Limits...
Restless leg syndrome: a neglected diagnosis.

Einollahi B, Izadianmehr N - Nephrourol Mon (2014)

Bottom Line: This neurologic condition is associated with increased risk of nocturnal hypertension as well as cardiovascular events and affects patient's sleep, which leads to anxiety, depression, and decreases quality of life.Presence of RLS in patients on hemodialysis is associated with higher mortality rate.The most important factor in diagnosis is physician's attention and clinical experience with this condition and using IRLSSG.

View Article: PubMed Central - PubMed

Affiliation: Nephrology and Urology Research Center, Baqiyatallah University of Medical Sciences, Tehran, IR Iran.

ABSTRACT

Context: Restless legs syndrome (RLS) is an irresistible urge to move legs that usually occur during inactivity and at night. This neurologic condition is associated with increased risk of nocturnal hypertension as well as cardiovascular events and affects patient's sleep, which leads to anxiety, depression, and decreases quality of life. Presence of RLS in patients on hemodialysis is associated with higher mortality rate. Most of the times, patients have indescribable symptoms. The aim of this review was to provide physicians with information to be aware and turn their attention to the patient's symptoms, which are the most important clue to diagnosis of RLS.

Evidence acquisition: For data extraction, we reviewed PubMed, Scopus, Google scholar, the Cochrane collaboration, and Up to Date databases with the keywords of restless legs syndrome, sleep disorders, and end-stage renal disease (ESRD). The most recent review articles, clinical trials, and cross-sectional studies with large sample sizes that had used International RLS Study Group criteria (IRLSSG) and had focused on demographic characteristics and renal function were included. This situation has described in primary and secondary forms. The former usually occurs in younger patients and seems to have genetic tendencies and the latter is due to the iron deficiency state, pregnancy, and ESRD.

Results: Two major theories are developed regarding the pathophysiology of RLS. The first one concerns central nervous system dopamine imbalance and the second one concerns intracellular iron dysregulation. The most common used pharmacologic agents in treatment of RLS are dopamine agonists. Other used therapeutic agents include levodopa, Alpha-2-delta calcium channel ligands, opioids, anticonvulsants, benzodiazepines, clonidine, iron therapy in low levels of serum ferritin, and nonpharmacologic therapies.

Conclusions: The most important factor in diagnosis is physician's attention and clinical experience with this condition and using IRLSSG.

No MeSH data available.


Related in: MedlinePlus

Diagnosis Flow Chart
© Copyright Policy - open-access
Related In: Results  -  Collection

License
getmorefigures.php?uid=PMC4318015&req=5

fig13129: Diagnosis Flow Chart

Mentions: It is important to note that all four parts are necessary for diagnosis. Sleep disturbances and daytime fatigue could develop in association with RLS. Patients with primary RLS have normal findings in neurologic examination and may experience spontaneous, rhythmic, episodic limb movements in sleep or while awake and at rest (Figure 1).


Restless leg syndrome: a neglected diagnosis.

Einollahi B, Izadianmehr N - Nephrourol Mon (2014)

Diagnosis Flow Chart
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4318015&req=5

fig13129: Diagnosis Flow Chart
Mentions: It is important to note that all four parts are necessary for diagnosis. Sleep disturbances and daytime fatigue could develop in association with RLS. Patients with primary RLS have normal findings in neurologic examination and may experience spontaneous, rhythmic, episodic limb movements in sleep or while awake and at rest (Figure 1).

Bottom Line: This neurologic condition is associated with increased risk of nocturnal hypertension as well as cardiovascular events and affects patient's sleep, which leads to anxiety, depression, and decreases quality of life.Presence of RLS in patients on hemodialysis is associated with higher mortality rate.The most important factor in diagnosis is physician's attention and clinical experience with this condition and using IRLSSG.

View Article: PubMed Central - PubMed

Affiliation: Nephrology and Urology Research Center, Baqiyatallah University of Medical Sciences, Tehran, IR Iran.

ABSTRACT

Context: Restless legs syndrome (RLS) is an irresistible urge to move legs that usually occur during inactivity and at night. This neurologic condition is associated with increased risk of nocturnal hypertension as well as cardiovascular events and affects patient's sleep, which leads to anxiety, depression, and decreases quality of life. Presence of RLS in patients on hemodialysis is associated with higher mortality rate. Most of the times, patients have indescribable symptoms. The aim of this review was to provide physicians with information to be aware and turn their attention to the patient's symptoms, which are the most important clue to diagnosis of RLS.

Evidence acquisition: For data extraction, we reviewed PubMed, Scopus, Google scholar, the Cochrane collaboration, and Up to Date databases with the keywords of restless legs syndrome, sleep disorders, and end-stage renal disease (ESRD). The most recent review articles, clinical trials, and cross-sectional studies with large sample sizes that had used International RLS Study Group criteria (IRLSSG) and had focused on demographic characteristics and renal function were included. This situation has described in primary and secondary forms. The former usually occurs in younger patients and seems to have genetic tendencies and the latter is due to the iron deficiency state, pregnancy, and ESRD.

Results: Two major theories are developed regarding the pathophysiology of RLS. The first one concerns central nervous system dopamine imbalance and the second one concerns intracellular iron dysregulation. The most common used pharmacologic agents in treatment of RLS are dopamine agonists. Other used therapeutic agents include levodopa, Alpha-2-delta calcium channel ligands, opioids, anticonvulsants, benzodiazepines, clonidine, iron therapy in low levels of serum ferritin, and nonpharmacologic therapies.

Conclusions: The most important factor in diagnosis is physician's attention and clinical experience with this condition and using IRLSSG.

No MeSH data available.


Related in: MedlinePlus