Topography of the sensations in primary restless legs syndrome

Objectives: To evaluate the topography of restless legs syndrome (RLS) sensations and to compare subgroups of patients based on RLS topography.

Methods: Forty-four treated patients with primary RLS were interviewed and reported the localization of RLS sensations on body diagrams.

Results: RLS sensations were felt deep inside the muscles of mainly the middle portions of the lower limbs in 86% of patients. Superposition of patients' drawings showed a predominant involvement of the upper calves (75%). RLS sensations were diffuse, affecting on average 21% of the body. They occurred bilaterally, but also unilaterally (41%). During symptomatic periods, 66% of the patients experienced sensations spreading, frequently from the legs to other limbs segments. Clinical features were similar in patients with sensations: superficial versus strictly deep; limited or not to the lower limbs; unilateral versus strictly bilateral; and spreading or not. The percentage of affected surface did not correlate with patient age, age at RLS onset, RLS duration and severity. The percentage of affected area in the lower limbs correlated with the one in the upper limbs (r=0.53; p=0.0003).

Conclusion: RLS sensations affect large body areas (predominantly the upper calves). Body diagrams could be used to explore the evolution of RLS topography and treatment effects.