Dopamine-refractory restless arms syndrome: a case report

Restless legs syndrome (RLS) is a common neurological disorder characterised by an uncontrollable urge to move the lower limbs, often accompanied by unpleasant sensations. It typically occurs in the evening and at night and improves with exercise. Restless arm syndrome (RAS) mainly affects the arms and rarely the legs. RAS appears to be very rare, as very few cases have been described. However, RAS may be underdiagnosed, especially when symptoms are mild or transient. A supportive feature for the diagnosis of Restless legs/arms Syndrome (RLS/RAS) is evidence of successful dopaminergic therapy.

This report describes the case of a patient with RAS who failed treatment with L-dopa, dopamine agonists and opioids. Only with the administration of gabapentin was it possible to achieve almost complete freedom from symptoms.

Clinicians should be aware of this rare condition, even if treatment with dopaminergic agonists is unsuccessful. A trial of calcium channel 2 ligands may still prove effective.