Restless leg syndrome

Question 1

What are the causes of restless legs?

Answer 1

Positive family history in 50% of patients with idiopathic RLS
Iron deficiency anaemia
Uraemia
Diabetes mellitus 
Pregnancy

Question 2

How do you diagnose restless legs syndrome?

Answer 2

Diagnosis is clinical

Bloods such as ferritin may be appropriate

Question 3

How do you treat restless legs syndrome?

Answer 3

Simple measures like walking, stretching, massaging limbs

Treat iron deficiency anaemia if present

1st line- Dopamine agonists- prampipexole, ropinirole, rotigotine patches

Benzodiazepines

Gabapentin

Question 4

What are the clinical features of RLS?

Answer 4

uncontrollable urge to move legs (akathisia). Symptoms initially occur at night but as condition progresses may occur during the day. Symptoms are worse at rest
paraesthesias e.g. ‘crawling’ or ‘throbbing’ sensations
movements during sleep may be noted by the partner - periodic limb movements of sleeps (PLMS)

Question 5

What are the side effects of rotigotine?

Answer 5

• paradoxical worsening

- Personality changes