Presenting symptoms in pediatric restless legs syndrome patients

Objective: The diagnosis restless legs syndrome (RLS) in children depends on the history told by the child and his parents. The description of symptoms given by the child himor herself is most important. Additional criteria are, among others, the results of polysomnography (PSG). Description of the presenting symptoms is the aim of the study. Methods: Survey in two European pediatric sleep centers of presenting symptoms in children who after a detailed work-up proved to have RLS. Results: Fifty-two percent of the 31 children presented with symptoms similar to those mentioned in the “four questions” relevant for the diagnosis of RLS. In the other patients the description included often very colourful wordings, such as “ants or spiders in the legs, legs want to kick, need to stretch.” All children were tired or sleepy during daytime and nearly all reported an urge to move. Insomnia was mentioned by 61% of the patients. The presenting symptoms did not differ significantly from those mentioned in a previous study in the US, but did so when compared to adults with RLS. PSG revealed an abnormal periodic limb movement index in 81% of the children. Conclusions: The description of presenting symptoms in children with the final diagnosis of RLS differs from that in adults. The results of this European study corroborate those from the US.