| 1 |
Do
you have abnormal sensations (pins and needles, burning,
pain) in legs with
an urge to move the limbs?
|
Yes/No |
| 2 |
Do
you have increased motor activity/restlessness to relieve
these symptoms?
|
Yes/No |
| 3 |
Do
these complaints occur at rest or worsen when at rest? |
Yes/No |
| 4 |
These
complaints are maximum at what time?
Daytime, at night or related to sleep
onset
|
Yes/No |
| 5 |
What
areas of body are affected?
Legs/hands/both
|
Yes/No |
| 6 |
What
gives relief to the complaints?
Walking, pressing, rubbing, tying with cloth
|
Yes/No |
| 7 |
Have
you or bed-partner noticed increased movements of toes
at night?
|
Yes/No |
| 8 |
Do
these symptoms disturb/delay sleep onset? |
|
| 9 |
Have
you ever noticed jerky movements of any part of the
body during the day/night?
|
Yes/No |
| 10 |
Duration of above complaints |
(months/years) |
|
If
answer to the above 4 question is "YES" then you might be having Restless
Legs Syndrome, consult a Sleep Specialist.
|
|
Requires the
full criteria to be fulfilled:
1. You have a strong
urge to move your legs which you may not be able to resist. The need to move is
often accompanied by uncomfortable sensations. Some words used to describe these
sensations include: "creeping", "itching", "pulling",
"creepy-crawly", "tugging" or "gnawing".
2. Your RLS Symptoms start or become worse when you are resting. The longer
you are resting, the greater the chance the symptoms will occur and the more severe
they are likely to be.
3. Your RLS symptoms get better when you move
your legs. The relief can be complete or only partial but generally starts very
soon after starting an activity. Relief persists as long as the motor activity
continues.
4. Your RLS symptoms are worse in the evening especially
when you are lying down. Activities that bother you at night do not bother you
during the day.
Primary
Features of RLS
An
urge to move, usually due to uncomfortable sensations that occur primarily in
the legs
Motor restlessness, expressed as activity, that relieves the urge
to move
Worsening of symptoms by relaxation
Variability over the course
of the day-night cycle, with symptoms worse in the evening and early in the night
Associated Features of RLS
Periodic
limb movements in sleep
Sleep disturbance especially difficulty in sleep
initiation
Dyskinesias while awake that occur almost exclusively at rest
Positive family history
Exclusion of potential underlying causes of RLS
Onset at any age with typically chronic and progressive course and occasional
remissions |
|
|
