Movement disorders: a sleep specialist's perspective.
This review focuses on restless legs syndrome (RLS) and Parkinson's disease (PD). These conditions are frequently encountered in clinical sleep medicine and are among the most important of the "nonapnea" sleep disorders. RLS and PD share many features, including derangement of central dopaminergic systems as the putative cause, akathisia, and nocturnal motor fluctuations. In addition, both conditions increase in prevalence with aging, exhibit a beneficial response to dopaminergic therapy, and cause marked sleep disturbances. They frequently overlap, with about 20% of patients with PD having symptoms of RLS. Both conditions appear to have a genetic predisposition that is "turned on" by environmental factors. Adverse responses to levodopa occur in both RLS and PD, manifested as rebound and augmentation in RLS and as fluctuations in motor response and dyskinesias in PD. Newer dopaminergic agents are helpful in the management of both conditions.
Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, University of Kentucky College of Medicine, Lexington, KY 40536-00847, USA.
Barbara
B
Phillips
D000316:Adrenergic alpha-Agonists / Q000627:therapeutic use; D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use; D000927:Anticonvulsants / Q000627:therapeutic use; D001569:Benzodiazepines / Q000627:therapeutic use; D015259:Dopamine Agents / Q000627:therapeutic use; D006801:Humans; D009069:Movement Disorders / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy*; D009294:Narcotics / Q000627:therapeutic use; D010300:Parkinson Disease / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy*; D012148:Restless Legs Syndrome / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy*; D012307:Risk Factors; D012893:Sleep Wake Disorders / Q000209:etiology
D000316:Adrenergic alpha-Agonists; D000319:Adrenergic beta-Antagonists; D000927:Anticonvulsants; D015259:Dopamine Agents; D009294:Narcotics; D001569:Benzodiazepines