Objective: To compare the clinical features of RLS patients with asymmetric distribution of discomfort and symmetry distribution, and provide new ideas for the diagnosis and treatment of RLS.

Background: Restless Legs Syndrome (RLS) is a common disorder of sensory dyskinesia. The main symptom of the patients is the discomfort of both lower extremities. In recent years, many studies have found that this discomfort in patients with RLS can also be displayed in unilateral or bilateral asymmetric distribution.

Methods: A total of 179 patients diagnosed as having restless legs syndrome in the Movement Disorders Clinic, Department of Neurology at Shanghai General Hospital from July 2014 to December 2016 were enrolled in the study. The patients demographic information and RLS clinical features were collected by face-to-face assessment. According to the distribution of patients with discomfort, patients with RLS were divided into bilateral symmetry group, upper limb group and unilateral group, and unilateral group was divided into simple unilateral and bilateral asymmetric group, the scales of International Restless Legs Syndrome Severity Scale (IRLSRS), Pittsburgh Sleep Quality Index (PSQI), and various statistical methods were used to explore the clinical features of RLS.

Results: In the 179 RLS patients, 45 patients (36%) had unilateral discomfort and 9 patients (5%) had upper extremity discomfort. There were 79 women (63.2%) in bilateral symmetrical RLS and 36 (80.0%) women in unilateral group (P<0.05). Bilateral symmetry group IRLSRS was 22.78 ± 6.52 points, PSQI score was 10.51±4.97 points, while unilateral group scores were 25.89±4.59 points and 13.00 ± 3.62 points (P<0.05). 18 patients (14.4%) in the bilateral symmetry group and 11 patients (24.4%) in the unilateral group with secondary RLS were associated with pregnancy. Compared with 1 patient (0.8%) in the bilateral symmetry group, unilateral group appeared in 4 cases (8.9%), there was a significant difference between the two groups (P<0.05).

Conclusions: Patients with unilateral or asymmetrical distribution of RLS have a greater proportion of women and higher IRLSSG and PSQI scores than those with bilateral symmetry. The proportion of RLS patients with secondary to pregnancy is higher than those with bilateral symmetrical symptoms. These results suggest that discomfort occurs in RLS patients with unilateral limbs or asymmetrically distributed are worse and may be associated with hormone levels. No differences in clinical features between patients with bilateral upper extremity discomfort and bilateral symmetry were found in this study.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/distribution-characteristics-of-limbs-discomfort-in-restless-legs-syndrome/