Revised Diagnostic Criteria for Restless Legs Syndrome (RLS)

Restless legs syndrome (RLS), a neurological sensorimotor disease often profoundly disturbing sleep and quality of life has variable expression influenced by genetic, environmental and medical factors. The symptoms vary considerably in frequency from less than once a month or year to daily and severity from mildly annoying to disabling. Symptoms may also remit for various periods of time.

Revised IRLSSG Diagnostic Criteria for RLS

RLS is diagnosed by ascertaining symptom patterns that meet the following five essential criteria adding clinical specifiers where appropriate.

Essential Diagnostic Criteria (all must be met)

  1. An urge to move the legs usually but not always accompanied by or felt to be caused by uncomfortable and unpleasant sensations in the legs.
  2. The urge to move the legs and any accompanying unpleasant sensations begin or worsen during periods of rest or inactivity such as lying down or sitting.
  3. The urge to move the legs and any accompanying unpleasant sensations are partially or totally relieved by movement, such as walking or stretching, at least as long as the activity continues.
  4. The urge to move the legs and any accompanying unpleasant sensations during rest or inactivity only occur or are worse in the evening or night than during the day.
  5. The occurrence of the above features are not solely accounted for as symptoms primary to another medical or a behavioral condition (e.g., myalgia, venous stasis, leg edema, arthritis, leg cramps, positional discomfort, habitual foot tapping).

Specifiers for Clinical Course of RLS

  1. Chronic-persistent RLS: Symptoms when not treated would occur on average at least twice weekly for the past year.
  2. Intermittent RLS: symptoms when not treated would occur on average < 2/week for the past year, with at least 5 lifetime events.

Specifier for Clinical Significance of RLS
The symptoms of RLS cause significant distress or impairment in social, occupational, educational or other important areas of functioning by the impact on sleep, energy/vitality, daily activities, behavior, cognition or mood.

 

References:

  1. During EH, Winkelman JW. Drug Treatment of Restless Legs Syndrome in Older Adults. Drugs Aging. 2019 Oct;36(10):939-946. [Medline]
  2. Ruppert E. Restless arms syndrome: prevalence, impact, and management strategies. Neuropsychiatr Dis Treat. 2019 Jul 1;15:1737-1750. [Medline]
  3. Allen RP, Picchietti DL, Garcia-Borreguero D, Ondo WG, Walters AS, Winkelman JW, Zucconi M, Ferri R, Trenkwalder C, Lee HB; International Restless Legs Syndrome Study Group. Restless legs syndrome/Willis-Ekbom disease diagnostic criteria: updated International Restless Legs Syndrome Study Group (IRLSSG) consensus criteria–history, rationale, description, and significance. Sleep Med. 2014 Aug;15(8):860-73. [Medline]

 

Created Nov 13, 2019.