Restless legs syndrome (RLS) is a common condition that is frequently 
unrecognized, misdiagnosed and poorly managed. It is characterized by 
uncomfortable sensations deep in the legs developing at rest that compel the 
person to move; symptoms are worst at night and sleep disturbance is common. RLS 
occurs in 7%-11% of the population in Western countries, and many such people 
experience troublesome symptoms. Primary RLS is familial in up to two thirds of 
patients. RLS may also be secondary to a number of conditions including iron 
deficiency, pregnancy and end-stage renal failure and, perhaps, neuropathy. 
Secondary RLS is most common in those presenting for the first time in later 
life. The pathogenesis of RLS probably involves the interplay of systemic or 
brain iron deficiency and impaired dopaminergic neurotransmission in the 
subcortex of the brain. RLS is very responsive to dopaminergic therapies. 
Rebound of RLS symptoms during the early morning and development of severe 
symptoms earlier in the day (augmentation) are problematic in those treated for 
a prolonged period with levodopa. Consequently, dopamine agonists have become 
first line treatment. Anti-convulsant medications and opioids are helpful in 
some patients. Correction of underlying problem wherever possible is important 
in the management of secondary RLS.