What tests are used to diagnose RLS and PLMD?
Doctors often order a blood test to measure iron (serum ferritin) levels for patients who may have RLS. Studies have found associations between low stores of iron in the body and increased RLS symptoms, probably because of iron's important role in brain dopamine function.
Similarly, iron deficiency can cause or worsen RLS in children and adolescents, even when the deficiency is not severe enough to cause anemia. A ferritin level of less than 50 mcg/L, which may even be in the low-normal range, indicates a potential problem.
A diagnosis of PLMD is based on three criteria:
- Periodic limb movements during sleep exceeding norms for age (more than 5 per hour for children)
- Clinical sleep disturbance and
- The absence of another primary sleep disorder or underlying cause (including RLS)
In a child with RLS, the physical exam is usually normal. Family history is important because there is a 50% chance of passing the RLS trait on to children if a parent has RLS.
How do providers at Children's Hospital Colorado make a diagnosis?
Medical professionals have developed criteria for diagnosing RLS in children ages 2 through 12 years with definite, probable or possible RLS:
- Definite RLS: A child feels an urge to move the legs that begins or worsens with sitting or lying down and is partially or totally relieved by movement. The urge is worse in the evening or night than during the day, or occurs exclusively in the evening or nighttime hours. Children describe the discomfort using their own words, such as "owies, tickle, tingle, static, bugs, spiders, ants, boo-boos, want to run, a lot of energy in my legs," etc. There is a clinical sleep disturbance for age. A biological parent or sibling has RLS. A sleep study has documented a periodic limb movement index of 5 or more per hour of sleep.
- Probable RLS: There is an urge to move the legs and the move begins or worsens with sitting or lying down. The urge to move is partially or totally relieved by movement, and the child has a biological parent or sibling with definite RLS.
- Possible RLS: The child has PLMD and a biological parent or sibling has definite RLS, but the child does not meet the criteria for definite or probable childhood RLS.
Adolescents (13 years and older) are evaluated with the adult criteria.
Ni vipimo gani vinavyotumiwa kugundua RLS na PLMD? Kwa kawaida, madaktari huagiza uchunguzi wa damu ili kupima kiwango cha chuma (serum ferritin) kwa wagonjwa ambao wanaweza kuwa na RLS. Utafiti unaonyesha kuwa kuna uhusiano kati ya kiwango cha chini cha chuma katika mwili na kuongezeka kwa dalili za RLS, labda kwa sababu ya jukumu muhimu la chuma katika utendaji wa dopamine ya ubongo. Vivyo hivyo, upungufu wa chuma unaweza kusababisha au kuharibu RLS kwa watoto na vijana, hata wakati upungufu huo haukuwa mkali vya kutosha kusababisha upungufu wa damu. Kiwango cha ferritin chini ya 50 mcg kwa lita, ambacho kinaweza kuwa katika kiwango cha chini cha kawaida, huonyesha tatizo linalowezekana. Ugonjwa wa PLMD hutegemea vigezo vitatu: - Harakati za mara kwa mara za viungo wakati wa usingizi zinazozidi viwango vya umri (zaidi ya 5 kwa saa kwa watoto) - Ugonjwa wa usingizi wa kliniki na - Kutokuwa na ugonjwa mwingine wa usingizi wa msingi au sababu ya msingi (ikiwa ni pamoja na RLS). Historia ya familia ni muhimu kwa sababu kuna uwezekano wa 50% wa kupitisha tabia ya RLS kwa watoto ikiwa mzazi ana RLS. Ugonjwa wa watoto katika Hospitali ya Colorado Wataalamu wa matibabu wametengeneza vigezo vya kugundua RLS kwa watoto wenye umri wa miaka 2 hadi 12 na RLS dhahiri, uwezekano au uwezekano: RLS dhahiri: Mtoto anahisi hamu ya kuhamisha miguu ambayo huanza au kuharibika wakati wa kukaa au kulala na hupunguzwa kwa sehemu au kabisa na harakati. Tamaa ni mbaya zaidi jioni au usiku kuliko wakati wa mchana, au hutokea tu katika saa za jioni au usiku. "Wanafunzi wanaweza kuelezea hali ya kutokuwa na furaha kwa kutumia maneno kama vile ""kucheka, kukwaruza, kukwaruza, kukaribia, kukaribia, kukaribia, kukaribia, kukaribia, kukaribia, kukaribia, kukaribia, kukaribia, kukaribia, kukaribia, kukaribia, kukaribia, kukaribia, kukaribia, kukaribia, kukaribia, kukaribia, kukaribia, kukaribia, kukaribia, kukaribia, kukaribia, kukaribia.""" Kuna tatizo la kulala kwa sababu ya umri. Wazazi au ndugu au dada wa kibinadamu wana RLS. Utafiti wa usingizi umeonyesha kuwa index ya mwendo wa viungo vya mwili ni 5 au zaidi kwa saa ya usingizi. - RLS ya uwezekano: Kuna hamu ya kuhamisha miguu na harakati huanza au huzidi kuwa mbaya kwa kukaa au kulala. Msaada wa kimwili wa mtoto wa kawaida ni kuondoa hisia za kusonga, na mtoto ana mzazi au ndugu au dada wa kimwili na RLS. - RLS inawezekana: Mtoto ana PLMD na mzazi wa kibiolojia au ndugu ana RLS dhahiri, lakini mtoto haukidhi vigezo vya RLS dhahiri au ya uwezekano wa utoto. Vijana (miaka 13 na zaidi) ni tathmini na vigezo vya watu wazima.