RESTLESS LEGS SYNDROME: A CASE-BASED REVIEW

At the conclusion of this activity, participants should be able to:

• Describe the prevalence and impact of restless legs syndrome (RLS)
• Identify risk factors or conditions that are associated with RLS
• Individualize behavioral and pharmacologic treatment plans for patients with RLS
• Identify 3 different perspectives on RLS: primary care, psychiatry, and neurology

Pretest Questions

1. Concerning the epidemiology of RLS, which of the following is NOT true?

a. RLS is often misdiagnosed or undiagnosed
b. The prevalence of RLS increases with age
c. RLS equally impacts males and females
d. Patients with idiopathic RLS are likely to have a family history of RLS

2. Which is NOT one of the 4 diagnostic criteria for RLS?

a. Urge to move the legs
b. Symptoms worse at rest
c. Symptoms worse in the evening or at night
d. Symptoms remain unresolved by movement

3. Which of the following statements about RLS is NOT true?

a. Dehydration is the largest risk factor for RLS
b. Most patients with RLS experience periodic limb movements in sleep (PLMS)
c. In pregnancy, RLS symptoms are most common in the third trimester
d. Approximately one third of hemodialysis patients have RLS

4. Which of the following RLS treatment considerations is NOT true?

a. Multiple types of drugs, including dopamine agonists, benzodiazepines and opiates, are
            approved by the US Food and Drug Administration for the treatment of moderate to severe RLS
b. Medications that may aggravate or trigger RLS symptoms include antidopaminergic medications
            (antipsychotics and antiemetics), some antidepressants, and antihistamines
c. Dopamine agonists have been shown to reduce RLS symptoms and are considered the initial
            treatment of choice
d. Behavioral treatment that increases sensation, such as hot showers or vigorous rubbing of the
            legs, may provide short-term relief for RLS symptoms