title: Depth and Distribution of Symptoms in Restless Legs Syndrome/ Willis-Ekbom Disease.
abstract: To determine the depth and distribution of sensory discomfort in idiopathic restless legs syndrome/Willis-Ekbom disease (RLS) and RLS concurrent with other leg conditions, specifically peripheral neuropathy, sciatica, leg cramps, and arthritis.
  
  
  
  RLS subjects (n = 122) were divided into 71 idiopathic RLS and 51 RLS-C, or Comorbid, groups. All subjects were examined by an RLS expert, answered standardized RLS questionnaires, and received a body diagram to draw the location and depth of their symptoms.
  
  
  
  Age was 63.04 ± 12.84 years, with 77 females and 45 males. All patients had lower limb involvement and 43/122 (35.25%) also had upper limb involvement. Of the 122 subjects, 42.62% felt that the RLS discomfort was only deep, 9.84% felt that the discomfort was only superficial, and 47.54% felt both superficial and deep discomfort. There were no defining characteristics in depth or distribution of RLS sensations that differentiated those patients with idiopathic RLS from those patients with RLS associated with other comorbid leg conditions. The sensation of arthritis was felt almost exclusively in the joints and not in the four quadrants of the leg, whereas the exact opposite was true of RLS sensations.
  
  
  
  Depth and distribution cannot be used as a discriminative mechanism to separate out idiopathic RLS from RLS comorbid with other leg conditions. Although seen in clinical practice, the total absence of patients with non-painful RLS only in the joints in the current study attests to the rarity of this presentation and raises the possibility of misdiagnosis under these circumstances. We recommend that such patients not be admitted to genetic or epidemiological studies.
authors.affiliation: Department of Psychiatry, University of Texas Health Science Center at San Antonio, TX.
authors.forename: Paul
authors.initials: P
authors.lastname: Yeh
authors.affiliation: Department of Neurology, Methodist Neurological Institute, Houston, TX.
authors.forename: William G
authors.initials: WG
authors.lastname: Ondo
authors.affiliation: Carle Neuroscience Institute, University of Illinois College of Medicine at Urbana-Champaign, Urbana, IL.
authors.forename: Daniel L
authors.initials: DL
authors.lastname: Picchietti
authors.affiliation: Viterbi Family Sleep Center, Scripps Clinic, La Jolla, CA.
authors.forename: J Steven
authors.initials: JS
authors.lastname: Poceta
authors.affiliation: RLS Center, Johns Hopkins University School of Medicine, Baltimore, MD.
authors.forename: Richard P
authors.initials: RP
authors.lastname: Allen
authors.affiliation: Carle Neuroscience Institute, University of Illinois College of Medicine at Urbana-Champaign, Urbana, IL.
authors.forename: Charles R
authors.initials: CR
authors.lastname: Davies
authors.affiliation: Department of Biostatistics, Vanderbilt School of Medicine, Nashville, TN.
authors.forename: Lily
authors.initials: L
authors.lastname: Wang
authors.affiliation: Department of Biostatistics, Vanderbilt School of Medicine, Nashville, TN.
authors.forename: Yaping
authors.initials: Y
authors.lastname: Shi
authors.affiliation: Department of Neurology, Vanderbilt University Medical Center, Nashville, TN.
authors.forename: Kanika
authors.initials: K
authors.lastname: Bagai
authors.affiliation: Department of Neurology, Vanderbilt University Medical Center, Nashville, TN.
authors.forename: Arthur S
authors.initials: AS
authors.lastname: Walters
mesh_terms: D004576:Electromyography; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012148:Restless Legs Syndrome / Q000175:diagnosis / Q000453:epidemiology* / Q000503:physiopathology*; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires
keywords: Willis-Ekbom disease; body diagram; restless legs syndrome; sensory depth; sensory distribution; topography