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DynaMed - Case Scenario #1 - RLS: Diagnosis, Treatment, Evidence, Education

DynaMed Search: Clinical Case Scenario

#1 - RLS: Diagnosis, Treatment, Evidence, Education

Mrs. T consults her primary care physician complaining of difficulty falling asleep. She has “nervous legs.” Restless Legs Syndrome is suspected (RLS).

What are factors in diagnosing RLS? What is current best evidence for its treatment?

  • Use search term: Restless Legs Syndrome, or RLS (Updated Nov. 6, 2008).
  • Select Restless Legs Syndrome topic or
  • Select Restless Legs Syndrome Tx or Dx
  • Read suggested diagnostic criteria for Restless Legs Syndrome Reference - (PLoS Med 2006 Apr;2(4):e170)
  • Read ‘Rule Out’ and ‘Testing to Consider’
  • Click on Treatment to review Treatment Overview
  • Scroll to Activity to view evidence for the role of exercise in reducing symptoms of RLS
    • There is mid-level evidence for exercise as a way to reduce RLS symptoms
  • Scroll to Medications to view the evidence for using dopamine agonists.
    • There is likely reliable evidence that dopamine agonists are effective for reducing symptom severity

The physician discusses treatment options with Mrs. T. Although there is some evidence that exercise will help to relieve her symptoms, Mrs. T has a history of osteoarthritis in her knees and has difficulty walking without pain.

Ropirinole (Requip) is prescribed for Mrs. T. after considering Level I evidence that the drug reduces symptoms.

The physician clicks on the link to AHFS Drug Information Essentials to view side effects and to check dosing information.

A patient handout is printed.