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Restless legs syndrome: overdiagnosed or underdiagnosed?

Nature Clinical Practice Neurology volume 3, pages 474–475 (2007)Cite this article

“Restless legs syndrome—the most common medical condition you have never heard of” runs a slogan that is often used by the Restless Legs Syndrome Foundation in the US. Although the medical knowledge and the number of publications on restless legs syndrome (RLS) have increased considerably, with 27 articles published in 1990, 378 in 2005, and 762 in 2006, there is still a lack of consistent knowledge and of experience in diagnosing patients with RLS. As a result, it is not clear how common the condition is, and there is considerable debate as to whether RLS is overdiagnosed or underdiagnosed.

The key feature of RLS is an urge to move the legs accompanied by a wide range of unpleasant sensory symptoms deep in the legs that are often difficult to describe precisely. The symptoms disappear during movement and recur during periods of rest, especially during sleep. In some patients a more painful variant of RLS disturbs evenings and periods of rest, often leading to the misdiagnosis of a chronic pain problem. All RLS symptoms follow a diurnal pattern of symptom severity, with symptoms being most prominent between midnight and 3.00 am; patients usually do not complain about RLS symptoms in the morning.1

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References

  1. Allen RP et al. (2003) Restless legs syndrome: diagnostic criteria, special considerations, and epidemiology: a report from the restless legs syndrome diagnosis and epidemiology workshop at the National Institutes of Health. Sleep Med 4: 101–119

    Article  Google Scholar 

  2. Winkelmann J and Ferini-Strambi L (2006) Genetics of restless legs syndrome. Sleep Med Rev 10: 179–183

    Article  Google Scholar 

  3. Paulus W and Trenkwalder C (2006) Less is more: pathophysiology of dopaminergic-therapy-related augmentation in restless legs syndrome. Lancet Neurol 5: 878–886

    Article  CAS  Google Scholar 

  4. Allen R (2004) Dopamine and iron in the pathophysiology of restless legs syndrome (RLS). Sleep Med 5: 385–391

    Article  Google Scholar 

  5. Walters AS (1995) Toward a better definition of the restless legs syndrome. The International Restless Legs Syndrome Study Group. Mov Disord 10: 634–642

    Article  CAS  Google Scholar 

  6. Berger K et al. (2004) Sex and the risk of restless legs syndrome in the general population. Arch Intern Med 164: 196–202

    Article  Google Scholar 

  7. Hornyak M et al. (2005) Impact of sleep-related complaints on depressive symptoms in patients with restless legs syndrome. J Clin Psychiatry 66: 1139–1145

    Article  Google Scholar 

  8. Mizuno S et al. (2005) Prevalence of restless legs syndrome in non-institutionalized Japanese elderly. Psychiatry Clin Neurosci 59: 461–465

    Article  Google Scholar 

  9. Nomura T et al. (2006) Prevalence and clinical characteristics of restless legs syndrome in Japanese patients with Parkinson's disease. Mov Disord 21: 380–384

    Article  Google Scholar 

  10. Tison F et al. (2005) Epidemiology of restless legs syndrome in French adults: a nationwide survey: the INSTANT Study. Neurology 65: 239–246

    Article  CAS  Google Scholar 

  11. Sevim S et al. (2003) Unexpectedly low prevalence and unusual characteristics of RLS in Mersin, Turkey. Neurology 61: 1562–1569

    Article  CAS  Google Scholar 

  12. Castillo PR et al. (2006) Prevalence of restless legs syndrome among native South Americans residing in coastal and mountainous areas. Mayo Clin Proc 81: 1345–1347

    Article  Google Scholar 

Download references

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  1. Paracelsus Elena Hospital, Klinikstraße 16, 34128 Kassel, Germany ctrenkwalder@gmx.de

Authors and Affiliations

  1. C Trenkwalder is Medical Director of the Paracelsus Elena Hospital, Center of Parkinsonism and Movement Disorders in Kassel, and Professor of Neurology at the University of Göttingen, Germany.,

    Claudia Trenkwalder

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  1. Claudia Trenkwalder
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Competing interests

The author declared associations with the following companies: Boehringer Ingelheim (consultant, speaker), GlaxoSmithKline (consultant, speaker), Novartis/Orion Pharma (consultant), and Schwarz Pharma (consultant, speaker).

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Trenkwalder, C. Restless legs syndrome: overdiagnosed or underdiagnosed?. Nat Rev Neurol 3, 474–475 (2007). https://doi.org/10.1038/ncpneuro0552

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