Bewertung von Instrumenten zur Diagnosefindung des Restless-Legs-Syndroms im Kindes- und Jugendalter

Restless legs syndrome (RLS) is a common sleep-related movement disorder characterised by an urge to move the legs caused by discomfort. Symptoms mainly occur in the evening or at night and improve with movement. In childhood and adolescence, RLS is underdiagnosed, resulting in delayed, appropriate treatment and difficult access to specialised care. Diagnosis requires fulfilment of the criteria of the International Restless Legs Syndrome Study Group (IRLSSG), considering an age- and development-dependent description of symptoms.

Evaluation of instruments for the diagnosis of RLS in children and adolescents.

In a three-phase study, a questionnaire, a semi-standardised interview and polysomnography were used to diagnose RLS in schoolchildren.

An individual RLS index score (−1.9 ± 9.5 points) was calculated for 1076 test subjects using the questionnaire to predict possible RLS. A semi-standardised interview was conducted with 188 conspicuous subjects (RLS index score 8.0 ± 7.0 points) to obtain a detailed medical history. Sixty subjects were diagnosed with “probable” or “unclear” RLS. A two-night polysomnography was performed in 15 subjects (RLS index score 13.3 ± 2.7 points). Five subjects showed an abnormal PLM index (periodic limb movements during sleep). An algorithm was developed from the study data, clinical experience and the literature.

The diagnosis of RLS in children and adolescents requires a structured diagnostic approach. The presented algorithm provides a possible consecutive procedure that enables a standardised diagnosis and treatment decision.