REVIEW – March 2007

Restless legs syndrome


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Restless legs syndrome (RLS) is a sensorimotor disorder associated with the circadian cycle, and it is the severest at night and the onset of the sleep period. RLS affects approximately 5–10% of the population. RLS is characterized by paresthesias (abnormal sensations) and motor restlessness occurring most often at the onset of sleep that provokes an urge to move the legs. The syndrome is associated with a number of medical conditions such as uremia, iron deficiency, neuropathy, and chronic neurological diseases (Parkinsons’s disease).
The diagnostic criteria for RLS were developed by the International Restless Legs Syndrome Study Group (IRLSSG), and it is measured by the international RLS  Study Group Rating Scale (IRLS). Polysomnographycally, it can be established when the number of periodic limb movements (PLM) per hour of sleep is more than five. The pathophysiology of RLS is unclear, but present research suggests that the reasons could be dysregulation of dopamine function and abnormal brain iron metabolism. The familial cases of RLS suggest a genetic predisposition.
Dopamine agonists represent the first-line therapy. Other drugs that may help control symptoms include gabapentin, opioids, and clonazepam. The paper is illustrated by three RLS cases that include the history of the illness, polysomnograms, and treatment.