Summary
No previous studies have explicitly addressed the issue of diagnostic criteria for restless legs syndrome (RLS) in children. Diagnosis of RLS in adults is primarily based on the patient's history. Children may exhibit and report symptoms of RLS differently from adults, depending on the child's chronological and developmental age and on the child's ability at verbal expression. Members of the study groups ‘Movement Disorder’ and ‘Paediatrics’ of the German Sleep Society have therefore elaborated a consensus proposal for diagnostic criteria of RLS in childhood by adapting and modifying the criteria of the International Restless Legs Syndrome Study Group used in adults. As minimal criteria for the diagnosis of RLS in childhood we propose: 1) The desire to move the legs is associated with sensations like discomfort or pain in the legs: 2) increase in dysaesthesiae in the legs at rest and decrease due to motor activity; 3) The dysaesthesiae of the legs are worse during the evening and at night; 4) The child obviously suffers from the symptomatology; and 5) The symptoms described should persist for at least 6 months. Additional clinical features proposed include: 6) Sleep disturbance and its consequences: 7) Involuntary movements of the legs while awake and at rest or periodic leg movements in sleep; 8) Normal neurological examination; and 9) Positive family history.
Zusammenfassung
Es ist wenig be kannt darüber, ob die Diagnosekriterien des Restless Legs Syndroms (RLS), die anhand der Symptome erwachsener Patienten erarbeitet worden sind, auch bei Kindern anwendbar sind. Die Diagnose des RLS bei Erwachsenen wird aufgrund der Anamnese gestellt. Die Symptome und Berichte der Kinder über ihre Symptome können sich in Abhängigkeit des chronologischen und Entwicklungsalters sowie der sprachlichen Ausdruckmöglichkeiten der Kinder von den Erwachsenen unterscheiden. Mitglieder der Arbeitsgruppen “Motorik” und “Pädiatrie” haben deshalb einen Vorschlag für Diagnosekriterien eines RLS im Kindesalter erarbeitet. Die vorgeschlagenen Diagnosekriterien stützen sich auf die Kriterien der International Restless Legs Study Group bei Erwachsenen. Als Minimalkriterien für die Diagnose werden vorgeschlagen: 1) Der Bewegungsdrang in den Beinen ist mit Missempfindungen oder Schmerzen in den Beinen verbunden; 2) Die Missempfindungen in den Beinen verstärken sich in Ruhe und bessern sich durch Bewegung; 3) Die Missempfindungen in den Beinen verstärken sich abends und nachts; 4) Es besteht subjektiver Leidensdruck beim Kind durch die Symptome; 5) Die beschriebenen Symptome bestehen seit mindestens 6 Monaten. Als zusätzliche klinische Zeichen können bestehen 6) Schlafstörungen und deren Konsequenzen: 7) Unwillkürliche Bewegungen der Beine im Wachzustand oder in Ruhe sowie periodische Beinbewegungen im Schlaf; 8) Unauffälliger neurologischer Befund und 9) Positive Familienanamnese.
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Further Members of the Study Groups “Movement Disorders” and “Paediatrics” of the German Sleep Society (DGSM): H. Benes, Schwerin; B. Dietz, Datteln: M. Harnish, Essen; J. Hellwig, Göttingen: M. Hellwig, Göttingen: T. Krause, Hegau/Singen; B. Kurella, Berlin; C. Meißner, Schwerin; B. Rieger, Apolda; M. Schredl, Mannheim; K. Stiasny, Marburg; T. Tings, Göttingen
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Hornyak, M., Happe, S., Trenkwalder, C. et al. Restless legs syndrome in childhood: A consensus proposal for diagnostic criteria. Somnologie 6, 133–137 (2002). https://doi.org/10.1046/j.1439-054X.2002.02188.x
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DOI: https://doi.org/10.1046/j.1439-054X.2002.02188.x