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Upper extremity symptoms can develop in restless legs syndrome, but are rarely the initial symptom. Objectives: To report a case of restless legs syndrome with restless arms as the initial symptom, and to review the literature. Design: Case report and literature review. Patient: A 78-year-old man had arm restlessness and sleep disturbance. A polysomnogram demonstrated sub-clinical periodic leg movements 1 year after the onset of his symptoms. Results: Two years later, he developed lowerdoi:10.1001/archneur.60.7.1013 pmid:12873861 fatcat:cxgp4igifvfufkdt2h4y76uibu