[Pathophysiology of restless leg syndrome and periodic leg movement disorder in view of the latest research findings].
Both restless leg syndrome and periodic leg movement disorder have been classified as primary sleep disorders by the International Classification of Sleep Disorders. Considering the characteristic clinical symptoms, it is supposed that their pathomechanism involves the peripheral and central stimulus-processing mechanisms of the nervous system as well as several elements of the motor system. During the last couple of years many new elements of the pathomechanism have been discovered, in particular the dysfunction of the postsynaptic dopamine receptors related to the iron metabolism of the central nervous system, the role of opiate receptors, and the involvement of subclinical small fiber neuropathy. Many of these findings have been incorporated into the diagnostic and treatment protocols used in the management of patients with restless leg syndrome or periodic leg movement disorder. Considering the rapidly increasing number of publications on their pathomechanism and the various fields it involves, the authors found it necessary to evaluate these data and to interpret their relationships within the frame of sleep-wake regulation.
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Péter
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Magyar Honvédség Központi Honvédkórház, Neurológial Osztály, Alvásdiagnosztikai és Terápiás Központ, Budapest. koves@axelero.net
Szakács
Zoltán
Z
D002490:Central Nervous System / Q000378:metabolism*; D018491:Dopamine Agonists / Q000627:therapeutic use; D018682:GABA Agents / Q000627:therapeutic use; D006801:Humans; D007501:Iron / Q000378:metabolism; D009069:Movement Disorders / Q000503:physiopathology; D017933:Peripheral Nervous System / Q000503:physiopathology; D011954:Receptors, Dopamine / Q000378:metabolism; D018079:Receptors, GABA / Q000187:drug effects / Q000378:metabolism; D012148:Restless Legs Syndrome / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology / Q000378:metabolism / Q000503:physiopathology*; D012890:Sleep; D014851:Wakefulness
D018491:Dopamine Agonists; D018682:GABA Agents; D011954:Receptors, Dopamine; D018079:Receptors, GABA; D007501:Iron