RESTLESS LEG SYNDROME
GULF NEUROLOGY
MOBILE,
AL
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DO YOU HAVE RESTLESS LEG SYNDROME (RLS)?
Please circle all that apply and show it your doctor. Do you
EXPERIENCE THE FOLLOWING?
1. An urge to move the legs? This may be as an uncomfortable sensation and may involve arms or other parts of the body in addition to legs.
Do you feel worms in veins arising deep in legs, not in the skin? Some people may describe it as cramping.
2. The urge to move or unpleasant sensations begins or worsens during periods of rest or inactivity such as lying or sitting.
3. The urge to move or unpleasant sensations are partially or totally relieved by movement, such as walking or stretching, at least as long as the activity continues.
4. The urge to move or unpleasant sensations are worse in the evening or night than during the day, or only occur in the evening or night.
NOTE: RLS should not start while walking; it requires rest to provoke symptoms. Any alerting activity reduces RLS. RLS symptoms may return as soon as movement stops, but relief persists as long as movement continues. RLS is not sleep related and rarely occurs in the morning around 6-10 AM.
Movement Disorders
