|
Nocturnal predominance |
Commonly awakens the patient rather than occurring while laying down to sleep but still awake |
| Nocturnal cramps |
Improved by stretching and massaging |
Abrupt onset Not alleviated by movement per se Typically localized |
| Peripheral sensory neuropathy, radiculopathy, myelopathy
|
Presents with superficial sensations described as shooting, burning, tingling, pain, etc. |
Not associated with the need to move
No improvement with movement
No circadian pattern |
|
Sensation of restlessness and muscle quivering |
Generalized sense of restlessness |
| Akathisia |
Partial relief by pacing and moving around Urge to move |
No circadian pattern but may be more noticeable at rest
Improvement with movement is never complete
Commonly due to dopamine blocking agents |
|
Sensation of restlessness |
Generalized |
| Severe anxiety |
May be associated with urge to move |
Only mild or no improvement with movement No circadian pattern |
| Myalgia/sore leg muscles |
Pain and/or discomfort |
Not limited to the lower extremities
Worsened, not improved, by movement
No urge to move |
| Arthropathy and other orthopedic disorders |
Localized pain and/or discomfort |
Worsened, not improved, by movement No urge to move |
| Positional discomfort (numbness) |
Present at rest, improved by mobility Lower limb predominance |
No circadian pattern but only noticeable at rest No restlessness or urge to move |
|
Associated with nonspecific discomfort |
Relieved by specific stereotypic movement only |
| Tics |
Urge to move |
Rarely occurs in the lower extremities |
|
Relieved by movement |
Commonly associated with other motor or vocal tics |
|
|
No circadian pattern
Involuntary movements, no urge to move |
| Painful legs moving toes |
Lower limb pain |
No relief with mobility
Commonly associated with spinal cord or peripheral lesions/trauma |
|
Subjective unpleasant sensation with no visible limb oscillations |
No circadian pattern but may be more noticeable at rest |
| “Internal” tremor in PD |
Improved by movement |
No urge to move |
|
Improved with levodopa or dopamine agonist |
Usually lateralized symptoms in both upper and lower extremities |
|
Sensation of heaviness |
No circadian pattern |
| Rigidity as part of parkinsonism |
Improved with levodopa or dopamine agonist |
No urge to move/no improvement with movement
Usually lateralized symptoms in both upper and lower extremities |
|
Painful, uncomfortable sensations |
Typically associated with abnormal posturing |
| “Off” dystonia in parkinsonism |
Lower limb predominance Improved with levodopa or dopamine agonist |
No urge to move/no improvement with movement
Different circadian pattern: common during longer “off” periods (morning) |
|
Lower limb predominance |
Involuntary random movements |
| Biphasic dyskinesias in PD |
Occurs during “off” periods, may improve with levodopa or dopamine agonist |
No urge to move/no improvement with movement |
|
Timing may mimic augmentation phenomena |
No circadian pattern |
