Anxiety, tension or mild depression. Although historically it was thought that these unpleasant sensations are usually confined to the calves, we have seen numerous patients in whom other body parts - arms, face, neck, back, and trunk were involved in a segmental fashion. I believe that Segmental Restless Body Syndrome with Lower Limbs Predominance is a more anatomically accurate descriptive name for this debilitating disorder. RLS and PMS appear to be closely linked manifestations of brainstem dysfunction and are treated similarly. These include iron deficiency, folate deficiency, uremia, pregnancy, peripheral neuropathies and radiculopathies.
Treatment is often very tricky and requires a lot of patience from the patient and physician.
Iron supplementation, even if Iron and Ferritin levels are normal is also recommended for prolong periods as an adjunctive treatment. Patients should also avoid caffeine and tricyclic antidepressants which make symptoms worse. Unfortunately, dopamine agonists, especially Sinemet, while being very effective initially, can produce symptoms augmentation within a few months. In these cases, symptoms can become more severe and spread to previously asymptomatic periods during daytime. In our experience one should avoid starting patients on Sinemet except in the mildest of cases and on the lowest possible dose.