Restless legs syndrome in childhood and adolescence

Abstract

The prevalence of restless legs syndrome (RLS) is lower among children than adults. This could be due to RLS manifestation later in life or false diagnoses in children caused by symptom similarity to other diseases such as attention deficient hyperactivity disorder (ADHD). The aim of this study was to test the reliability and validity of a questionnaire designed to identify RLS-related symptoms in children and adolescents. The questionnaire was designed for two age groups (6–12 and 13–18 years). It was distributed among 11 pediatric RLS patients and 22 healthy children and adolescents (control group). The control group answered the questionnaire twice (M1, M2; 14-day separation). Reliability was analyzed descriptively and with Spearman correlation coefficients, intraclass correlation coefficients (ICC), and test–retest variability (TRV). An index was calculated by transferring the 12 answers concerning RLS symptoms into a coding system, grading each answer between −2 and 2 and adding the grades to an index value. Low index values hint at the absence of RLS-related symptoms. Student’s t‑test was used to test the difference between healthy controls and pediatric patients. In the control group, 84% of answer pairs were identical between M1 and M2. Mean TRV was 8% (range: 2–16%), Spearman correlation coefficient 0.762, and ICC 0.754 (confidence interval: 0.473–0.899). Comparison between controls and pediatric RLS patients showed that RLS patients had significantly higher (p < 0.001) index values (mean ± SD: 18.8 ± 4) compared to controls (mean ± SD: −3.8 ± 7.6). The questionnaire can distinguish between supposedly healthy and RLS-diagnosed children and adolescents in most cases. Nonetheless, the questionnaire cannot be used alone as a diagnostic instrument.