Restless Legs Syndrome FAQ
Second Installment - January 14, 1999
Are areas of the body other than the legs ever affected by RLS?
In most people with RLS, abnormal sensations affect only the legs or the legs are more involved than the arms. These deep-seated, uncomfortable sensations are typically predominant in the calves; however, the thighs or the feet may sometimes be involved. Rarely, patients may experience such sensations in the trunk or genital area.
Do people with RLS experience a typical pattern of symptoms? In other words, if someone initially has symptoms affecting only the legs, will that remain the case?
RLS is usually a chronic, progressive disease. As the disease progresses, there is an increased likelihood that symptoms may involve the arms as well as other parts of the body, but this is not true in every case. It is important to note that the abnormal sensations may fluctuate from one part of the body to the other many times over a single 24-hour period.
What do the paresthesias/dyesthesias associated with RLS usually feel like? Are they uncomfortable or are they truly painful?
The paresthesias and dysesthesias associated with RLS are typically deep seated–that is, they are felt deep within the legs or other affected areas, rather than at "skin level." These abnormal sensations are described as tingling, cramping, burning, creeping, itching, pulling, or aching. Other descriptions include numbness, a crawling sensation or the feeling that water is flowing under the skin, pins and needles, or an "antsy" feeling. The majority of those with RLS characterize such sensations as uncomfortable and annoying yet do not perceive them as painful. However, in some rare cases, some patients may experience pain in affected areas.Can children be affected by RLS?
Although RLS is more common with increasing age, the disease may also occur during childhood or adolescence. Unfortunately, children with RLS are frequently misdiagnosed. The motor restlessness associated with restless legs syndrome may sometimes be mistaken for "fidgetiness" or "nervousness," potentially leading to an improper diagnosis of growing pains, anxiety disorders, or attention-deficit hyperactivity disorder (ADHD). However, it is also important to note that there have been some cases in which children have been affected by both ADHD and RLS. The relationship between these two disorders remains unclear.
First Installment - November 4, 1998
How common is restless legs syndrome?
Restless legs syndrome (RLS) is a common condition that may affect up to 12 million people in the United States. Approximately 5% to 15% of the general population may be affected by varying degrees of RLS.
What is the difference between the medical terms "paresthesias" and "dyesthesias"?
The term "paresthesias" refers to abnormal touch sensations that are experienced in the absence of external stimuli, such as abnormal prickling, burning, or tingling. "Dyesthesias" is a term that means distortion of any sense, particularly touch, or an unpleasant, abnormal sensation.
Is there a specialized test that may confirm RLS?
There is no one specific test that may be used to confirm a diagnosis of restless legs syndrome. However, confirmation of PLMS during a specialized sleep study is strongly suggestive of restless legs syndrome since the condition occurs only rarely outside of RLS.
Are any such medications considered first-line therapies for RLS?
Dopaminergic agents are considered the drugs of choice in the treatment of RLS since they may relieve all major symptoms associated with the disease including abnormal sensations, restlessness, involuntary movements, and associated sleep disturbances. Such dopaminergic agents may include dopamine precursors such as carbidopa/levodopa or dopamine agonists such as pramipexole (Mirapex®)or ropinirole (Requip®).
Do opioid agents cause daytime augmentation?
Opioid therapy rarely causes daytime augmentation. However, some may experience a return of their symptoms after the discontinuation of opioid therapy; such symptoms may temporarily be more severe than before the initiation of pharmacologic therapy.
Is it true that, in women who experience RLS during pregnancy, symptoms may disappear soon after delivery?
In women who experience RLS prior to becoming pregnant, associated symptoms often worsen during pregnancy. However, the severity of RLS symptoms may return to previous levels after delivery. Previously unaffected women may begin to experience RLS while they are pregnant, but symptoms typically subside after delivery.
