Sensations are described as crawling, creeping, aching, jittery, or fidgety in nature. Motor restlessness usually accompanies the paresthesias.
Symptoms typically occur at night with associated sleep disturbance.
The disorder is intermittent, and long asymptomatic periods can occur. Restless legs syndrome is idiopathic in the majority of patients but may be the presenting sign of iron deficiency, and it is also common in diabetes mellitus, uremia, pregnancy, rheumatoid arthritis, vitamin B 12 deficiency, and polyneuropathy. History is used to make the diagnosis. Consider needle electromyography and nerve conduction studies if polyneuropathy is suspected. Consider sleep studies to document sleep disturbances and periodic movements of sleep in difficult cases or if sleep apnea is suspected.