What is Restless Legs Syndrome and Why the New Name?

Restless Legs Syndrome (RLS) is a neurological condition associated with abnormal sensations in the legs. It is estimated that 5% of the general population and as many as 10% of those over the age of 65 have this disease. The first known recorded description of this disease was by the neurologist Dr. Thomas Willis in 1685:.

"Wherefore to some, when being a Bed they betake themselves to sleep, presently in the Arms - and Leggs,
Leapings and Contractions of the Tendons, and so great a Restlessness and Tossings of their Members ensue,
that the diseased are no more able to sleep, than if they were in a Place of the greatest Torture"

Several other descriptions of this disease appeared in the medical literature after Willis' initial 1685 description, but it was not until 1944 that the broader clinical features of the disease were formulated into a "syndrome" by Dr. Karl Ekbom.  He referred to the condition as "restless legs".  In the past 65 years, there has been tremendous progress in the development of better treatments for the symptoms and also better understanding the pathology.  So in honor of the physician who first described this ailment as a disease and to the physician who first defined its clinical features as a syndrome, along with the last 20 years of research defining its pathology, RLS has been given a new name, Willis-Ekbom Disease (WED).

There are four primary features of RLS:

• Uncomfortable sensation in the legs with a clear need or urge to move the legs. The sensation may be described in many different ways, from aching and pulling to creepy crawling feelings. The sensations are usually uncomfortable, even unbearable more than painful, but some patients may experience the sensation as painful.  In the end, all sufferers can clearly identify an overwhelming need or urge to move the legs as a driving force behind their complaint. These sensations may be felt anywhere from the thigh to the ankle. One or both legs may be affected. For some people, the sensations are also felt in the arms, trunk, or even all over.
   
• The symptoms are worse at night. Symptoms may present only at bedtime or they may start in the evening when trying to sit for any period of time.  Some individuals may have symptoms throughout the day, but these symptoms will always be worse at night and better sometime in the morning.  Sleep problems are common with RLS because of the difficulty it causes in getting to sleep and difficulty in staying asleep.  Those with moderate to severe RLS often live on less than 5 hours of sleep a night.  Therefore it is not surprising that those more severely affected report increased problems with anxiety and depression and have a marked decrease in their quality of life.
   
• The symptoms come on with rest. The primary sensations are triggered or induced by rest or relaxation.  The more comfortable the RLS patient tries to become in the evening, the more likely the symptoms will start.  Increasing drowsiness, sleepiness , or anything that decreases alertness is likely to trigger the sensation, e.g. trying to lie quiet at baedtime, sitting through a long plane flight during the day.  Whether trying to sit through a movie or quietly reading a book, the symptoms make what used to be enjoyable unbearable.
   
• The symptoms are relieved with movement. All sufferers learn quickly that getting up and walking will immediately relieve the symptoms. However, as soon as the individual settles back into a restful state, the symptoms may quickly return. Any movement of the legs will usually bring about some immediate, although temporary relief.  If the legs are not moved, they may jump on their own. In some individuals, there may be semi-involuntary movements of the legs preceded by only a very brief sensation. Most individuals with RLS will have rhythmic or semi-rhythmic movements of their legs while they are asleep. Although they may not be aware of their movement, usually their bed partner is. It is this movement of the legs, this constant walking to ward off the sensation that lead Dr. Ekbom to use the term "restless legs", thus the term "Restless Legs Syndrome" was born.

Next: What are the causes of RLS?

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