The mean age of onset is the third and fourth decade of life. Typically there is a slow progression over years but onset can be more rapid. There is a higher risk of RLS in those who have first degree relatives who also suffer from it. It has also been linked to iron deficiency anaemia and kidney disease. RLS is common in pregnancy. Medication is not recommended in pregnancy or when breastfeeding and management should follow the behavioural and physical advice below. Sensory symptoms can occur on their own but are often accompanied by periodic repetitive, involuntary leg movements, usually while asleep.
Diagnostic criteria for restless leg syndrome (2012 revised IRLSSG)
(all 5 criteria must be met)
- An urge to move the legs usually but not always accompanied by or felt to be caused by an uncomfortable and unpleasant sensation in the legs.
- The urge to move the legs and any accompanying unpleasant sensations begin or worsen during periods of rest or inactivity such as lying down or sitting.
- The urge to move the legs and accompanying unpleasant sensations are partially or totally relieved by movement, such as walking or stretching, at least as long as the activity continues.
- The urge to move the legs and accompanying unpleasant sensations during rest or inactivity only occur or are worse in the evening or night than during the day.
- The occurrence of the above features is not solely accounted for by symptoms primary to another medical condition or behavioural condition (eg neuropathy, myalgia, venous stasis, leg oedema, arthritis, leg cramps, positional discomfort or habitual toe tapping).
- full blood count
- ferritin - serum ferritin concentrations below 50ng/mL has been associated with RLS
- renal function, liver function, glucose, HbA1c, vitamin B12, folate and calcium levels.