Diagnosis:
The 4 following are required:
- An urge to move the legs due to an unpleasant feeling in the legs.
- Begins or gets worse when at rest or not moving around frequently.
- Is partly or completely relieved by movement (such as walking or stretching) for as long as the movement continues.
- Is worse in the evening and at night, or only occurs in the evening or at night.
Investigations to consider:
FBC, U&E, Creatinine
Iron studies: low ferritin
Treatment:
Correct anemia
Pharmacological:
- Pramipexole, rotigotine, cabergoline (but cardiovascular risk), and gabapentin enacarbil (Level A, strong evidence)
- Ropinirole, pre-gabalin, and IV ferric carboxymaltose use (Level B moderate evidence)
- Levodopa (Level C, weak evidence)
Non-pharmacological:
- Pneumatic compression (Level B moderate evidence)
- Near-infrared spectroscopy (Level C weak evidence)
- Transcranial magnetic stimulation TMS (Level C weak evidence)
- Vibrating pads (Level C weak evidence)
- Moderate exercise
Related articles:
Related articles:
- Winkelman JW, Armstrong MJ, Allen RP, Chaudhuri KR, Ondo W, Trenkwalder C, Zee PC, Gronseth GS, Gloss D, Zesiewicz T. Practice guideline summary: Treatment of restless legs syndrome in adults: Report of the Guideline Development, Dissemination, and Implementation Subcommittee of the American Academy of Neurology. Neurology. 2016 Nov 16. pii:. PMID:27856776DOI:10.1212/WNL.0000000000003388