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Restless Legs Syndrome and Sleep-Related Movement Disorders

Trotti, Lynn Marie MD, MSc

doi: 10.1212/CON.0000000000000488
Review Articles

ABSTRACT Purpose of Review: This article provides an update on six sleep-related movement disorders: restless legs syndrome (RLS), periodic limb movement disorder, sleep-related leg cramps, bruxism, rhythmic movement disorder, and propriospinal myoclonus, with an emphasis on RLS.

Recent Findings: RLS is a common sensorimotor disorder that impairs quality of life. RLS is frequently comorbid to neurologic, psychiatric, vascular, and inflammatory diseases. Accumulating evidence implicates the pathophysiology of RLS as a state of dopamine dysfunction and iron deficiency that occurs on a background of genetic susceptibility conferred by 6 gene polymorphisms. Multiple treatments approved by the US Food and Drug Administration (FDA) are available. Dopamine agonists and α2δ calcium channel ligands are considered first-line treatments, but these treatments have very different side effect profiles that should be taken into consideration.

Summary: Sleep-related movement disorders are frequently encountered in clinical practice. For some disorders, particularly RLS and periodic limb movement disorder, our understanding of biology, epidemiology, and treatment is advanced. For others, much work is needed to determine optimal treatment strategies.

Address correspondence to Dr Lynn Marie Trotti, 12 Executive Park Dr NE, Atlanta, GA 30329, Lbecke2@emory.edu.

Relationship Disclosure: Dr Trotti serves on the editorial board of the Journal of Clinical Sleep Medicine and has received personal compensation as a speaker for the American Academy of Neurology, Associated Professional Sleep Societies, Movement Disorder Society, New Jersey Sleep Society, New York University, Ohio State University, and Southern Sleep Society. Dr Trotti has received research/grant support from the National Institute of Neurological Disorders and Stroke and the National Institutes of Health (K23 NS083748).

Unlabeled Use of Products/Investigational Use Disclosure: Dr Trotti discusses the unlabeled/investigational use of benzodiazepines, botulinum toxin, clonazepam, and clonidine for the treatment of bruxism; of clonazepam for the treatment of hypnic myoclonus and rhythmic movement disorder; of carbamazepine, carisoprodol, diltiazem, gabapentin, lamotrigine, magnesium, oxcarbazepine, quinine, and verapamil for the treatment of leg cramps; of clonazepam and topiramate for the treatment of propriospinal myoclonus; and of gabapentin, iron (including ferric carboxymaltose), opioids, and pregabalin for the treatment of restless legs syndrome.

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© 2017 American Academy of Neurology
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