The Diagnostic Criteria
The International Restless Legs Syndrome Study Group (IRLSSG) in 2014 produced consensus diagnostic criteria for the diagnosis of restless legs syndrome. To make a diagnosis an individual must meet all of the essential diagnostic criteria.
- 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.
- Sometimes the urge to move the legs is present without the uncomfortable sensations and sometimes the arms or other parts of the body are involved in addition to the legs.
- For children, the description of these symptoms should be in the child’s own words.
- 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.
- 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.
- When symptoms are very severe, relief by activity may not be noticeable but must have been previously present.
- 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.
- When symptoms are very severe, the worsening in the evening or night may not be noticeable but must have been previously present.
- The occurrence of the above features is not solely accounted for as symptoms primary to another medical or a behavioural condition (e.g. myalgia, venous stasis, leg oedema, arthritis, leg cramps, positional discomfort, habitual foot tapping).
The clinical course of the syndrome is further classified into:-
- Chronic persistent – untreated symptoms are present at least twice a week on average for the preceding year
- Intermittent – untreated symptoms occurring less than twice a week on average over the preceding year with at least five lifetime events
The clinical course criteria do not apply to paediatric patients or in condition provoked restless legs (e.g. pregnancy or drug induced)