Restless Legs Syndrome (RLS)

Clinical Overview

Restless legs syndrome (RLS) is a neurological movement disorder characterized by a compelling urge to move the legs usually accompanied by an uncomfortable and unpleasant sensations.

Symptoms begin or worsen during periods of rest or inactivity, are partially or totally relieved by movement, and are worse in the evening or at night. Despite being a common disorder, RLS is generally underdiagnosed. The prevalence of RLS in the general population is 5%–10%, making it the most common movement disorder.

Prevalence increases with advancing age and the condition is observed more frequently in women. Delayed sleep onset, multiple awakenings, and a reduction in sleep efficiency all contribute to significant sleep disturbance in these patients. RLS can be idiopathic and begin at any age, or secondary to conditions such as, iron deficiency, renal failure, neuropathy, and normal pregnancy.

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Although the etiology of RLS is still unclear, evidence suggests that the symptoms result from central dopaminergic dysfunction. Although results should be interpreted with caution, brain-imaging studies have shown abnormal dopamine receptor binding and dopamine hypoactivity. Iron deficiency has also been implicated in the etiology of RLS.

Dopamine agonists and l-dopa have demonstrated efficacy in the management of RLS and in contrast, certain agents that block the dopaminergic system aggravate RLS symptoms. Other known treatments for RLS include gabapentin, benzopdiazepines, and opiates.

Contributed by Marcelo Merello, MD
Director, Neuroscience Department
Head Movement Disorders Section
Institute for Neurological Research Raul Carrea (FLENI)
Buenos Aires, Argentina

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