History and Introduction
Restless legs syndrome (RLS) is a neurologic disorder that was first described in the medical literature by T. Willis in 1672.[1,2] More than 250 years later, in 1945, Karl Ekbom applied the phrase "restless legs" to the syndrome.[3,4] Ekbom later wrote a paper on "growing pains" and "restless legs" and differentiated between them because growing pains were generally presumed to last only through childhood, whereas RLS had an early onset but was believed to persist into adulthood.[3-5] In 1960, Brenning noted that complaints of growing pains in children correlated with a higher risk of developing RLS-like symptoms as adults.[3,4] Primary RLS is believed to be an autosomal dominant disorder and, recently, scientists located a gene associated with RLS susceptibility on chromosome 12q for French-Canadian families, 14q for an Italian family, and 9p for 2 American families.[6,7]
RLS is a sensory and motor disorder characterized by an uncontrollable sensation in the legs accompanied by an irresistible urge to move the legs, which usually results in partial or complete resolution immediately, albeit transiently.[7] There are many subtle variations of this disorder. To complicate matters, the diagnosis is purely clinical and thus depends on accurate historians to convey their subjective complaints. This poses a problem, especially in children. Consequently, RLS in children is believed to be underdiagnosed. Because primary care physicians typically comprise the frontline for the diagnosis and treatment of this disorder, accurate assessment by this physician population is critical. Children with RLS can present with conduct problems including aggression, inattention, hyperactivity, and daytime somnolence because of an inability to sleep or difficulty maintaining sleep. These symptoms may result from an associated periodic limb movement disorder (PLMD) or other problems such as aches and pains.[8] The consequences of RLS can be serious and include unsatisfactory performance in school, poor social development, and abnormal social interactions resulting in incorrect diagnoses of various psychiatric illnesses, including attention deficit hyperactivity disorder (ADHD), among others.
