What is restless legs syndrome?
RLS causes an irresistible urge to move the legs, usually accompanied by uncomfortable sensations (creeping, crawling, aching). Symptoms are worse at rest and in the evening, and improve with movement. It significantly disrupts sleep.
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Causes and evaluation
Primary RLS is genetic/idiopathic. Secondary causes include iron deficiency (most common — check ferritin), pregnancy, kidney failure, diabetes, peripheral neuropathy and medications (antidepressants, antihistamines). Evaluation includes clinical criteria, iron studies and medication review.
Treatment
Iron supplementation if deficient, avoid aggravating medications, dopamine agonists (pramipexole, ropinirole) or alpha-2-delta ligands (gabapentin, pregabalin) for persistent symptoms. Avoid caffeine, alcohol and nicotine.