TY - JOUR
T1 - Restless Legs Syndrome
T2 - Clinical features, diagnosis and a practical approach to management
AU - Wijemanne, Subhashie
AU - Ondo, William
PY - 2017/12/1
Y1 - 2017/12/1
N2 - 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.
AB - 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.
KW - augmentation
KW - dopamine agonist
KW - iron
KW - periodic limb movement disorder
KW - restless legs syndrome
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U2 - 10.1136/practneurol-2017-001762
DO - 10.1136/practneurol-2017-001762
M3 - Review article
C2 - 29097554
AN - SCOPUS:85037679187
VL - 17
SP - 444
EP - 452
JO - Practical Neurology
JF - Practical Neurology
SN - 1474-7758
IS - 6
ER -