Restless legs syndrome is common in patients with multiple sclerosis but has not 
been reported as occurring due to an acute, inflammatory, demyelinating attack. 
Restless legs syndrome is known to be related to low brain iron levels. Multiple 
sclerosis has been associated with the abnormal accumulation of iron in the 
chronic, progressive phase of axonal degeneration. Iron deficiency may play a 
role in demyelination. This suggests that restless legs syndrome may be caused 
by the inflammatory, demyelinating component of multiple sclerosis rather than 
axonal degeneration. The author presents a case of self-limited restless legs 
syndrome occurring as an acute attack of multiple sclerosis, supporting the 
notion that inflammatory demyelination is the underlying pathophysiology of 
restless legs syndrome in multiple sclerosis.