Restless legs syndrome in children: a review and update on pharmacological options

Restless legs syndrome (RLS), formally identified and described by Ekbom in the 1940s, is a common clinical disorder, characterized by an overwhelming urge to move the legs, often accompanied by uncomfortable and unpleasant sensations. This impulse can also be present in the upper limbs or other parts of the body. Well recognized in the adult population, the symptoms associated with this condition have commonly been reported to originate in childhood. However, identifying prospectively children suffering from RLS is still a challenging issue. Iron deficiency has been recognized as a feature frequently associated with RLS. Some authors also make a connection with the deficiency, RLS and other common problems encountered in children, such as attention deficit disorder with hyperactivity (ADHD). Linkage to different chromosomal loci has been achieved in recent genetic studies of large kindred, as well as identification of specific genes. Therapeutic considerations in children range from providing sound sleep hygiene to intervening pharmacologically. In that regard, use of iron supplements, dopaminergic stimulation, anticonvulsants, opiates, and benzodiazepines will be assessed along with newer options, such as rotigotine and gabapentin enacarbil. Considerations specific to childhood do apply, as no pharmacological therapy for restless legs syndrome have been approved by the Federal Drug Administration (FDA) in individuals of the pediatric age group.