Clinical Analysis of Restless Legs Syndrome in Korean Children

Seo, Hyeeun; Kim, Saeyoon; Kwon, Soonhak

Abstract

PURPOSE
Restless legs syndrome (RLS) is a common neurologic sleep disorder, but it is frequently undiagnosed in Korean children. This study aimed to investigate clinical features of RLS in Korean children.
METHODS
We reviewed the medical records of seven patients who had been diagnosed with RLS at the pediatric department of Kyungpook National University Hospital from March to September 2011.
RESULTS
The mean age was 7.5+/-3.4 years (M:F=5:3). Chief complaints included abnormal movement during sleep (n=5, 71.4%), leg pain (n=1, 14.3%), and headache (n=1, 14.3%). Three showed inattention or hyperactivity, and one patient was taking medication for attention deficit hyperactivity disorder (ADHD). Six (85.7%) had sleep disturbance, and family history for RLS was positive in 3 (42.9%). Three patients (42.9%) showed a periodic limb movement index of 5 or more per hour of sleep that was compatible with supportive criteria of RLS. Serum testing, including a complete blood count, iron, total iron binding capacity, and ferritin, was performed. Among 5 children who demonstrated iron deficiency, 1 showed very low ferritin of 7 ng/mL, and after oral iron supplementation (3 mg/kg/day) over 1 month, there was dramatic improvement in leg pain and daytime behavior. Two patients who underwent treatment with pramipexole (0.125 mg) also had much improvement in sleep onset and daytime behavior.
CONCLUSION
RLS can have a serious impact on quality of life in pediatric patients, so we need to find the children with RLS. Iron repletion therapy is effective for the patient with RLS who shows iron deficiency. In addition, use of a dopamine agonist is an effective treatment option for pediatric RLS.