Restless Legs Syndrome diagnosis

Restless legs syndrome diagnosis can be difficult, as there is currently no laboratory test available to pinpoint it.

Restless legs syndrome is clinically diagnosed by evaluating the patient's history and symptoms.

In 1995, the International Restless Legs Syndrome Study Group identified four basic criteria for diagnosing Restless legs syndrome:

• symptoms that are worse or present only during rest and are partially or temporarily relieved by activity,
• a desire to move the limbs, often associated with paresthesiasor dysesthesias,
• motor restlessness, and
• nocturnal worsening of symptoms.

Questions to help individuals determine whether they are experiencing Restless legs syndrome:

• Do you experience "creeping, crawling or uncomfortable, difficult-to-describe feelings" in the legs or arms that are relieved by moving or rubbing them?
• Is there a correlation between your Restless legs syndrome symptoms and time of day? Do the symptoms worsen with rest or inactivity?
• Do sensations interfere with sleep onset or returning to sleep?
• What are the daytime consequences (e.g., fatigue, sleepiness, confusion, lack of attention)?
• Does your bed partner report that your legs or arms jerk during sleep? (Relates to periodic limb movements of sleep.)
• Do you have secondary causes of Restless legs syndrome, such as low iron stores, diabetes mellitus, kidney disease or pregnancy? 
• Is there a relationship between symptoms and medications, such as tricyclic antidepressants or selective serotonin reuptake inhibitors?
• Did you begin to experience the symptoms at the same time you made a change in medication?
• Do family members report similar symptoms? Have any family members been diagnosed with Restless legs syndrome?

An individual's description of symptoms to their doctor is essential in ensuring an accurate diagnosis. You may find it helpful to keep a sleep diary if you suspect you might be experiencing Restless legs syndrome and are experiencing problems sleeping.

Your doctor will conduct a full physical and neurological exam to check for nerve damage or blood vessel problems and may order a series or blood tests to rule out medical disorders associated with Restless legs syndrome.

In most people with restless legs syndrome (RLS), poor sleep and daytime sleepiness are the most bothersome symptoms. Many people do not link their sleep problem with the strange sensations in their legs.

If you are having these sensations, be sure to mention it to your health care provider. This provides a very important clue to what is causing you to sleep poorly.

There is no lab test or imaging study that can prove that you have Restless legs syndrome. However, certain tests can identify underlying medical causes such as anemia, other deficiencies, and metabolic disorders that could cause Restless legs syndrome.

• Polysomnography (sleep testing) may be necessary to diagnose the sleep disturbances and determine if you have periodic limb movements. This is especially important in people who continue to have significant sleep disturbances despite relief of Restless legs syndrome symptoms with treatment.
• You may have blood drawn to check your blood cell counts and hemoglobin, basic organ functions, chemistry, and thyroid hormone levels. You also may be checked for certain infections that could cause secondary Restless legs syndrome.
• Needle electromyography and nerve conduction studies may be done if your health care provider sees signs of neuropathy.