Restless Legs Syndrome: Clinical features, diagnosis and a practical approach to management

Subhashie Wijemanne, William Ondo

Research output: Contribution to journalReview articlepeer-review

30 Scopus citations

Abstract

Restless legs syndrome (RLS) is a chronic neurological disorder that interferes with rest and sleep. It has a wide spectrum of symptom severity, and treatment is started when symptoms become bothersome. Dopamine agonists and calcium channel apha-2-delta antagonists (gabapentin, gabapentin enacarbil and pregabalin) are first-line treatments; calcium channel alpha-2-deltas are preferred over dopamine agonists because they give less augmentation, a condition with symptom onset earlier in the day and intensification of RLS symptoms. Dopamine agonists can still be used as first-line therapy, but the dose should be kept as low as possible. Iron supplements are started when the serum ferritin concentration is ≤75 μg/L, or if the transferrin saturation is less than 20%. For severe or resistant RLS, a combined treatment approach can be effective. Augmentation can be very challenging to treat and lacks evidenced-based guidelines.

Original languageEnglish (US)
Pages (from-to)444-452
Number of pages9
JournalPractical Neurology
Volume17
Issue number6
DOIs
StatePublished - Dec 1 2017

Keywords

  • augmentation
  • dopamine agonist
  • iron
  • periodic limb movement disorder
  • restless legs syndrome

ASJC Scopus subject areas

  • Clinical Neurology

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