Periodic Limb Movement Disorder

What is periodic limb movement disorder (PLMD)?

Periodic limb movements disorder involves periodic episodes of repetitive movements, usually in the legs, that occur about every 20-40 seconds. The movements may appear as brief muscle twitches, jerking movements, or an upward flexing of the feet. These movements occur in clusters, lasting from a few minutes to a few hours. Most children and adolescents with periodic limb movement disorder will not be aware of the movements. Periodic limb movement disorder can result in frequent brief arousals throughout the night, leading to daytime sleepiness.

Children and adolescents with periodic limb movement disorder may also have restless legs syndrome (RLS), a movement disorder in which a child or adolescent experiences uncomfortable sensations in the legs during periods of rest or sitting still. The sensations are usually described as creepy, crawly, tingling, or painful and can make it difficult for a child or adolescent to fall asleep at bedtime.

What causes periodic limb movement disorder?

The cause of periodic limb movement disorder is unknown. periodic limb movement disorder can be related to low iron (anemia). Additionally, some children with chronic diseases, such as diabetes and kidney disease, are at increased risk for developing periodic limb movement disorder.

What are the symptoms of periodic limb movement disorder?

The symptoms of periodic limb movement disorder may include any of the following, although many children and adolescents with periodic limb movement disorder do not report any symptoms:

1. Leg movements: Repetitive leg movements in sleep characterize periodic limb movement disorder, but the child or adolescent is probably not aware of these movements.
2. Sleep disruption : Children and adolescents with periodic limb movement disorder may experience wakings throughout the night as a result of the multiple arousals from sleep.
3. Restless sleep. A child or adolescent with periodic limb movement disorder may be described as a restless sleeper due to the leg movements and the frequent arousals .
4. Daytime sleepiness. The frequent arousals in sleep can result in significant daytime sleepiness.
5. Behavior and academic problems. Children and adolescents with periodic limb movement disorder may have daytime behavior and academic problems, such as hyperactivity, impulsivity, and irritability, which is the result of the sleep disruption.

How is periodic limb movement disorder diagnosed?

Periodic limb movement disorder is diagnosed by overnight sleep study. This will require your child or adolescent to stay overnight in a sleep laboratory. In addition, a medical history and physical examination will be conducted.

How is periodic limb movement disorder treated?

Treatment for periodic limb movement disorder may involve any of the following:

1. Medication. For children and adolescents with periodic limb movement disorder who have significant sleep disruption, medication may be recommended. There are a number of different types of medications that can help.
2. Avoid caffeine. Caffeine can make periodic limb movement disorder symptoms worse; so all caffeine should be avoided. Caffeine can be found in many sodas, tea, and coffee, but also in chocolate and medications (e.g., Midol, Excedrin).
3. Iron deficiency. Low levels of iron or folic acid can contribute to periodic limb movement disorder symptoms, so an iron or folic acid supplement may be prescribed by your child’s doctor.