Restless Chest Syndrome: A Rare Variant of Restless Legs Syndrome

A 23-year-old Japanese woman presented with a 1-month history of dyspnoea and chest discomfort. Since the symptoms improved with dynamic and sensory stimulation and also caused insomnia, we considered a variant of restless legs syndrome (RLS) called 'restless chest syndrome', although there were no symptoms in the extremities. We initiated oral administration of pramipexole 0.25 mg daily, and her symptoms, including dyspnoea, chest discomfort and insomnia, improved within 1 week. RLS should be considered in the differential diagnosis in patients who present with abnormal sensations that worsen at night, with insomnia, regardless of the site of the symptoms.

Learning points: In restless legs syndrome, rare localised sensations in the chest, back, abdomen, face, arm and perineum rather than the lower extremities, have been reported.Dynamic stimuli, intellectual activity and sensory stimuli have been reported to temporarily ease restless legs syndrome symptoms.Restless legs syndrome should be considered in patients who present with abnormal sensations that worsen at night, with insomnia, regardless of the site of the symptoms.