ABSTRACT
The most prominent symptom of the restless legs syndrome (RLS) is an unpleasant sensation in the legs, and occasionally in the arms, that the patients describe as crawling, creeping, extremely unpleasant, and sometimes painful. In addition, motor symptoms such as periodic leg movements (PLM) during sleep (PLMS) and wakefulness (PLMW), as well as nonperiodic involuntary leg movements, are present in a majority of patients. The present chapter is organized along the anatomical structures that may be involved in the origin of these sensory and motor symptoms summarizing neurophysiologic, neuroendocrinologic, and brainimaging studies. To that end, we will first review research pertaining to peripheral factors in RLS (see Section ‘‘The Periphery’’), and then in more detail the involvement of the spinal cord (see Section ‘‘The Spinal Cord’’) and the brain (see Section ‘‘The Brain’’) including subcortical (see Section ‘‘Brainstem’’) and cortical structures (see Section ‘‘Cortex’’).
