Abstract
Restless legs syndrome (RLS) is a disorder characterized by an urge to move the lower limbs primarily at night. The urge is present at rest and is relieved by movement. However, in some cases the presentation is not straight forward and the diagnosis relies on a variety of supportive data rather than the formal diagnostic criteria alone. The present case is a representative example of this with atypical symptoms involving the urge to only move the toes rather than the legs. It highlights further unique features of RLS in that the patient’s symptoms were exacerbated by lithium and associated with nocturnal eating syndrome.
Highlights
Restless legs syndrome (RLS), known as Willis-Ekbom disease, is a common disorder affecting 2-10% of the general population
We report a unique case of RLS affecting only the toes that was exacerbated by lithium
As RLS was suspected and given the temporal relationship of her symptom worsening to starting lithium, the medication was discontinued and she was started on a low dose of quetiapine at bedtime instead
Summary
Restless legs syndrome (RLS), known as Willis-Ekbom disease, is a common disorder affecting 2-10% of the general population. We report a unique case of RLS affecting only the toes that was exacerbated by lithium. Her nocturnal urge to move her toes began when she was a teenager and progressively worsened over the years, she did not seek medical evaluation.
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