title: Restless legs syndrome: clinical presentation diagnosis and treatment.
abstract: Restless legs syndrome (RLS) is a circadian disorder of sensory-motor integration that may be related to genetically determined dysregulation of iron transport across the blood-brain barrier. Dopamine agonists (DAs) have been considered the first-line therapy, but with the growing appreciation of problems associated with long-term treatment, particularly augmentation and impulse control disorder, alpha-2-delta drugs, such as gabapentin, are now considered the first line of treatment in patients with troublesome RLS. Opioids can be considered as an alternative therapy, particularly in patients with DA-related augmentation. In more severe cases, a combination therapy may be required. Intravenous iron therapy may be considered on those patients with refractory RLS.
authors.affiliation: Parkinson's Disease Center and Movement Disorders Clinic, Baylor College of Medicine, Houston, Texas, USA.
authors.forename: Subhashie
authors.initials: S
authors.lastname: Wijemanne
authors.affiliation: Parkinson's Disease Center and Movement Disorders Clinic, Baylor College of Medicine, Houston, Texas, USA. Electronic address: josephj@bcm.edu.
authors.forename: Joseph
authors.initials: J
authors.lastname: Jankovic
mesh_terms: D000588:Amines / Q000009:adverse effects / Q000627:therapeutic use; D000701:Analgesics, Opioid / Q000009:adverse effects / Q000627:therapeutic use; D052160:Benzothiazoles / Q000009:adverse effects / Q000627:therapeutic use; D003509:Cyclohexanecarboxylic Acids / Q000009:adverse effects / Q000627:therapeutic use; D018491:Dopamine Agonists / Q000009:adverse effects / Q000627:therapeutic use; D000077206:Gabapentin; D006801:Humans; D007211:Indoles / Q000009:adverse effects / Q000627:therapeutic use; D008691:Methadone / Q000009:adverse effects / Q000627:therapeutic use; D000077487:Pramipexole; D012148:Restless Legs Syndrome / Q000175:diagnosis* / Q000188:drug therapy* / Q000209:etiology; D013764:Tetrahydronaphthalenes / Q000009:adverse effects / Q000627:therapeutic use; D013876:Thiophenes / Q000009:adverse effects / Q000627:therapeutic use; D005680:gamma-Aminobutyric Acid / Q000009:adverse effects / Q000627:therapeutic use
chemical_list: D000588:Amines; D000701:Analgesics, Opioid; D052160:Benzothiazoles; D003509:Cyclohexanecarboxylic Acids; D018491:Dopamine Agonists; D007211:Indoles; D013764:Tetrahydronaphthalenes; D013876:Thiophenes; C046649:ropinirole; D005680:gamma-Aminobutyric Acid; D000077206:Gabapentin; D000077487:Pramipexole; C047508:rotigotine; D008691:Methadone
keywords: Augmentation; Dopamine agonist; Gabapentin; Methadone; Pramipexole; Restless legs syndrome; Ropinirole; Rotigotine