Restless Legs Syndrome in Children and Adolescents

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What is restless legs syndrome?
Restless legs syndrome (RLS) is a movement disorder in which the child or adolescent reports an uncomfortable and irresistible urge to move his or her legs. This urge usually happens at bedtime but can occur at other times when the legs have been inactive, such as when sitting still for a long period of time (eg, during long car rides or while watching a movie). To relieve the discomfort, the child or adolescent moves his or her legs, stretches his or her legs, tosses and turns, or gets up and walks or runs around. The relief experienced is usually immediate.

What causes restless legs syndrome?
The exact cause of this disorder is not known. RLS can be related to a low iron level or sometimes associated with diabetes, kidney or some neurological diseases. RLS sometimes runs in families and there is thought to be a genetic link in these cases. Many types of drugs used in the treatment of other disorders may cause RLS as a side effect.

What are the signs and symptoms of restless legs syndrome?
Symptoms of restless legs syndrome include:

  • Leg discomfort or "heebie-jeebies" – uncomfortable leg sensations described as creeping, itching, pulling, crawling, cramping, tugging, tingling, burning, gnawing, or pain. Feeling of "Coca Cola in the veins" has been described. These sensations usually occur at bedtime but can occur at other times of leg inactivity.
  • Urge to move legs – to relieve leg discomfort, children and adolescents have an uncontrollable urge to move their legs.
  • Sleep disruption – additional time is often needed to fall asleep because of the urge to move the legs to relieve the discomfort. Sometimes staying asleep may also be difficult.
  • Bedtime behavior problems – because children have a hard time falling asleep, they may not always stay in bed and sometimes need to get out of bed to stretch their legs to relieve discomfort.
  • Daytime sleepiness – problems with falling asleep and staying asleep may result in problems with daytime sleepiness.
  • Behavior and school performance problems – again, due to sleep disruption, problems may emerge in the child’s academic performance or in daytime behavior (irritability, moodiness, difficulty concentrating, hyperactivity, etc)

How is restless legs syndrome diagnosed?
Unfortunately, there is no specific test for restless legs syndrome. Diagnosis is made based on symptoms. A medical history and complete physical exam is conducted to rule out any other possible health problems. An overnight sleep study may be recommended to evaluate for other sleep disorders, especially periodic limb movement disorder (a movement disorder in which legs kick or twitch during sleep but the child is usually not aware of the symptoms).

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Last Updated: 1/5/2009

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