Practice guideline summary: Treatment of restless legs syndrome in adults

Winkelman, John W.; Armstrong, Melissa J.; Allen, Richard P.; Chaudhuri, K. Ray; Ondo, William G.; Trenkwalder, Claudia; Zee, Phyllis C.; Gronseth, Gary S.; Gloss, David; Zesiewicz, Theresa

doi:10.1212/wnl.0000000000003388

Cited by 199 publications

(71 citation statements)

References 46 publications

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“…Guidelines for the management of RLS/WED include those from the American Academy of Neurology (2016), 167 153 We thank Anne-Marie Williams for her help with editing.…”

Section: Guidelinesmentioning

confidence: 99%

New concepts in the management of restless legs syndrome

Garcı́a-Borreguero¹,

Cano-Pumarega²

2017

BMJ

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Restless legs syndrome (RLS), also known as Willis-Ekbom disease (WED) is a neurological condition with an overall prevalence in adults of 5-10% in Europe and North America. It is characterised by strong feelings of restlessness and distressing paraesthesia-like sensations in the lower legs, particularly when at rest. The symptoms vary considerably in severity and frequency. RLS/WED has a variable clinical expression influenced by genetic, environmental, and medical factors. Research into the pathophysiology of RLS/WED has found that various genetic markers and existing dysfunctions in dopaminergic mechanisms and iron mechanisms play a central role. Until recently, the first line treatment of RLS/WED was with low dose dopamine agonists, with three drugs having been approved by the US Food and Drug Administration and the European Medicines Agency. However, the occurrence of dopaminergic augmentation and an overall increase in severity of symptoms during long term treatment with dopamine agonists is leading to a shift towards non-dopaminergic alternatives as initial treatments, and particularly to αδ ligands. Recent international guidelines recommend, whenever possible, to start treatment with these drugs (αδ ligands) to avoid augmentation from the start. Other (eg, glutamatergic or adenosine) neurotransmitters might also play an important role in causing RLS/WED and might thus lead to new treatments.

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“…Guidelines for the management of RLS/WED include those from the American Academy of Neurology (2016), 167 153 We thank Anne-Marie Williams for her help with editing.…”

Section: Guidelinesmentioning

confidence: 99%

New concepts in the management of restless legs syndrome

Garcı́a-Borreguero¹,

Cano-Pumarega²

2017

BMJ

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“…UPHB'de uykuya dalmada ve uykuyu sürdürmede güçlük, sabah erken uyanma, yorgun uyanma ve gün içinde uykululuk gibi yakınmalar sıklıkla görülür. Yaygınlık oranı % 3,9 olarak bildirilmiştir 41,42 . Kadın cinsiyet, ileri yaş, kafein ve stres ile ilişkilendirilmiştir.…”

Section: Uykuda Periyodik Hareket Bozukluğu (Uphb)unclassified

“…Kadınlarda ve yaşlılarda (>65 yaş) daha sıktır. Etiyopatogenez tam olarak açıklığa kavuşmamıştır40,42 .HBS; birincil olarak ya da demir eksikliği (anemi ile birlikte ya da olmaksızın), periferik polinöropati, ileri evre böbrek yetmezliği, diyabetes mellitus, romatoid artrit gibi bazı hastalıkların seyri sırasında, bazı ilaçların kullanımıyla ya da gebelikte ortaya çıkabilir[40][41][42] . Ailesel geçiş %25-50 oranında ve otozomal dominanttır.…”

unclassified

Uyku Bozuklukları: Sınıflama ve Tedavi

Keskin

Tamam

2018

Arşiv Kaynak Tarama Dergisi

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Sleep can be defined as a different state of consciousness and is necessary for the normal and healthy functioning of the human body. Sleep disturbances are known to cause loss in functionality and decrease in quality of life and can occur primarily or due to another physical illness or mental disorder. The aim of this article is to overview the sleep disorders in the light of recent classification systems and treatment algorithms.

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“…However, this treatment strategy is only efficacious for those with end-stage renal disease on hemodialysis (24). End-stage renal disease can reduce erythropoietin levels.…”

Section: Introductionmentioning

confidence: 99%

“…Specifically, prolonged-release oxycodone/naloxone has been implicated as an RLS treatment (24). Oxycodone is a semi-synthetic opioid found to yield analgesic effects via the binding of µ-opioid receptors on neurons (53).…”

Section: Introductionmentioning

confidence: 99%

Nerve Decompression and Restless Legs Syndrome: A Retrospective Analysis

Anderson¹,

Fritz

Benson³

et al. 2017

Front. Neurol.

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IntroductionRestless legs syndrome (RLS) is a prevalent sleep disorder affecting quality of life and is often comorbid with other neurological diseases, including peripheral neuropathy. The mechanisms related to RLS symptoms remain unclear, and treatment options are often aimed at symptom relief rather than etiology. RLS may present in distinct phenotypes often described as “primary” vs. “secondary” RLS. Secondary RLS is often associated with peripheral neuropathy. Nerve decompression surgery of the common and superficial fibular nerves is used to treat peripheral neuropathy. Anecdotally, surgeons sometimes report improved RLS symptoms following nerve decompression for peripheral neuropathy. The purpose of this retrospective analysis was to quantify the change in symptoms commonly associated with RLS using visual analog scales (VAS).MethodsForty-two patients completed VAS scales (0–10) for pain, burning, numbness, tingling, weakness, balance, tightness, aching, pulling, cramping, twitchy/jumpy, uneasy, creepy/crawly, and throbbing, both before and 15 weeks after surgical decompression.ResultsSubjects reported significant improvement among all VAS categories, except for “pulling” (P = 0.14). The change in VAS following surgery was negatively correlated with the pre-surgery VAS for both the summed VAS (r = −0.58, P < 0.001) and the individual VAS scores (all P < 0.01), such that patients who reported the worst symptoms before surgery exhibited relatively greater reductions in symptoms after surgery.ConclusionThis is the first study to suggest improvement in RLS symptoms following surgical decompression of the common and superficial fibular nerves. Further investigation is needed to quantify improvement using RLS-specific metrics and sleep quality assessments.

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Practice guideline summary: Treatment of restless legs syndrome in adults

Abstract: Objective: To make evidence-based recommendations regarding restless legs syndrome (RLS) management in adults.Methods: Articles were classified per the 2004 American Academy of Neurology evidence rating scheme. Recommendations were tied to evidence strength.

Cited by 199 publications

References 46 publications

New concepts in the management of restless legs syndrome

New concepts in the management of restless legs syndrome

Uyku Bozuklukları: Sınıflama ve Tedavi

Nerve Decompression and Restless Legs Syndrome: A Retrospective Analysis

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