Neurology Book

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Restless Legs Syndrome in Children

Aka: Restless Legs Syndrome in Children, Pediatric Restless Leg Syndrome
  1. See Also
    1. Restless Legs Syndrome
    2. Sleep Problems in Children
  2. Epidemiology
    1. Prevalence: 2% in children
  3. Risk Factors
    1. Family History of first degree relative with Restless Legs Syndrome
    2. Iron Deficiency Anemia
  4. Symptoms
    1. See Restless Leg Syndrome
    2. Urge to move legs and leg discomfort (may be difficult for a child to express)
  5. Complications
    1. Sleep deprivation and secondary negative impact on behavior, mood, attention and cognition
  6. Associated Conditions
    1. Attention Deficit Hyperactivity Disorder
  7. Diagnosis
    1. Polysomnogram (Sleep Study)
      1. May be needed in unclear cases (especially is too young to communicate a history)
    2. Diagnostic criteria: At least 2 of the following (if child unable to communicate symptoms)
      1. Sleep disturbance
      2. First degree relative with Restless Legs Syndrome
      3. Periodic Limb Movements 5 or more per hour during Polysomnogram
  8. Differential Diagnosis
    1. Sleep Problems in Children
    2. Growing Pains
    3. Akathisia
  9. Management
    1. Avoid Caffeine
    2. Avoid Tobacco (nicotine)
    3. Avoid medications that provoke Restless Legs Syndrome
      1. See Restless Legs Syndrome
      2. Antihistamines
      3. Selective Serotonin Reuptake Inhibitors
      4. Tricyclic Antidepressants
    4. Treat Iron Deficiency Anemia
      1. Iron replacement indicated for Serum Ferritin <50 mcg/L
      2. Recheck Serum Ferritin again in 3 months
      3. Kryger (2002) Sleep Med 3(2): 127-32 [PubMed]
    5. Medications
      1. No medications are approved in children for Restless Legs Syndrome
      2. Gabapentin (Neurontin) has been used in severe cases
  10. References
    1. Carter (2014) Am Fam Physician 89(5): 368-77 [PubMed]
    2. Picchietti (2007) Pediatrics 120(2): 253-66 [PubMed]
    3. Rajaram (2004) Sleep 27(4): 767-73 [PubMed]

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