Restless leg syndrome: diagnostic and therapeutical approach
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Keywords

restless legs syndrome
levodopa
iron
dopamine agonists

Abstract

Restless legs syndrome (RLS) is a primary sensoriomotor disorder, common but underdiagnosed. RLS is clinically defined by (I) an urge to move the legs accompanied by unpleasant feeling in them, (II) a worsening of symptoms with sleep, rest or inactivity, (III) total or parcial improvement with activity and (IV) a worsening of symptoms in the evening and at night. The challenge is to differentiate the SPI diagnosis of disorders with similar symptoms such as polyneuropathy, the myoclonus, arterial disease among others, to give each patient the best treatment depending on their degree of involvement, symptoms and comorbidities present. There are several treatment options such as levodopa, gabapentin and oral iron, but dopamine agonists persist as the management of choice because most patients respond favorably to them.


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References

Benes h, Walters A, Allen R, hening W, Kohnen R. Definition of Restless Legs Syndrome, How to Diagnose it, and How to Differentiate It from RLS Mimics. Movement Disorders 2007: S401-408.

Llaneza-González MA, Abella-Corral J, Aldrey-Vázquez JM, Aneiros-Díaz A, Arribi Macías M, Santos-García D. Síndrome de las piernas inquietas. Rev Neurol, 2009: S33-36.

Satijap, Ondo W.Restless Legs Syndrome. CNS Drugs, 2008: 497-18.

hening W, Walters AS, Allen Rp, et al. Impact, diagnosis and treatment of restless legs syndrome (RLS) in a primary care population: the REST (RLS Epidemiology, Symptoms, and Treatment) primary care study. Sleep Medicine, 2004: 237-46.

Trotti LM, Bhadriraju S, Rye D.An uptade on the pathophysiology and genetics of restless legs syndrome. Current Neurol Neurosc Report, 2008: 281-87.

Staedt J, Stoppe G, Kogler A, et al.Dopamine D2 receptor alteration in patients with periodic movements in sleep (nocturnal myoclonus). 71-4, s.l.: J Neural Transm Gen Sect 1993: 93.

Baier pC, Trenkwalder C.Circadian variation in restless legs syndrome. Sleep medicine 2007: 645-50.

Connor J.Pathophysiology of Restless Legs Syndrome: Evidence for iron involvement. Current Neurol Neurosc Report, 2008: 162-66.

Villalibre-Valderrey M.I, Martínez-Orozco f.J. Sín- drome de piernas inquietas y movimientos periódicos de las extremidades durante el sueño. Master en Sueño: Fisiología y Medicina. Madrid 2007: 468-92.

Walters AS.Toward a better definition of the restless legs syndrome. The International Restless Legs Syndrome Study Group. Mov Disord, 1995, 10:634-42.

Allen Rp, picchietti D, hening WA, et al. Restless legs syndrome: diagnostic criteria, special considerations, and epidemiology. A report from the restless legs syndrome diag- nosis and epidemiology workshop at the National Institutes of Health. Sleep Med, 2003; 4: 101-19.

Oerter W, Trenkwalder C, Zucconi M, benes h, Garcia Borreguero D, Bassetti C et al. State of the art in restless legs syndrome therapy: Practice recommendations for treating restless legs syndrome. Movement Disorders, 2007: S466-75.

högl B, Zucconi M, Provini F.RLS, PLM, and their differential diagnosis. Movement Disorders, 2007: S414-19.

Alvarez MV, Driver-Dunckley EE, Caviness JN, Adler Ch, Evidente VG.Case series of painful legs and moving

toes: clinical and electrophysiologic observations. Mov Disord

; 30: 2062-6.

Stiansky-Kolster K, Kohnen R, Möller JC, Oertel Wh.Validation of the “L DOPA test” for diagnosis of rest- less legs syndrome. Mov Disord 2006; 21: 133-39.

Allen Rp, Earley CJ. Augmentation of the restless legs syndrome with carbidopa/levodopa. Sleep 1996; 19: 205-13.

ferini-Strambi L. Treatment options for restless legs syndrome. Expert Opin Pharmacother 2009: 545-54.

Collado-Seidel V, Kazenwadel J, Wetter TC. A con- trolled study of additional SR-L-Dopa in L-Dopa responsive RLS with late night symptoms. Neurology 1999; 52: 285-90.

Schlesinger I, Ravin pD. Dopamine agonists induce episodes of irresistible daytime sleepiness. Eur Neurol 2003; 49: 30-3.

Oertel Wh, Stiasny-Kolster K, Bergthold B, et al. Efficacy of pramipexole in restless legs syndrome: a 6 week, multi-center, randomized, double blind study (Effect RLS Study). Mov Disord 2007; 22: 213-19.

Oertel Wh, Benes h, Garcia-Borreguero D, et al. Efficacy of rotigotine transdermal system in severe restless legs syndorme; a randomized, double-blind, placebo controlled, six week dose finding trial in Europe. Sleep Medicine 2007; 9: 228-39.

Walters AS, hening WA, Kavey N, et al.A double-blind randomized crossover trial of bromocriptine and placebo in restless legs syndrome. Ann Neurol 1988; 24: 455-8.

Trenkwalder C, hundemer h-p, Lledo A, et al.Efficacy of pergolide in treatment of restless legs syndrome: the PEARLS-Study. Neurology 2004; 62: 1391-897.

Walters AS, Winkelmann J, Trenkwalder C, et al.Long term follow up on restless lgs syndrome patients treated with opioids. Mov Dis 2001; 6: 1105-9.

Silber M, Ehrenberg B, Allen R, Buchfuhrer M, Earley C, hening W, Rye D. An algorithm for the management of restless legs syndrome. Mayo Clin Proc 2004: 916-22.

Garcia-Borreguero D, Larrosa O, de la Llave Y, Verger K, et al.Treatment of restless legs syndrome with gabapentin: a double blind, cross over study. Neurology 2002; 59: 1573-79.

Mitler MM, Browman Cp, Menn SJ, et al. Nocturnal myoclonus: treatment efficacy of clonazepam and temazepam. Sleep 1986; 9: 385-92.

Wang J, O´Reilly B, Venkataraman R, Mysliwiec V, Mysliwiec A. Efficacy of oral iron in patients with restless legs syndrome and a low normal ferritin: A randomized, double-blind, placebo-controlled study. Sleep Medicine, 2009, pág. Article in press.

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