[Restless Legs Syndrome]

Abstract

Restless leg syndrome (RLS) is a sensorimotor disorder characterized by unpleasant sensations in the lower limbs and an urge to move them, which often results in insomnia or difficulty in maintaining sleep. Although RLS is less prevalent in Asian populations than in Western countries, it remains common and often underdiagnosed. The diagnosis is based on international consensus criteria, and its pathophysiology is thought to involve central dopaminergic dysfunction and impaired iron metabolism in the brain. Management strategies include iron supplementation, lifestyle, and pharmacological treatment using dopamine agonists and α2δ ligands. However, drug-induced augmentation remains challenging. The 2024 clinical guidelines published by the Japanese Society of Neurological Therapeutics provide evidence-based recommendations and a treatment algorithm addressing both standard therapy and augmentation. This review summarizes the current knowledge on the epidemiology, diagnosis, pathophysiology, and treatment of RLS, with a focus on the implications of the new guidelines.