Uncomfortable and unpleasant sensations in the legs without an urge to move as the initial manifestation of Parkinson’s disease

A 74-year-old man presented with creepy, dull and restless sensation of the legs for a year. The abnormal leg sensation occurred predominantly during rest and evening. However, the patient denied having the urge to move his legs. The abnormal sensations did not fulfill the criteria for restless legs syndrome (RLS) or leg motor restlessness, a condition in which an urge to move the legs exists but not fulfilling 4 essential features of RLS. Neurological examination showed right-side dominant parkinsonism. Dopaminergic treatment provided marked improvement in the leg restlessness and parkinsonism. Any restlessness or abnormal sensation in the legs at late-onset could be an early sensorimotor manifestation of PD.