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  • Cited by 1
  • Print publication year: 2008
  • Online publication date: August 2009

7 - Restless legs syndrome and periodic limb movement disorder

from SECTION 2 - SLEEP DISORDERS

Summary

The most characteristic features of the restless legs syndrome (RLS) are uncomfortable sensations in one or more usually lower limbs, associated with an urge to move the affected limbs. Those sensations vary widely in severity from merely annoying to significantly unpleasant. Periodic limb movements disorder (PLMD) can only be diagnosed when a polysomnographic recording has been performed. In the past few decades neuroimaging, neurophysiological, and pharmacological studies have contributed to the development of a variety of hypotheses on the pathogenesis of the disorder. The usually immediate and striking efficacy of treatment with dopaminergic agents, and the observation that dopamine receptor antagonism can clinically worsen RLS symptoms, indicates a central role of the dopaminergic system in RLS pathophysiology. Peripheral polyneuropathy, which, similar to RLS, often causes paresthesias and pain in the limbs and tends to worsen at night, is probably the most common differential diagnosis.
FURTHER READING
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Allen, RP, Picchietti, D, Hening, WA, et al. 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; 4:101–19.
American Academy of Sleep Medicine. The International Classification of Sleep Disorders: Diagnostic and Coding Manual, 2nd edn (ICSD–2). Westchester, IL: American Academy of Sleep Medicine, 2005.
Hening, W. The clinical neurophysiology of the restless legs syndrome and periodic limb movements. Part I: diagnosis, assessment, and characterization. Clin Neurophysiol 2004; 115:1965–74.
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