How to distinguish RLS and Periodiic Limb Movements?

RLS affects me in different ways at different times - sometimes I feel the urge to move so I move my leg voluntarily; sometimes I start to feel the urge to move but my leg kicks by itself before I have time to move voluntarily; sometimes I don't even feel the urge to move - my leg just kicks by itself. When I don't feel the urge to move, is that Periodic Limb Movements? It just feels like RLS speeded up.

20 Replies

  • Hi,

    I am not sure of the answer to your question, but I can certainly sympathise!

    I am getting exactly the same symptoms, except they are happening in my arms hands face and body too!

    I have been taking premipexole 0.008 for for about 9 months, after sudden severe onset of RLS, 1 in the morning 1 lunchtime and 3 at night.

    I have wondered if it could be Augmentation already, I have even hit myself in the face with the jerks and have trouble with using my hands too, my legs keep feeling as if they are going to give way, weird!

    I thought PLM was when you were asleep?

    Will be interested in your answers,


  • Hello Caz

    Sorry to hear that you are still having a lot of problems. It's very difficult I know. Yesterday and tonight have been some of my worst symptoms for a long time. Have you seen your neurologist lately? I am not sure of the dosage for pramipexole but have you thought of moving to the longer acting version? Perhaps that might help. Peter x

  • Thanks Peter, I will ask my Doctor about this, perhaps it will help, I hope you are doing better!


  • Mirapexin prolonged release pill, the higher dose is 1.05mgs Cazbaz :)

  • Thanks Keeley, I am not on a prolonged release version, I will ask about it!


  • I forgot to day that I do not have a neurologist, My GP is my person I see for RLS.

    May be I should see one, I hesitate to ask, as I have recently seen a Rheumatologist,for arthritis, and am seeing the Cardiologist this week.


  • RLS is what stops you from sleeping, or wakes you up or stops you from resting.

    PLMD happens when you are asleep, you wouldnt KNOW you are kicking around in your sleep. Both different condtions, but you can have both or one or the other.

    So, RLS is when you are awake, PLMD is when you are asleep. :)


  • More than 80% of RLS patients suffer from PLMD. Most of them when they are asleep, but there are lots of patients with severe 24/7 symptoms who experience these PLM's during the day. They are called periodic limb movements while awake (PLMA's).

    With augmentation your symptoms get worse in a relatively short time, you can't sit or rest as long as you could before and/or your symptoms start earlier in the day and/or your symptoms spread to other body parts and/or your medication works for a shorter period.

    It is sometimes difficult to distinguish augmentation from tolerance or propression of RLS itself.

  • The only way I was told to distinguish and identify periodic limb movements is to have a sleep study. I had one in 2004 and I do have periodic limb movements. They also found that my sleep was too short. I have symptoms 24/7 and of course it can get worse with age. I agree it is difficult to distinguish augmentation from progression of RLS but one way is to lessen the meds and see what happens after a reasonable period of time. That will vary from person to person.

  • Hi Peter,

    I really wish I could have a sleep study, as I have had serious sleep disturbances since long before RLS came on.

    I do stop breathing occasionally, too.


  • if you stop breathing thats bad, i would ask for a sleep study, as that sounds like "sleep apnea" my father has it, and he has a mask to use at bedtime, to help him breathe, cant remember the name of it now

  • Hi Keeley,

    I suppose I had better tell my GP about this too, I feel as If I am falling apart, I never saw a doctor from one year to the next now I seem to always be there!

    I do not know if it is true sleep apnea, I awake not being able to breathe, and it takes what seems ages before I can get a breath, and I am wheezing and gasping for a while.


  • Are you serious about PLMAs? It's like something out of Monty Python! If you do not know you are "kicking" with PLMD 'cos you're asleep, PLMAs would suggest you have RLS-type symptoms during the day but don't know you're having them...weird. Perhaps the question should not be "What's the difference between RLS and PLMD?" but "What's the difference between RLS and PLMA?" Hate to be a pedant :) but I've never heard of PLMAs before... Tpebop, Kent, Britain.

  • Hi,

    It is a bit like that, I have hit myself in the face before now, and cannot always hold on to a cup, luckily they mainly happen at night and in the morning, but yes it has its funny side, LOL!


  • I'm sorry, it should be PLMW (while awake) and not PLMA. As I said, many severe patients have these limb movements in daytime, including myself. In every book on RLS written by experts they are mentioned. You don't notice them when you are asleep (but they can wake you up) and when you have them during the day you certainly notice them!

    I agree: with augmentation, when you up your DA dose it probably will work for a short time and then your RLS gets worse; when you up the dosis because of progression of RLS itself or because of tolerance your RLS gets better (generally speaking).

  • I have never heard of PLMW either....???? Are you sure you dont mean myoclonic jerks.

  • RLS is voluntary movement because you HAVE to move. PLMD is involuntary leg jerks and arm jerks that do not wake you up but disturb you from reaching the right levels of sleep. Myoclonic jerks are involuntary jerking while you are awake, and trying to relax, but they are involuntary. RLs is the only voluntary movement disorder, in other words that "URGE TO MOVE" or you feel like you will explode. Again, ww.rlshelp.orgt,, and are all good web sites and get yourself a little more educated i thwe different kinds of movement disorders. RLS has LOT of cousins. :) It can only help, and it is one of the best ways to combat RLS,. Knowledge is power.

  • Have you ever tried beating the RLS by resisting the urge to move? I used to when I was younger but my leg would always jump anyway, So if I hold out against moving voluntarily, my leg will move involuntarily. That's why it seems all part of the same condition to me.

    Thanks for all your answers.

  • I'm still not sure what it's called, but whenever I'm tired I have Involuntary Leg Movements every 10-20 seconds while awake, I do not feel any urge to move my legs and I cannot control it unless I stand up.

    It started 20 years ago as an involuntary sensation in ether knee when tired but was able to sleep off. It's slowly progressed to involuntary knee/ankle spasms to now full involuntary leg kicking every day. It always happens while awake but only when I'm tired. For the last 5 years If left untreated, the involuntary leg kicking will now keep me awake all night.

    I was originally taking regular Ropinirole (6mg) but it would cause me to suddenly fall asleep in the middle of whatever I was doing. Not good!

    I now take 6mg Ropinirole XL (extended release tablets) and that treats my symptoms about 90% of the time without the sudden sleepiness. As long as I take it the same time every day, I'm able to relax without kicking. There are the occasional unexplained nights when it takes longer to work and I'm up pretty late waiting.

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