Diagnosis of the restless legs syndrome: the use of the sleep laboratory
K. Ray Chaudhuri, C. Warren Olanow, Per Odin in Restless Legs Syndrome, 2004
Because of the subjective nature of the clinical features of restless legs syndrome (RLS), the diagnosis of RLS is usually based on the patient’s clinical history1. Thus, a recent international workshop on the diagnosis and epidemiology of RLS, sponsored by the National Institutes of Health, defined four essential diagnostic criteria, all of which can be assessed by clinical history alone2. These criteria are: (1) A compelling urge to move the limbs, usually (although not necessarily) associated with paresthesias and dysesthesias. The discomfort is often described in terms such as: creeping, crawling, itching, burning, searing, tugging, pulling, drawing, aching, heat/coldness, ‘electric current like’, restlessness or pain, and seems to be located deep in the muscle or bone, and more seldom in joints3. The sensory symptoms involve the legs, but in almost half of the patients the arms also. The discomfort can occur unilaterally or bilaterally.
Diagnostic criteria
K. Ray Chaudhuri, C. Warren Olanow, Per Odin in Restless Legs Syndrome, 2004
The diagnosis of RLS is mainly based on the patient’s clinical history1,2. In patients with typical symptoms, the diagnosis is easy. However, it can be difficult in patients with either atypical symptomatology or co-morbidity, for example with other sleep or movement disorders. The diagnosis of RLS is based on criteria proposed by a consensus conference held at the National Institutes of Health, May 1-3, 2002, in Bethesda, Maryland, USA2. These criteria are essentially based on criteria published by the International Restless Legs Syndrome Study Group, IRLSSG1, and represent an update of these as a result of the improved understanding of the disease. Allen and colleagues also developed new criteria for the diagnosis of RLS in the cognitively impaired elderly (Tables 2.3 and 2.4) and in children (Tables 2.5-2.8). The consensus conference also suggested diagnostic criteria for RLS augmentation (Table 2.9).
Types of Sleep Disturbances in Women
Zippi Dolev, Mordechai Zalesch, Judy Kupferman in Sleep and Women's Health, 2019
This chapter describes the common types of sleep disorders from which women suffer: Insomnia, Restless legs syndrome, Obstructive sleep apnea, Excessive daytime sleepiness and Parasomnia. Women will express depression in the classic manner of low moods, depressive thoughts, early rising, or oversleeping, whereas for men, depression can be expressed in workaholism, attacks of rage and anger, need for excessive activity and risk taking, or alcohol and drug abuse, as well as insufficient sleep. Narcolepsy is a chronic neurological disorder that is unrelated to mental illness or psychological or hormonal problems and is usually caused by the brain's inability to regulate the sleep and wake cycles because of a lack of cells that produce the neuropeptide orexin. In extreme premenstrual dysphoric disorder, excessive sleeping can be observed as part of the general condition. Sleep-related eating disorders are an almost unstudied phenomenon for which information is very sparse.
Treating restless legs syndrome: current pathophysiological concepts and clinical trials
Published in Expert Opinion on Investigational Drugs, 2002
Restless legs syndrome is a distinctive clinical syndrome with a prevalence of about 5% in the general population. One of the outstanding characteristics of restless legs syndrome is its extreme responsiveness to dopaminergic agents. Together with the latest pathophysiological and genetic findings, recent epidemiological and clinical data give a new insight into the classification of restless legs syndrome, thus building the theoretical foundation for the development of new pharmacological methods in its treatment. Current efforts within this area focus on establishing dopaminergic substances for therapy. The hypothesis of a disturbed iron metabolism in restless legs syndrome has been revived by recent theoretical considerations. The present review attempts to explain current strategies of treatment for restless legs syndrome in relation to aetiological, genetic and pathophysiological findings.
Association of restless legs syndrome, pain, and mood disorders in parkinson's disease
Published in International Journal of Neuroscience, 2016
Abdul Qayyum Rana, Abdul Rehman M. Qureshi, Labiba Rahman, Ajantha Jesudasan, Kevin K. Hafez, Mohammad A. Rana
Purpose/Aims: The objectives of the study were to analyze the association between Parkinson's disease and restless legs syndrome, and to explore the relationship between mood disorder comorbidity (anxiety and depression), pain, and restless legs syndrome. Methods: This study included 123 Parkinson's disease patients and 123 non-Parkinson's disease patients matched for age and gender, and evaluated for anxiety severity, depression severity, pain severity, pain interference, pain disability, and restless legs syndrome prevalence. This was performed using semi-structured interviews and a neurological examination through the restless legs syndrome diagnostic criteria and the following inventories; Hospital Anxiety and Depression Scale, Brief Pain Inventory, and Pain Disability Index. Results: Parkinson's disease patients had significantly greater anxiety severity, depression severity, pain severity, pain interference, pain disability, and restless legs syndrome prevalence in comparison to controls. In addition, Parkinson's disease patients’ comorbid for anxiety and depression had significantly greater pain severity, pain interference, and pain disability, but not RLS prevalence, in comparison to Parkinson's disease only, Parkinson's disease anxiety, and Parkinson's disease depression patients. Conclusions: Pain interference, pain severity, and pain disability is greater among Parkinson's disease patients with anxiety and depression, in comparison to Parkinson's disease patients without anxiety and depression. On the contrary, the prevalence of restless legs syndrome was not found to be relevant.
Ropinirole in the treatment of restless legs syndrome
Published in Expert Review of Neurotherapeutics, 2005
Rajdeep S Kakar, Clete A Kushida
Ropinirole is an original nonergoline dopamine agonist indicated for the treatment of Parkinson’s disease. However, recent developments in the study of restless legs syndrome have demonstrated another role for this drug. The symptoms of restless legs syndrome are responsive to dopaminergic agents such as ropinirole. The dosage of ropinirole needed to treat the symptoms of restless legs syndrome appears to be much smaller than what is necessary for Parkinson’s disease therapy. The liver is primarily responsible for the metabolism of ropinirole, which has an elimination half-life of approximately 6 h. Ropinirole is generally well tolerated, with no serious adverse effects. Clinical studies have indicated that ropinirole can effectively reduce the motor symptoms of restless legs syndrome and improve overall sleep quality.
Related Knowledge Centers
- Periodic Limb Movement Disorder
- Idiopathic
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- Neurological Disorder
- Iron Deficiency
- Ferritin
- Paresthesia