Depth and distribution of symptoms in restless legs syndrome/ Willis-Ekbom disease

Paul Yeh, William G. Ondo, Daniel L. Picchietti, J. Steven Poceta, Richard Allen, Charles R. Davies, Lily Wang, Yaping Shi, Kanika Bagai, Arthur S. Walters

Research output: Contribution to journalArticle

Abstract

Study Objectives: To determine the depth and distribution of sensory discomfort in idiopathic restless legs syndrome/Willis-Ekbom disease (RLS) and RLS concurrent with other leg conditions, specifically peripheral neuropathy, sciatica, leg cramps, and arthritis. Methods: RLS subjects (n = 122) were divided into 71 idiopathic RLS and 51 RLS-C, or Comorbid, groups. All subjects were examined by an RLS expert, answered standardized RLS questionnaires, and received a body diagram to draw the location and depth of their symptoms. Results: Age was 63.04 ± 12.84 years, with 77 females and 45 males. All patients had lower limb involvement and 43/122 (35.25%) also had upper limb involvement. Of the 122 subjects, 42.62% felt that the RLS discomfort was only deep, 9.84% felt that the discomfort was only superficial, and 47.54% felt both superficial and deep discomfort. There were no defining characteristics in depth or distribution of RLS sensations that differentiated those patients with idiopathic RLS from those patients with RLS associated with other comorbid leg conditions. The sensation of arthritis was felt almost exclusively in the joints and not in the four quadrants of the leg, whereas the exact opposite was true of RLS sensations. Conclusions: Depth and distribution cannot be used as a discriminative mechanism to separate out idiopathic RLS from RLS comorbid with other leg conditions. Although seen in clinical practice, the total absence of patients with non-painful RLS only in the joints in the current study attests to the rarity of this presentation and raises the possibility of misdiagnosis under these circumstances. We recommend that such patients not be admitted to genetic or epidemiological studies.

Original languageEnglish (US)
Pages (from-to)1669-1680
Number of pages12
JournalJournal of Clinical Sleep Medicine
Volume12
Issue number12
DOIs
StatePublished - 2016

Fingerprint

Restless Legs Syndrome
Leg
Arthritis
Joints
Muscle Cramp
Sciatica
Peripheral Nervous System Diseases
Diagnostic Errors
Upper Extremity
Epidemiologic Studies
Lower Extremity

Keywords

  • Body Diagram
  • Restless Legs Syndrome
  • Sensory Depth
  • Sensory Distribution
  • Topography
  • Willis-Ekbom Disease

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine
  • Neurology
  • Clinical Neurology

Cite this

Yeh, P., Ondo, W. G., Picchietti, D. L., Steven Poceta, J., Allen, R., Davies, C. R., ... Walters, A. S. (2016). Depth and distribution of symptoms in restless legs syndrome/ Willis-Ekbom disease. Journal of Clinical Sleep Medicine, 12(12), 1669-1680. https://doi.org/10.5664/jcsm.6356

Depth and distribution of symptoms in restless legs syndrome/ Willis-Ekbom disease. / Yeh, Paul; Ondo, William G.; Picchietti, Daniel L.; Steven Poceta, J.; Allen, Richard; Davies, Charles R.; Wang, Lily; Shi, Yaping; Bagai, Kanika; Walters, Arthur S.

In: Journal of Clinical Sleep Medicine, Vol. 12, No. 12, 2016, p. 1669-1680.

Research output: Contribution to journalArticle

Yeh, P, Ondo, WG, Picchietti, DL, Steven Poceta, J, Allen, R, Davies, CR, Wang, L, Shi, Y, Bagai, K & Walters, AS 2016, 'Depth and distribution of symptoms in restless legs syndrome/ Willis-Ekbom disease', Journal of Clinical Sleep Medicine, vol. 12, no. 12, pp. 1669-1680. https://doi.org/10.5664/jcsm.6356
Yeh, Paul ; Ondo, William G. ; Picchietti, Daniel L. ; Steven Poceta, J. ; Allen, Richard ; Davies, Charles R. ; Wang, Lily ; Shi, Yaping ; Bagai, Kanika ; Walters, Arthur S. / Depth and distribution of symptoms in restless legs syndrome/ Willis-Ekbom disease. In: Journal of Clinical Sleep Medicine. 2016 ; Vol. 12, No. 12. pp. 1669-1680.
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AU - Allen, Richard

AU - Davies, Charles R.

AU - Wang, Lily

AU - Shi, Yaping

AU - Bagai, Kanika

AU - Walters, Arthur S.

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AB - Study Objectives: To determine the depth and distribution of sensory discomfort in idiopathic restless legs syndrome/Willis-Ekbom disease (RLS) and RLS concurrent with other leg conditions, specifically peripheral neuropathy, sciatica, leg cramps, and arthritis. Methods: RLS subjects (n = 122) were divided into 71 idiopathic RLS and 51 RLS-C, or Comorbid, groups. All subjects were examined by an RLS expert, answered standardized RLS questionnaires, and received a body diagram to draw the location and depth of their symptoms. Results: Age was 63.04 ± 12.84 years, with 77 females and 45 males. All patients had lower limb involvement and 43/122 (35.25%) also had upper limb involvement. Of the 122 subjects, 42.62% felt that the RLS discomfort was only deep, 9.84% felt that the discomfort was only superficial, and 47.54% felt both superficial and deep discomfort. There were no defining characteristics in depth or distribution of RLS sensations that differentiated those patients with idiopathic RLS from those patients with RLS associated with other comorbid leg conditions. The sensation of arthritis was felt almost exclusively in the joints and not in the four quadrants of the leg, whereas the exact opposite was true of RLS sensations. Conclusions: Depth and distribution cannot be used as a discriminative mechanism to separate out idiopathic RLS from RLS comorbid with other leg conditions. Although seen in clinical practice, the total absence of patients with non-painful RLS only in the joints in the current study attests to the rarity of this presentation and raises the possibility of misdiagnosis under these circumstances. We recommend that such patients not be admitted to genetic or epidemiological studies.

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