Sleep-related movement disorders.

Abstract

PURPOSE OF REVIEW:

This article reviews the sleep-related movement disorders, including restless legs syndrome (RLS; Willis-Ekbom disease), periodic limb movement disorder, rhythmic movement disorders, sleep-related bruxism, and sleep-related leg cramps.

RECENT FINDINGS:

The prevalence of clinically significant RLS is 1.5% to 3.0%. The pathophysiology of RLS may involve abnormal iron transport across the blood-brain barrier and down-regulation of putaminal D2 receptors. The availability of the rotigotine patch provides an additional form of dopaminergic therapy for RLS. Calcium channel alpha-2-delta ligands (gabapentin, gabapentin enacarbil, and pregabalin) provide alternative therapies for RLS especially in patients with augmentation, impulse control disorders, or hypersomnia induced by dopamine agonists. Long-term use of opioid medication is safe and effective for refractory cases of RLS.

SUMMARY:

RLS is a common disorder causing considerable morbidity. Accurate diagnosis and appropriate investigations are essential. Many effective therapies are available, but the side effects of each class of medication should be considered in determining optimal treatment. Periodic limb movements of sleep, bruxism, and rhythmic movement disorders are sleep-related phenomena often accompanying other sleep disorders and only sometimes requiring primary therapy. Sleep-related leg cramps are generally idiopathic. Management is challenging with few effective therapies.

• Authors: Michael H Silber
• Journal: Continuum (Minneapolis, Minn.) (Continuum (Minneap Minn)) Vol. 19 Issue 1 Sleep Disorders Pg. 170-84 (Feb 2013) ISSN: 1538-6899 [Electronic] United States
• PMID: 23385700 (Publication Type: Case Reports, Journal Article, Review, Video-Audio Media)

Chemical References

• Calcium Channel Blockers
• Receptors, Dopamine D2

Topics

• Aged
• Calcium Channel Blockers (therapeutic use)
• Female
• Humans
• Male
• Middle Aged
• Movement Disorders (complications, drug therapy, metabolism)
• Nocturnal Myoclonus Syndrome
• Receptors, Dopamine D2 (metabolism)
• Restless Legs Syndrome
• Sleep Bruxism
• Sleep Wake Disorders (complications, drug therapy, metabolism)
• Sleep-Wake Transition Disorders