLS

Restless legs syndrome (RLS), also known as Willis-Ekbom disease, is a neurological sensorimotor disorder characterized by an urge to move the legs, often accompanied by uncomfortable or unpleasant sensations such as crawling, tingling, or aching. Symptoms typically begin or worsen during periods of rest or inactivity, are most severe in the evening or night, and improve with movement or distraction.

The condition varies in severity and duration. Many people experience intermittent symptoms, while others have persistent or daily symptoms that disrupt sleep. Periodic limb movements during sleep (PLMS) can occur and may contribute to sleep disturbance. RLS can occur at any age, including childhood, and a genetic predisposition has been observed in many cases.

RLS is more common in adults and tends to run in families. Risk factors include iron deficiency, pregnancy, chronic kidney disease, diabetes, peripheral neuropathy, and certain medications (such as some anti-nausea and antipsychotic drugs). Secondary RLS is linked to other medical conditions; primary or idiopathic RLS has unclear causes but often shows a genetic component.

Diagnosis is clinical, based on patient history and symptoms. There is no single laboratory test for RLS. Evaluations often include ferritin or iron studies to assess iron status, since iron deficiency can worsen symptoms. Diagnostic criteria emphasize an urge to move the limbs with uncomfortable sensations, symptoms worse at rest and in the evening, and relief with movement, without other explanations.

Treatment aims to relieve symptoms and improve sleep. Mild cases may respond to sleep hygiene measures and treating underlying iron deficiency if present. Iron therapy is recommended when ferritin is low. Pharmacologic options include dopamine agonists (for example, pramipexole, ropinirole) and non-dopaminergic options such as gabapentin, pregabalin, or gabapentin enacarbil. Avoidance of medications that can worsen RLS and addressing comorbid conditions are important components of management.