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Restless legs syndrome is a relatively common condition affecting 5 to 10% of the population. A guided history of looking for the four cardinal signs can often be unmasked, but, predominantly in the evening and at night, Primary Restless Leg Syndrome can easily remain undiagnosed if not actively sought. Of unknown etiology and mechanism, it can be favored by several neurological, endocrinological, rheumatologic, metabolic, toxic or medicinal conditions that deserve to be corrected.
Introduction
Although detailed in its current description by the Swedish neurologist Karl Ekbom in the 1940s, 1,2 restless legs syndrome is a relatively common situation affecting 5 to 10% of the population. 3.4Although prevalence increases with age, symptomatology may appear in childhood where some association with hyperactive children has been described. This mainly evening or nocturnal symptomatology can escape the clinician during the hours of consultations. General and family physicians are certainly best placed to detect, diagnose and manage most patients with this syndrome. This work, which is primarily intended for them, tends to make a current review of this syndrome in its various clinical and practical aspects.
Definition
Secondary Restless Leg Syndrome is present in 80% of polysomnographies of patients with restless legs syndrome. These periodic movements predominate during sleep and, by definition, take the form of puffs of at least four movements lasting from 1/2 to 5 seconds and appearing every 5 to 90 seconds. Typically, these are movements of flexion of the leg, dorsiflexion of the ankle and extension of the big toe. Other movements involving either the trunk or the upper limbs may appear. Nevertheless, these periodic movements predominate in the lower limbs and are generally observable mainly during sleep.
Far from being pathognomonic of restless legs syndrome, these periodic movements can appear in the normal subject, especially the elderly. These periodic movements of sleep must be differentiated from the movements occurring during sleep apnea syndrome. In that case, movements usually appear when breathing resumes. During the day before, they appear only during the rest, their periodicity is less obvious, and they can sometimes trigger or be incorporated into voluntary movements which give them a prolonged appearance. Although rare, these periodic movements of the day before are often the only clinical manifestation observable in these patients whose symptomatology, evening or nocturnal, escapes the examination in office. Restless Leg Syndrome Diagnosis Near Me appears only during rest, their periodicity is less obvious, and they can sometimes trigger or be incorporated into voluntary movements which give them a prolonged appearance. Although rare, these periodic movements of the day before are often the only clinical manifestation observable in these patients whose symptomatology, evening or nocturnal, escapes the examination in office. They appear only during rest, their periodicity is less obvious, and they can sometimes trigger or be incorporated into voluntary movements which give them a prolonged appearance. Although rare, these periodic movements of the day before are often the only clinical manifestation observable in these patients whose symptomatology, evening or nocturnal, escapes the examination in office.
Sleep disorders can also accompany restless legs syndrome. These are primarily difficulties in initiating sleep, rarely accompanied by daytime fatigue, unlike other sleep disorders where this complaint is in the foreground. Nevertheless, the introduction of the treatment of this syndrome, including dopaminergic agonists, can cause such drowsiness.
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