Restless Legs Syndrome: Medical History

Medical history (history of illness) represents an important component in the diagnosis of restless legs syndrome (RLS). Family history

  • Is there more than one affected person in your family?

Social anamnesis

Current medical history/systemic history (somatic and psychological complaints).

  • Do you suffer from a strong urge to move your legs while awake or asleep?
  • Have you experienced sensory disturbances (e.g., tingling, pulling, probing, burning, itching, cold or hot sensations) and/or pain in the leg area?
  • Are the symptoms unilateral or bilateral?
  • When does this discomfort occur? At rest or under stress?
  • Do you have sleep disturbances?
  • Do you have daytime sleepiness?
  • Do you suffer from reduced performance?
  • Do you feel depressed?

Vegetative anamnesis incl. nutritional anamnesis

  • Do you sleep enough?
  • Do you eat a balanced diet?
  • Do you like to drink coffee, black and green tea? If so, how many cups per day?
  • Do you drink other or additional caffeinated beverages? If so, how much of each?
  • Do you drink alcohol? If so, what drink(s) and how many glasses per day?
  • Do you use drugs? If yes, what drugs (opiates) and how often per day or per week?

Self history incl. medication history.

  • Pre-existing conditions (neurological diseases)
  • Operations
  • Allergies
  • Pregnancies

Medication history

Often the disease is recognized by a neurologist based on the typical symptoms. The four main diagnostic criteria are:

  • Urge to move the legs
  • Sensory disturbances or pain
  • Complaints exclusively at rest with or without improvement by movement
  • Predominance of symptoms in the evening and at night

With the help of a questionnaire – IRLS Severity Scale (IRLS; Walters et al. IRLSSG International Restless Legs Syndrome Study Group 2003), which contains ten questions about the symptoms of restless legs syndrome in terms of their severity, frequency and influence of the symptoms on night’s rest and daily life in the last week, the doctor can estimate the extent of the disease.

  • How severe would you rate the RLS symptoms in the legs or arms? Very severe – Fairly – Moderately – Slightly – Not present.
  • How strong would you rate your urge to move because of your RLS symptoms? Very strong – fairly – moderately – slightly – not present.
  • How much was the RLS discomfort in your legs or arms relieved by movement? Not at all – a little – moderately – completely or almost completely; no RLS symptoms needed to be relieved
  • How much was your sleep disturbed by your RLS symptoms? Very – fairly – moderately – slightly – not at all
  • How tired or sleepy were you during the day because of your RLS symptoms? Very – fairly – moderately – a little – not at all
  • Overall, how severe were your RLS symptoms? Very severe – fairly – moderately – slightly – not at all.
  • How often did your RLS symptoms occur? Very often (6-7 days/week) – Often (4-5 days/week) – Sometimes (2-3 days/week) – Rarely (1 day/week) – Not at all.
  • If you had RLS symptoms, how severe were they on average? Very (8 hours or more/ day) – Fairly (3-8 hours/ day) – Moderately (1-3 hours/ day) – Mildly (< 1 hour/ day) – Not present.
  • How much have your RLS symptoms affected your ability to carry out your daily activities, for example, to have a satisfying family, personal, school, or work life? Very – fairly – moderately – slightly – not at all.
  • How much did your RLS symptoms affect your mood, for example, were you angry, depressed, sad, anxious, or irritable?Very – fairly – moderately – slightly – not at all

RLS – total score

0 = no RLS 1-10 = slight 11-20 = moderate 21-30 = severe 31-40 = very severe