Hanyang Med Rev.  2013 Nov;33(4):216-220. 10.7599/hmr.2013.33.4.216.

Diagnosis and Treatment of Restless Legs Syndrome

Affiliations
  • 1Department of Neurology, Korea University College of Medicine, Seoul, Korea. jungky@korea.ac.kr

Abstract

Restless legs syndrome (RLS) is a sensorimotor neurologic disorder, in which the primary symptom is a compelling urge to move the legs accompanied by unpleasant and disturbing sensations in the legs. RLS is relatively common, affecting 2.5 to 15% of the general population, with prevalence rates increasing alongside age. Sleep disturbance is the most common symptom owing to RLS leg symptoms. In addition, daytime dysfunction, cognitive decline, and mood disturbance are also common in patients with RLS. Iron and dopamine are implicated in the pathophysiology of RLS, however, the underlying pathophysiology of RLS is still not fully understood. The diagnosis can be made based on the symptom characteristics, differential diagnosis is important because many conditions could mimic RLS symptoms. Dopaminergic agents are recommended for the first line treatment of RLS. Alpha2delta anticonvulsants such as gabapentin and pregabalin are also effective for controlling RLS symptoms.

Keyword

Restless Legs Syndrome; Diagnosis; Therapeutics; Dyssomnias

MeSH Terms

Amines
Anticonvulsants
Cyclohexanecarboxylic Acids
Diagnosis*
Diagnosis, Differential
Dopamine
Dopamine Agents
Dyssomnias
gamma-Aminobutyric Acid
Humans
Iron
Leg
Nervous System Diseases
Prevalence
Restless Legs Syndrome*
Sensation
Pregabalin
Amines
Anticonvulsants
Cyclohexanecarboxylic Acids
Dopamine
Dopamine Agents
Iron
gamma-Aminobutyric Acid

Cited by  1 articles

Sleep and Health
Seok Hyun Cho
Hanyang Med Rev. 2013;33(4):187-189.    doi: 10.7599/hmr.2013.33.4.187.


