Restless Legs Syndrome

HISTORY:

‍Restless legs for ‍ ‍hoursdays

Severity: ‍mildmoderatesevere

Pattern: ‍constantintermittent, ‍nocturnal only

Worsening factors: ‍none

Treatments tried: ‍none, ‍effectiveineffective

‍leg pain

‍leg cramps

‍tingling

‍swelling

‍sleep disturbances

‍sleep apnea

‍daytime sleepiness

‍depression

‍difficulty concentrating

‍impaired memory



EXAM:

General appearance: ‍well-appearing

Vital signs: ‍normal, BP ‍, HR ‍, RR ‍, SpO2 ‍ %, Temp ‍°

Skin: ‍no rash

Extremities: ‍edema, ‍warm, cap refill ‍< 3 sec> 3 sec, pulses ‍normal, ‍

Musculoskeletal: joints ‍ ‍normal, ‍no limited ROM

Neurologic: cranial nerves ‍normal, strength ‍5/5 throughout, sensation ‍normal, reflexes ‍2+ throughout, cerebellar function ‍normal, gait ‍stable

Mental status: ‍alert, ‍oriented, speech ‍clear, mood ‍normal, thought process ‍organized, ‍no suicidal ideation, judgment ‍good



ASSESSMENT:

‍Restless legs syndrome ‍likelysuspectedpossible

DDx: ‍



PLAN:

- Blood work: ‍CBC, ‍ferritin, ‍TSH, ‍B12, ‍electrolytes, ‍creatinine, ‍glucose

- Sleep study

- ‍Dopaminergic agents

- ‍Benzodiazepines

- ‍Opioids

- ‍Anticonvulsants

- Stretching exercises before bed

- Regular exercise

- Good sleep hygiene

- Avoidance of caffeine

- Avoidance of alcohol

- Smoking cessation counseling

- Referral to neurologist

- Referral to sleep specialist

- Follow-up in ‍ ‍weeksmonths

- Return if symptoms worsen, if new symptoms develop such as pain or numbness, or if symptoms do not improve with treatment