Restless legs syndrome: clinical presentation diagnosis and treatment

Subhashie Wijemanne; Joseph Jankovic

doi:10.1016/j.sleep.2015.03.002

Restless legs syndrome: clinical presentation diagnosis and treatment

Sleep Med. 2015 Jun;16(6):678-90. doi: 10.1016/j.sleep.2015.03.002. Epub 2015 Mar 10.

Authors

Subhashie Wijemanne¹, Joseph Jankovic²

Affiliations

¹ Parkinson's Disease Center and Movement Disorders Clinic, Baylor College of Medicine, Houston, Texas, USA.
² Parkinson's Disease Center and Movement Disorders Clinic, Baylor College of Medicine, Houston, Texas, USA. Electronic address: josephj@bcm.edu.

PMID: 25979181
DOI: 10.1016/j.sleep.2015.03.002

Abstract

Restless legs syndrome (RLS) is a circadian disorder of sensory-motor integration that may be related to genetically determined dysregulation of iron transport across the blood-brain barrier. Dopamine agonists (DAs) have been considered the first-line therapy, but with the growing appreciation of problems associated with long-term treatment, particularly augmentation and impulse control disorder, alpha-2-delta drugs, such as gabapentin, are now considered the first line of treatment in patients with troublesome RLS. Opioids can be considered as an alternative therapy, particularly in patients with DA-related augmentation. In more severe cases, a combination therapy may be required. Intravenous iron therapy may be considered on those patients with refractory RLS.

Keywords: Augmentation; Dopamine agonist; Gabapentin; Methadone; Pramipexole; Restless legs syndrome; Ropinirole; Rotigotine.

Publication types

Review

MeSH terms

Amines / adverse effects
Amines / therapeutic use
Analgesics, Opioid / adverse effects
Analgesics, Opioid / therapeutic use
Benzothiazoles / adverse effects
Benzothiazoles / therapeutic use
Cyclohexanecarboxylic Acids / adverse effects
Cyclohexanecarboxylic Acids / therapeutic use
Dopamine Agonists / adverse effects
Dopamine Agonists / therapeutic use
Gabapentin
Humans
Indoles / adverse effects
Indoles / therapeutic use
Methadone / adverse effects
Methadone / therapeutic use
Pramipexole
Restless Legs Syndrome / diagnosis*
Restless Legs Syndrome / drug therapy*
Restless Legs Syndrome / etiology
Tetrahydronaphthalenes / adverse effects
Tetrahydronaphthalenes / therapeutic use
Thiophenes / adverse effects
Thiophenes / therapeutic use
gamma-Aminobutyric Acid / adverse effects
gamma-Aminobutyric Acid / therapeutic use

Substances

Amines
Analgesics, Opioid
Benzothiazoles
Cyclohexanecarboxylic Acids
Dopamine Agonists
Indoles
Tetrahydronaphthalenes
Thiophenes
ropinirole
gamma-Aminobutyric Acid
Gabapentin
Pramipexole
rotigotine
Methadone