Restless legs syndrome

Abstract

Restless legs syndrome (RLS) is a common neurological sensory-motor disorder that is characterized by intense restlessness and unpleasant creeping sensations deep inside the lower legs. Symptoms appear when the legs are at rest and are worst in the evening and at night. They force patients to keep moving their legs, and often to get out of bed and wander about. Periodic limb movements (PLMS) are also common during sleep amongst those suffering from RLS, and sleep efficiency is severely reduced. There are idiopathic as well as symptomatic forms of RLS, the latter being associated with e.g. pregnancy, iron deficiency and chronic renal failure. A family history of RLS is very common and pedigrees in these cases suggest an autosomal-dominant transmission with high penetrance. Genetic investigations have been performed in order to identify genes associated with RLS. Several loci have been found (on chromosomes 12q, 14q, 9p, 2q, 20p and 16p). Pathophysiology of RLS remains incompletely understood. However, advanced brain imaging studies and positive results of dopaminergic treatment suggest that RLS may be generated by dopamine dysfunction locally within the central nervous system. At present, there is a wide range of treatment options including levodopa, dopamine agonists, opioids, benzodiazepines, antiepileptic drugs and iron supplements.

A randomized, double-blind, placebo-controlled trial of intravenous iron sucrose in restless legs syndrome

“…Several case series have indicated that RLS patients with anemia or low serum ferritin may benefit from iron treatment [8][9][10]. This study excluded subjects who were anemic and included subjects with a broad range of ferritin values.…”

“…In patients with RLS symptoms and a peripheral iron deficiency, treatment with oral iron will improve, or in some cases eliminate the RLS symptoms [8][9][10]. What is less clear is whether or not increasing the peripheral iron load in patients, who have otherwise "normal" serum iron values, will improve RLS symptoms and change iron in the brain.…”

Plasma iron levels appraised 15 days after spinal cord injury in a limb movement animal model

“…Similar to this SCI animal model, a decreased sleep efficiency, an increase in the number of arousals and in the presence of PLMs have been reported in clinical situations. 9 Iron concentration is another factor associated with SCI and PLM. Liu et al 10 analyzed the total concentrations of iron, protein carriers and low-weight iron in rats with SCI between the T3 and L1 vertebrae.…”

Prevalence of Willis-Ekbom Disease/Restless Legs Syndrome During Pregnancy: A Review

“…Six studies had participants who completed self-administered questionnaires [17][18][19][20][25][26][27], another seven conducted face to face interviews [16, 21-24, 26, 29, 31], and three studies did not specify how data was collected [28,30,31].…”

“…This yielded 131 articles in Pub Med. Of these, 16 were peer-reviewed articles specifically dealing with the prevalence of WED/RLS during pregnancy and were written in the English language; these 16 articles, spanning 1945 -2012, were included in this review ( Table 1) [16][17][18][19][20][21][22][23][24][25][26][27][28][29][30][31].…”