J Korean Neuropsychiatr Assoc.  2020 Feb;59(1):13-19. 10.4306/jknpa.2020.59.1.13.

Updates on the Diagnosis and Treatment of Restless Legs Syndrome

Affiliations
  • 1Department of Psychiatry, Gil Medical Center, Gachon University College of Medicine, Incheon, Korea. kangsg@gachon.ac.kr

Abstract

Restless legs syndrome (RLS) is a neurological sleep disorder characterized by an urge to move the legs or arms and is associated with discomfort and paresthesia in the legs. RLS is diagnosed based on the clinical symptoms, and polysomnography is performed to quantify the periodic limb movements during sleep or in patients who undergo the suggested immobilization test. Determining the cause of RLS is important for accurately diagnosing and evaluating this condition. The treatment of RLS varies according to the etiology, severity, and frequency of the patients' symptoms. Accurate identification and treatment of the cause of RLS are important in patients with secondary RLS. Iron supplementation could be useful in patients with uremia, iron deficiency, and for RLS during pregnancy. Dopamine agonists have been used as the first-line treatment for primary RLS. On the other hand, augmentation is a known adverse effect associated with the long-term use of dopamine agonists. Therefore, recent treatment guidelines recommend the administration of anticonvulsants, such as pregabalin and gabapentin, to treat RLS. Iron, opioids, or benzodiazepines may be useful in patients refractory to anticonvulsants or dopamine agonists. RLS is a chronic condition. Therefore, it is essential to establish a long-term treatment plan, considering both the efficacy and adverse effects of therapeutic agents used in patients.

Keyword

Restless legs syndrome; Diagnosis; Polysomnography; Treatment; Anticonvulsants; Dopamine agonist; Iron

MeSH Terms

Analgesics, Opioid
Anticonvulsants
Arm
Benzodiazepines
Diagnosis*
Dopamine Agonists
Extremities
Hand
Humans
Immobilization
Iron
Leg
Paresthesia
Polysomnography
Pregabalin
Pregnancy
Restless Legs Syndrome*
Sleep Wake Disorders
Uremia
Analgesics, Opioid
Anticonvulsants
Benzodiazepines
Dopamine Agonists
Iron
Pregabalin
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