Reference

1. Trenkwalder C, Paulus W. Restless legs syndrome: pathophysiology, clinical presentation and management. Nat Rev Neurol. 2010; 6:337–346.
Article
2. Allen RP, Picchietti D, Hening WA, Trenkwalder C, Walters AS, Montplaisi J. Restless legs syndrome: diagnostic criteria, special considerations, and epidemiology. A report from the restless legs syndrome diagnosis and epidemiology workshop at the National Institutes of Health. Sleep Med. 2003; 4:101–119.
Article
3. Choi JW, Lee JK, Ko D, Lee GT, Jung KY, Kim KH. Fronto-temporal interactions in the theta-band during auditory deviant processing. Neurosci Lett. 2013; 548:120–125.
Article
4. Jung KY, Koo YS, Kim BJ, Ko D, Lee GT, Kim KH, et al. Electrophysiologic disturbances during daytime in patients with restless legs syndrome: further evidence of cognitive dysfunction? Sleep Med. 2011; 12:416–421.
Article
5. Kim JB, Koo YS, Eun MY, Park KW, Jung KY. Psychosomatic symptom profiles in patients with restless legs syndrome. Sleep Breath. 2013; 17:1055–1061.
Article
6. Koo B. Periodic limb movements during sleep: review of physiology and pathology. J Korean Sleep Res Soc. 2012; 9:23–27.
Article
7. Ferri R, Zucconi M. Heart rate and spectral EEG changes accompanying periodic and isolated leg movements during sleep. Sleep. 2008; 31:16–17.
Article
8. Eun MY, Seok HY, Kim JB, Jung KY. Comparison of sleep quality and polysomnographic findings in patients with RLS according to the presence of periodic limb movements during sleep. J Korean Sleep Res Soc. 2011; 8:4–8.
Article
9. Hening WA, Allen RP, Washburn M, Lesage SR, Earley CJ. The four diagnostic criteria for Restless Legs Syndrome are unable to exclude confounding conditions ("mimics"). Sleep Med. 2009; 10:976–981.
Article
10. Hening WA, Allen RP, Thanner S, Washburn T, Heckler D, Walters AS, et al. The Johns Hopkins telephone diagnostic interview for the restless legs syndrome: preliminary investigation for validation in a multi-center patient and control population. Sleep Med. 2003; 4:137–141.
Article
11. Cho YW, Lee MY, Yun CH, Shin WC, Hong SB, Kim JH. The reliability and validity of the Korean version of paradigm of questions for epidemiology studies of restless legs syndrome and the Johns Hopkins telephone diagnostic interview form for the restless legs syndrome. J Korean Neurol Assoc. 2007; 25:494–499.
12. Benes H, Walters AS, Allen RP, Hening WA, Kohnen R. Definition of restless legs syndrome, how to diagnose it, and how to differentiate it from RLS mimics. Mov Disord. 2007; 22:Suppl 18. S401–S408.
Article
13. Allen RP, Walters AS, Montplaisir J, Hening W, Myers A, Bell TJ, et al. Restless legs syndrome prevalence and impact: REST general population study. Arch Intern Med. 2005; 165:1286–1292.
14. Cho YW, Shin WC, Yun CH, Hong SB, Kim JH, Allen RP, et al. Epidemiology of restless legs syndrome in Korean adults. Sleep. 2008; 31:219–223.
Article
15. Do JY, Yoon CH, Kim WJ, Yang KI, Park SH, Chu MK. Prevalence of restless legs syndrome in Korean adult population: comparison between international restless legs syndrome study group criteria and Cambridge-Hopkins diagnostic questionnaire. J Korean Sleep Res Soc. 2013; 10:7–14.
Article
16. Yun CH, Lee SK, Kim H, Park HK, Lee SH, Kim SJ, et al. Association between irritable bowel syndrome and restless legs syndrome in the general population. J Sleep Res. 2012; 21:569–576.
Article
17. Allen R. Dopamine and iron in the pathophysiology of restless legs syndrome (RLS). Sleep Med. 2004; 5:385–391.
Article
18. Connor JR, Ponnuru P, Wang XS, Patton SM, Allen RP, Earley CJ. Profile of altered brain iron acquisition in restless legs syndrome. Brain. 2011; 134:959–968.
Article
19. Silber MH, Ehrenberg BL, Allen RP, Buchfuhrer MJ, Earley CJ, Hening WA, et al. An algorithm for the management of restless legs syndrome. Mayo Clin Proc. 2004; 79:916–922.
Article
20. Aurora RN, Kristo DA, Bista SR, Rowley JA, Zak RS, Casey KR, et al. The treatment of restless legs syndrome and periodic limb movement disorder in adults-an update for 2012: practice parameters with an evidence-based systematic review and meta-analyses: an American Academy of Sleep Medicine Clinical Practice Guideline. Sleep. 2012; 35:1039–1062.
21. Garcia-Borreguero D, Ferini-Strambi L, Kohnen R, O'Keeffe S, Trenkwalder C, Hogl B, et al. European guidelines on management of restless legs syndrome: report of a joint task force by the European Federation of Neurological Societies, the European Neurological Society and the European Sleep Research Society. Eur J Neurol. 2012; 19:1385–1396.
Article
22. Garcia-Borreguero D, Allen RP, Kohnen R, Hogl B, Trenkwalder C, Oertel W, et al. Diagnostic standards for dopaminergic augmentation of restless legs syndrome: report from a World Association of Sleep Medicine-International Restless Legs Syndrome Study Group consensus conference at the Max Planck Institute. Sleep Med. 2007; 8:520–530.
23. Ondo W, Romanyshyn J, Vuong KD, Lai D. Long-term treatment of restless legs syndrome with dopamine agonists. Arch Neurol. 2004; 61:1393–1397.
Article
24. Manconi M, Ferri R, Zucconi M, Bassetti CL, Fulda S, Arico D, et al. Dissociation of periodic leg movements from arousals in restless legs syndrome. Ann Neurol. 2012; 71:834–844.
Article
Full Text Links
  • HMR
Actions
Cited
CITED
export Copy
Close
Share
  • Twitter
  • Facebook
Similar articles
Copyright © 2024 by Korean Association of Medical Journal Editors. All rights reserved.     E-mail: koreamed@kamje.or.kr