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Diagnosis and Treatment of Restless Legs Found Lacking


 

SAN FRANCISCO–Roughly 3% of all visits to primary care physicians involve patients who are experiencing at least twice-weekly symptoms of restless legs syndrome, which are having an appreciably negative effect on their quality of life, according to the findings of a large international survey.

But their restless legs syndrome (RLS) typically remains undiagnosed or misdiagnosed, Wayne Hening, M.D., reported at the annual meeting of the American Academy of Neurology. “Awareness of the condition and accurate diagnosis by primary care physicians appear to be low,” observed Dr. Hening of Robert Wood Johnson Medical School, New Brunswick, N.J.

He called for a new continuing medical education emphasis on consideration of RLS in the differential diagnosis of patients with sleep disorders involving difficulty in falling asleep and frequent awakening.

Dr. Hening presented data from the RLS Epidemiology, Symptoms, and Treatment (REST) Primary Care Study, in which more than 23,000 patients who visited participating primary care physicians in the United States, United Kingdom, Spain, Germany, and France during a 2-week period filled out an RLS screening questionnaire.

Patients in the GlaxoSmithKline-sponsored study who were flagged as having at least weekly symptoms suggestive of RLS were asked to complete a more detailed follow-up questionnaire, and their primary care physicians were asked to complete a questionnaire about the patient's medical history.

Roughly 3% of the patients were deemed by investigators to have RLS symptoms likely to warrant treatment on the basis of self-report of at least twice-weekly frequency of symptoms and “some” or “high” negative impact upon quality of life. This cohort had a mean age of 56.6 years, with symptom onset at 45.8 years; 68% were women.

Overall, 88% of the patients reported having at least one sleep-related problem; 43% characterized sleep disturbance as their most troublesome RLS symptom. Also, 27% rated uncomfortable feelings in their legs as their most troublesome symptom, while 21% listed pain as their top symptom.

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