Different Kinds of Movement Disorders:
  • Parkinson’s Disease:
  • Dyskinesias
  • Restless Leg Syndrome (RLS)
Do you have Restless Leg Syndrome (RLS)?
Please circle all that apply to you. Print this form and show it to your Doctor.
DO YOU EXPERIENCE THE FOLLOWING?
  1. An urge to move the legs. This may be as an uncomfortable sensation and may involve arms or other parts of the body in addition to the legs. Do you feel worms in veins arising deep in the legs, not in the skin? Some people describe this as cramping.
  2. The urge to move or unpleasant sensations are partially or totally relieved by movement such as; walking or stretching at least as long as the activity continues.
  3. The urge to move or unpleasant sensations begins or worsens during periods of rest or inactivity such as lying or sitting.
  4. The urge to move or unpleasant sensations are worse in the evening or night than during the day, or only occur in the evening or night.
NOTE: RLS should not start while walking; it requires rest to provoke symptoms. Any alerting activity reduces RLS. RLS symptoms may return as soon as movement stops, but relief persists as long as movement continues. RLS is not sleep related and rarely occurs in the morning around 6-10 am.