Restless Leg Syndrome in Children



Although Restless Leg Syndrome in children is not as common as it is in adults, it does happen. In fact, many adults that are diagnosed can trace their symptoms back to childhood. When they were kids, they were told that the feelings in their legs were "growing pains", but they later realize that it was RLS that bothered them in their younger years.









What Causes Restless RLS in Children?

Research is still being done to find the cause of Restless leg syndrome in children. Although answers are limited, three major themes have emerged:

  • Family History of RLS
  • Underactivity of the brain transmitter dopamine
  • Brain iron deficiency

How Often Does Restless Legs Syndrome in Children Occur?

RLS affects about 5-10 percent of adults in some countries. In the United States alone, RLS is believed to afflict more than 10 million children and adolescents. Although most research has focused on adults, RLS symptoms often occure during childhood and adolescence.

About 35 percent of patients report RLS onset prior to age 20, and one in ten report that the syndrome appeared during the first decade of life. Multiple reports now document the occurrence of RLS, as well as the related problem PLMD (Periodic Limb Movement Disorder), during childhood and adolescence.

Introduction to Restless Legs in Children

Symptoms of both RLS and PLMD can range from mild to severe and can negatively impact a child's quality of life. Accurate diagnosis of RLS and PLMD is so important to a child's well being. The most important reasons for early diagnosis of Restless leg syndrome in children are:

  • Discovering why a child is uncomfortable and irritable can help parents understand their child's underlying problem(s).

  • Early treatment and diagnosis may help to reduce or eliminate RLS symptoms in children.

  • As a large population of children with RLS are diagnosed, the medical community have more cases to study.

  • Children who experience poor intellectual or emotional function due to these sleep disorders can have their problems addressed more directly.

Signs and Symptoms in Children with RLS

The signs and symptoms in restless leg syndrome in children are very similar to adults. Children with RLS seek to relieve their discomfort by fidgeting, stretching, walking, running, rocking, or changing positions in bed.

Since children cannot always describe their symptoms, many times restless leg syndrome is misdiagnosed as:

  • Growing Pains
  • ADHD - inattentiveness and hyperactivity

Unlike adults, children tend to experience their symptoms more during the day than at night.

Diagnosis of Restless Leg Syndrome in Kids

Children may experience and present symptoms of RLS differently than adults, so diagnosis can be challenging. Since restless leg syndrome has only recently been diagnosed in children, few physicians have experience in diagnosing RLS.

Some common themes for diagnosis are:

  • Sensations of limb discomfort
  • Disturbed Sleep
  • Family History
  • Physical Examination (to check for iron deficiency)
  • Sleep Testing

    Children must meet the following criteria that medical professionals have developed to have definite RLS:

    (The child must meet all four of the following adult criteria)

    1. There is an urge to move the legs.2. The urge to move begins or worsens with sitting or lying down.3. The urge to move is partially or totally relieved by movement.4. The urge to move is worse in the evening or night than during the day, or occurs exclusively in the evening or nighttime hours.

    - AND -

    The child describes leg discomfort using his or her own words. Examples of age appropriate descriptors: oowies, tickle, tingle, static, bugs, spiders, etc.

    - OR -

    The child meets criteria 1-4 above

    - AND -

    Two of the three following supportive criteria:

    1. There is a clinical sleep disturbance for age.2. A biological parent or sibling has definite RLS.3. A sleep study has documented a periodic limb movement index of 5 or more per hour of sleep.

Sleep Habits of RLS and Children

Sleep disturbance is common among children with RLS. In children, the sleep disturbance may precede or overshadow the complaint of leg discomfort. The quality and quantity of a child's sleep are often diminished, and this sleep deprivation can result in moodiness, irritability, inattentiveness, fatigue, or hyperactivity.

PLMS in Children

Periodic limb movements in sleep (PLMS) are characterized by brief jerks (0.5 to 5.0 seconds in duration) of the limbs during sleep, typically recurring at 20 to 40 second intervals.

PLMS are more common in the toes, feet, and legs than in the arms. An affected individual is usually not aware of the movements or of the associated transient arousals that disrupt sleep continuity.

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Source:

"Restless Legs Syndrome and Periodic Limb Movement Disorder in Children and Adolescents: A Guide for Healthcare Professionals." Children and RLS. (On-Line Posting) 2007. The Restless Legs Syndrome Foundation. 20 June 2008 (https://www.rls.org/NetCommunity/Document.Doc?&id=347).