Restless legs syndrome or diabetic peripheral neuropathy: diagnostic dilemmas and clinical insights from a case report.

OBJECTIVE: Diabetic peripheral neuropathy (DPN) comorbid with restless legs syndrome (RLS) is relatively rare and easily causes diagnostic dilemmas due to highly overlapping clinical manifestations. This study aimed to clarify the differential diagnosis and clinical recognition of DPN comorbid with RLS. RESEARCH DESIGN AND METHODS: A retrospective analysis was conducted on a case of type 2 diabetes with lower extremity discomfort. We reviewed the prevalence of RLS in diabetic neuropathy, its diagnostic workflow, distinguishing features between RLS and DPN, as well as the evolving therapeutic concepts for RLS. RESULTS: The patient presented with 6-month lower extremity discomfort, rest-induced aggravation, movement-related relief, nocturnal exacerbation, and severe sleep disturbance. Nerve conduction study and DPN screening were abnormal. Pregabalin therapy significantly alleviated symptoms. A diagnosis of secondary RLS was confirmed. CONCLUSIONS: Secondary RLS is easily confused with DPN. Strict guideline-based assessment and comorbidity management are critical for accurate diagnosis and optimal care.