Restless Legs Syndrome in Children

Abstract

Restless legs syndrome (RLS) is a common pediatric condition that often goes undiagnosed. The genetics and pathophysiology of this sensorimotor condition are still not well understood. RLS can affect any part of the body, but the thighs and calves are the most commonly affected. Because of unpleasant sensations caused by RLS, these patients experience sleep disturbance and its consequences. The diagnosis of RLS is a clinical one. RLS occurs at a higher frequency and the symptoms are more severe in patients with iron deficiency; therefore, correcting iron deficiency improves the symptoms. Both pharmacologic and nonpharmacologic interventions can be effective in the treatment of children with RLS. However, in contrast to adults with RLS, most children with RLS are not treated with pharmacologic agents because the symptoms are not as severe as they are in adults. [ Pediatr Ann . 2018;47(12):e504–e506.]

Iron Deficiency Anemia in Children Residing in High and Low-Income Countries: Risk Factors, Prevention, Diagnosis and Therapy

“… 12 , 13 Febrile seizures, breath-holding spells, and restless leg syndrome have also been shown to be much more prevalent in people with iron deficiency. 14 – 16 In adolescent and young adult females, isolated iron deficiency is associated with fatigue and cold intolerance that is relieved with appropriate oral iron therapy. 17 …”

“…12,13 Febrile seizures, breath-holding spells, and restless leg syndrome have also been shown to be much more prevalent in people with iron deficiency. [14][15][16] In adolescent and young adult females, isolated iron deficiency is associated with fatigue and cold intolerance that is relieved with appropriate oral iron therapy. 17 The worldwide prevalence of anemia has slightly decreased in the past 20 years, but the situation remains concerning in Central and Western Africa.…”

Artificial Neural Networks Analysis of polysomnographic and clinical features in Pediatric Acute-Onset Neuropsychiatric Syndrome (PANS): from sleep alteration to “Brain Fog”

“…Systemic iron deficiency is described in about two-thirds of children with restless legs syndrome (RLS) and it seems to be related to a more severe symptomatology. 53 , 54 In the Wisconsin Sleep Cohort, a PLM index >15 was associated with low (<50 ng/mL) serum ferritin levels suggesting a role for low iron stores in the pathogenesis of Periodic Limb Movements. 26 A current explanation is that iron deficiency may result in a dopaminergic dysfunction supporting the RLS and PLMD, since iron is a necessary cofactor for dopamine production via tyrosine hydroxylase.…”

Common sleep disorders in children: assessment and treatment

“…RLS is multifactorial; iron deficiency, vitamin D deficiency, medications, diabetes Mellitus, sleep instability, and genetic susceptibility are the main causes. 38,39 The RLS is characterized by frequent recurrent movements during sleep, involving large muscle groups, and is described by parents as frequent repositioning or disruption of bed sheets. Essential diagnostic criteria according to International Restless Legs Syndrome Study Group are the following (1) duration of symptoms more than 3 months; (2) movements during sleep that occur for at least 3 nights/week; (3) video polysomnography showing five or more large body movements per hour; (4) presence of symptoms, which include sleepiness, behavioral concerns, or cognitive deficits; and (5) exclusion of other conditions that might cause restless sleep.…”

“…The use of dopaminergic agents such as ropinirole, pramipexole, or rotigotine skin patches in adolescents, is mainly empiric. 38 Parasomnias. Parasomnias affect up to 50% of children.…”