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Clinical features and diagnosis of restless legs syndrome/Willis-Ekbom disease and periodic limb movement disorder in adults

Author
William G Ondo, MD
Section Editors
Howard I Hurtig, MD
Alon Y Avidan, MD, MPH
Deputy Editor
April F Eichler, MD, MPH

INTRODUCTION

Restless legs syndrome (RLS), also called Willis-Ekbom disease (WED), is a common sleep-related movement disorder characterized by an often unpleasant or uncomfortable urge to move the legs that occurs during periods of inactivity, particularly in the evenings, and is transiently relieved by movement. During sleep, most patients with RLS/WED have characteristic limb movements, called periodic limb movements of sleep (PLMS), which may or may not be associated with arousal from sleep.

Although long referred to as RLS, the eponymous name was adopted by the RLS Foundation from 2011 to 2015 in an effort to move away from the term restless legs, which was felt to be poorly representative of the true nature of the disorder and demeaning by many of those affected [1]. The name WED recognizes the original description by Dr. Thomas Willis in the 17th century and seminal case series published by Dr. Karl-Axel Ekbom in the 1940s.

Periodic limb movement disorder (PLMD) is characterized by a clinical sleep disturbance attributed to an increased number of PLMS, in the absence of alternative causes of the sleep complaints. PLMD and RLS/WED are distinct, mutually exclusive diagnoses.

This topic will discuss the epidemiology, pathophysiology, clinical features, and diagnosis of RLS/WED and PLMD in adults. Treatment of RLS/WED and PLMD in adults, RLS/WED during pregnancy and lactation, and RLS/WED and PLMD in children are reviewed separately. (See "Treatment of restless legs syndrome/Willis-Ekbom disease and periodic limb movement disorder in adults" and "Restless legs syndrome/Willis-Ekbom disease during pregnancy and lactation" and "Restless legs syndrome/Willis-Ekbom disease and periodic limb movement disorder in children".)

EPIDEMIOLOGY

Restless legs syndrome/Willis-Ekbom disease (RLS/WED) of any severity occurs in 5 to 15 percent of adults in studies that include primarily Caucasian populations [2,3]. Estimates of clinically significant RLS/WED are lower (2 to 3 percent), and studies that rely exclusively on questionnaires may overestimate prevalence.

                        

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