Restless Leg Syndrome In Children: Signs, Symptoms And Treatment

Let it be. It is just growing up pains, assured Shrishti's husband when she expressed concern about their son, Rishi, moving his legs uncontrollably. The problem would get worse when he was lying down. There were days when 10-year-old Rishi would complain that he could not control the movement in his legs and that it was tiring for him. His parents told him not to worry and did not pay much attention. However, when Rishi's condition took a turn for the worse, Shrishti consulted their family physician. A detailed examination revealed that Rishi had restless leg syndrome (RLS).

Children suffering from restless leg syndrome experience uncomfortable sensations in their body, which may go away when they shake their legs. Apart from the physical discomfort, children with RLS may also face stigma because they are often ridiculed and misunderstood for the continuous, odd movement of their legs.

Here is what parents need to know about the signs, symptoms and treatment of RLS:

What is Restless Leg Syndrome?

Restless Leg Syndrome (RLS), also known as Jimmy legs, is an uncontrollable urge in a child to move his limbs to ease discomfort, pain and odd sensations in the body, specially in the legs. In most cases, moving the affected body part can provide relief for some period. However, the urge may recur after a while. The child may also seek comfort by fidgeting, stretching, walking, running or changing his position in bed.

RLS is a common condition in children. If a child is fidgety or has leg pain around bedtime nd problems lying still, it could be a sign of this condition.

While the specific cause of RLS is not known, the condition may be There may also be a corelation between Attention Deficit Hyperactivity Disorder (ADHD) and RLS. In a 2008 research published in the Journal of Clinical Sleep Medicine, sleep specialists showed that at least 25 per cent of the children with ADHD, may have RLS or Periodic Limb Movement Disorder or combination of the two.

Is it RLS or something else?

The condition needs proper evaluation, diagnosis and treatment. Unfortunately, parents may fail to recognise the symptoms and it can also be misdiagnosed.

Growing pains (recurring pain symptoms in children in the 3-12 age group) and RLS have very similar symptoms with one important difference that could change the diagnosis. Both disorders cause children to feel leg discomfort, often in the evening or at night. With RLS, the uncomfortable sensations may go away when the child moves, while that is not the case with growing pains.

How is it diagnosed?

Diagnosing RLS in children is difficult, since it is hard for a child to describe where it hurts, when and how often the symptoms occur and how long the symptoms last. Also, there is no specific test for RLS. A doctor will make the diagnosis based on the symptoms. A complete physical examination has to be conducted and medical history of the affected child taken, to rule out any other possible health problem.

Signs and symptoms

Leg discomfort: An uncomfortable sensation described as itching, pulling, crawling, cramping, tugging, tingling, burning, gnawing or pain.

Sleep disruption: The child needs extra time to fall asleep due to the constant urge to move the legs.

Bedtime behaviour problems: Children may not always stay in bed and sometimes need to get out of bed to stretch their legs.

Behavioural problems: Due to sleep disruption, the child may exhibit certain behaviours like irritability, moodiness, difficulty concentrating and hyperactivity.

Treatment options

• Follow a fixed bedtime: Make sure the child gets into bed when he is sleepy. Do not encourage reading, watching television or playing games, once he is in bed.
  
• Avoid caffeine: Drinking anything that contains caffeine can make the condition worse. Avoid coffee, tea, colas and certain medicines with caffeine.
  
• Use local comfort aids for legs: Parents can try heating pads, cold compress or rubbing legs to provide temporary relief to the child. Walking, stretching or other relaxation techniques may also help.
  
• Supplement micronutrients: Low levels of iron and folic acid can contribute to symptoms.
  
• Try medicines: Consult your child's paediatrician, who can examine her and prescribe medicines, if necessary.
  
• Avoid self-medication: Eliminate unnecessary medications, both prescription as well as over the counter, and herbal products.
  
• Conduct a dietary review: Make sure the child is eating a healthy and well-balanced diet. Talk to your child's paediatrician for advice on her diet.
  

RLS is usually a long-standing condition. However, with timely diagnosis and treatment, children suffering from this problem can lead a normal life.

The author is a pediatrician at a hospital in Mumbai.

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