The Irresistible Urge to Move

by Douglas R. Sinclair, DO, Lexington Neurology

Restless legs syndrome is a neurological condition characterized by an uncomfortable sensation in the legs, often accompanied by an irresistible urge to move them. Usually, the symptoms occur or worsen at night. The diagnostic aspect of this symptom is that the abnormal sensation disappears if you get up and move around on your legs. It typically returns right away when you sit down or lie back down in bed. There is no diagnostic testing for this. We make a clinical diagnosis based on symptoms confirmed through a routine examination.

Researchers have identified a correlation between iron deficiency and magnesium deficiency; therefore, we typically evaluate these levels at the time of diagnosis. However, many people experience restless legs syndrome despite having normal levels of iron and magnesium. If you have an iron or magnesium deficiency, your restless legs syndrome may improve with treatment to restore iron and magnesium levels to normal. 

Commonly used medications to treat restless leg syndrome are dopamine agonists (like Requip, Mirapex or Neupro) or gabapentin. Low doses tend to be effective, but some patients may require higher doses.

Restless legs can be hereditary. Patients with a familial history of restless leg syndrome tend to require higher doses of medications, have symptoms during the day instead of just at night, and experience symptoms in other parts of their body, not just in their legs.  We estimate about 50% of cases have a genetic component based on clinical interviews.

Those with unexplained restless legs syndrome may need to take a dopamine agonist or gabapentin to manage their symptoms. It is worth noting that patients occasionally experience spontaneous remission of the condition.



Douglas R. Sinclair, DO, Lexington Neurology