Restless Legs Syndrome and Periodic Leg Movements in Sleep - Diagnosis and Treatment

Overview

The restless legs syndrome (RLS) and periodic leg movements in sleep (PLMS) occur frequently concurrently and are conditioned by a similar pathophysiology were insufficiency of dopaminergic transmission dominates. Both these conditions have a high prevalence: RLS - 15% in the whole population and PLMS in advanced age groups as high as 45%. RLS is diagnosed from the case-history - the symptoms affect most frequently the lower extremities. The minimal criteria of RLS are: compulsive movement associated with paraesthesias/dysaesthesias, motor unrest, deterioration of symptoms in the evening and during the night and relief during movement. RLS frequently interferes with falling asleep and nocturnal sleep. PLMS occur during NREM sleep, interferes with its architecture and lead to the sensation of non-refreshing sleep. Movements (in the great majority elevation of the great toe) occur repeatedly, most frequently after 20-30 sec. PLMS can be diagnosed only by all-night recording. Treatment of RLS and PLMS is usually successful. L-DOPA, dopamine agonists and clonazepam (the evening dosage) are used as the treatment of the choice.

Key words:
restless legs syndrome - periodic movements - sleep - diagnosis - treatment