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From the Movement Disorder Group (Drs. Walters and Hening, and K. Hickey, J. Maltzman, S. Chokroverty), Department of Neurology, UMDNJ-Robert Wood Johnson Medical School, New Brunswick, NJ; Rutgers University (T. Verrico and D. Joseph), New Brunswick, NJ; Neurology Service (Drs. Walters and Hening, and S. Chokroverty), Department of Veterans Affairs Medical Center, Lyons, NJ; Restless Legs Syndrome Foundation, Inc. (V. Wilson), Orange Park, FL; and Department of Neurology (S. Chokroverty), St. Vincent's Hospital and Medical Center, New York, NY.
Supported by a VA Merit Review grant to Dr. Walters.
Presented in part at the 46th annual meeting of the American Academy of Neurology, Washington, DC, May 1994.
Received February 27, 1995. Accepted in final form April 20, 1995.
Address correspondence and reprint requests to Dr. Arthur S. Walters, Department of Neurology CN 19, UMDNJ-Robert Wood Johnson Medical School, New Brunswick, NJ 08903-0019.
Article abstract-After verifying the diagnosis of restless legs syndrome (RLS) in 105 patients who are part of a nationwide support group, we undertook a telephone survey of their symptomatology. We then compared the answers with those of 33 of our own RLS patients who had undergone a neurologic examination and had a periodic limb movement in sleep (PLMS) index of >5 (number per hours of sleep). Although RLS has generally been considered to be a condition of middle to older age, the results for the support group, and for our patients, are similar in that more than a third of the patients in each group experienced their first symptoms before the age of 20. Initial lack of diagnosis or misdiagnosis by a physician were common and the symptoms were commonly thought to be psychogenic whatever the age of onset. In some cases, young age-onset RLS was severe from the start. For younger age-onset patients whose symptoms were severe enough to seek immediate medical attention, confounding or misdiagnoses included "growing pains" and attention deficit hyperactivity disorder. However, medical attention was generally not sought until the fourth decade. Most respondents stated that this was because their symptoms were mild at onset and then progressed. In the older age-onset patients, misdiagnoses also included skin irritation, arthritis, and malingering. A total remission of symptoms of a month or more was present in at least 15% of the individuals in all groups surveyed. More than 50% of the respondents know of one or more first-degree relatives affected by RLS. Five of our 33 patients had RLS initially triggered either by diabetic peripheral neuropathy or lumbosacral radiculopathy.
NEUROLOGY 1996;46: 92-95
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