ABSTRACT
Restless legs syndrome (RLS) is a disorder characterized by a sensation of unpleasant paresthesias occurring mainly in the legs associated with an irresistible desire to move the affected extremities. Symptoms are typically alleviated by movement and tend to occur predominantly while at rest during the evening hours, but may also occur during the day. These disagreeable sensations and movements may lead to nocturnal insomnia and chronic sleep deprivation with excessive daytime sleepiness and impaired quality of life. The condition is frequently unrecognized or misdiagnosed because patients may have difficulty describing the sensation (often using terms such as itchy, creepy, or crawly) and may be unaware that they suffer chronic sleepiness. The syndrome was first described in 1672 by Sir Thomas Willis as a night-time ‘unquietness’ of the limbs that interfered with sleep1,2. Karl A. Ekbom, a Swedish neurologist and surgeon, published a comprehensive account of this syndrome in 1945 and termed it ‘restless legs’3. Lugaresi and colleagues subsequently used polysomnographic monitoring to document the involuntary leg movements seen in 87.8% of patients with RLS and termed them periodic limb movements of sleep (PLMS)4. PLMS have subsequently been described in several other sleep disorders and neurologic diseases5, including narcolepsy6,7, obstructive sleep apnea8 and Parkinson’s disease9.
