Restless Legs Syndrome Treatment & Management

  • Author: Ali M Bozorg, MD; Chief Editor: Selim R Benbadis, MD   more...
 
Updated: Apr 4, 2012
 

Approach Considerations

Treatment for restless legs syndrome (RLS) may not be necessary for patients with mild or sporadic symptoms or for those without significant impairment.[24] Treatment should be tailored to the patient's specific symptoms.[24]

Drug therapy for primary RLS is largely symptomatic, since cure is possible only in secondary disease. In some patients, RLS symptoms occur sporadically, with spontaneous remissions lasting weeks or months. The use of pharmacologic treatment on an irregular basis is warranted in such cases. Continuous pharmacologic treatment should be considered if patients complain of having RLS symptoms at least 3 nights each week.

Nonpharmacologic management

Sleep hygiene measures should be recommended to all patients. Moreover, patients with mild RLS who are sensitive to caffeine, alcohol, or nicotine should avoid these substances. Offending medications such as SSRIs, diphenhydramine, and dopamine antagonists also should be discontinued when possible.

Exercise may be helpful for some patients; however, this has not been systemically studied. In general, physical measures are only partially or temporarily helpful and should be avoided prior to bedtime.

Some patients benefit from different physical modalities before bedtime, such as a hot or cold bath, a whirlpool bath, limb massage, or vibratory or electrical stimulation of the feet and toes.

Nonpharmacological management and sleep hygiene measures are the treatments of choice in children. A regular sleep/wake schedule and the elimination of stimulating activity and caffeine prior to bedtime are important measures.

Outpatient care

Patients should be monitored by a neurologist or their primary care provider for development of adverse events, augmentation, or rebound.

Proceed to Medication
 
 
Contributor Information and Disclosures
Author

Ali M Bozorg, MD  Assistant Professor, Comprehensive Epilepsy Program, Department of Neurology, University of South Florida College of Medicine

Ali M Bozorg, MD is a member of the following medical societies: American Academy of Neurology, American Academy of Sleep Medicine, and American Epilepsy Society

Disclosure: Cyberonics Honoraria Speaking and teaching; UCB, Inc. Honoraria Speaking and teaching

Chief Editor

Selim R Benbadis, MD  Professor, Director of Comprehensive Epilepsy Program, Departments of Neurology and Neurosurgery, Tampa General Hospital, University of South Florida College of Medicine

Selim R Benbadis, MD is a member of the following medical societies: American Academy of Neurology, American Academy of Sleep Medicine, American Clinical Neurophysiology Society, American Epilepsy Society, and American Medical Association

Disclosure: UCB Pharma Honoraria Speaking, consulting; Lundbeck Honoraria Speaking, consulting; Cyberonics Honoraria Speaking, consulting; Glaxo Smith Kline Honoraria Speaking, consulting; Pfizer Honoraria Speaking, consulting; Sleepmed/DigiTrace Honoraria Speaking, consulting

Additional Contributors

Jose E Cavazos, MD, PhD, FAAN Associate Professor with Tenure, Departments of Neurology, Pharmacology, and Physiology, Program Director of the Clinical Neurophysiology Fellowship, University of Texas School of Medicine at San Antonio; Co-Director, South Texas Comprehensive Epilepsy Center, University Hospital System; Director of the San Antonio Veterans Affairs Epilepsy Center of Excellence and Neurodiagnostic Centers, Audie L Murphy Veterans Affairs Medical Center

Jose E Cavazos, MD, PhD, FAAN is a member of the following medical societies: American Academy of Neurology, American Clinical Neurophysiology Society, American Epilepsy Society, and American Neurological Association

Disclosure: GXC Global, Inc. Intellectual property rights Medical Director - company is to develop a seizure detecting device. No conflict with any of the eMedicine articles that I wrote or edited.

William G Irr, MD Consulting Staff, Department of Neurology Service, St Luke's Episcopal Hospital of Houston

William G Irr, MD is a member of the following medical societies: American Academy of Neurology.

Disclosure: Nothing to disclose.

Juan Latorre, MD Research Fellow, Department of Physical Medicine and Spinal Cord Injury Medicine, The Institute for Rehabilitation and Research

Juan Latorre, MD is a member of the following medical societies: American Academy of Physical Medicine and Rehabilitation

Disclosure: Nothing to disclose.

Erasmo A Passaro, MD, FAAN Director, Comprehensive Epilepsy Program/Clinical Neurophysiology Lab, Bayfront Medical Center, Florida Center for Neurology

Erasmo A Passaro, MD, FAAN is a member of the following medical societies: American Academy of Neurology, American Academy of Sleep Medicine, American Clinical Neurophysiology Society, American Epilepsy Society, American Medical Association, and American Society of Neuroimaging

Disclosure: Glaxo Smith Kline Honoraria Speaking and teaching; UCB Honoraria Speaking and teaching; Pfizer Honoraria Speaking and teaching; Forest Honoraria Speaking and teaching

Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Medscape Reference Salary Employment

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