Epidemiology
Etiology
Pathophysiology
The pathophysiology of RLS is incompletely understood but likely involves CNS iron deficiency (even in patients with normal serum iron levels) and abnormalities in dopaminergic transmission.
Clinical features
- A recurrent urge to move the legs that is:
- Typically relieved by movement
- Triggered and/or worsened with rest
- Worse in the evening and at night (may occur exclusively at night)
- The urge to move the legs is often accompanied by uncomfortable sensations (e.g., pain, pins and needles, itching, tickling, or crawling sensations).
Diagnostics
Treatment
- Provide oral iron supplementation
- Alpha-2-delta ligands (e.g., gabapentin enacarbil, pregabalin, or gabapentin): first-line for most patients, unless contraindicated
- Low-dose nonergot dopamine agonists (e.g., pramipexole, ropinirole, rotigotine)