USMLE Forum Archives - USMLE Step 3 - RESTLESS LEG SYNDROME (RLS)
RESTLESS LEG SYNDROME (RLS)
meduploader - 05-29-09 14:48
Characterized by intense, uncomfortable paresthesias of the legs (often described as a “crawling” or “creeping” sensation) that are relieved by leg movement and are worse at night upon going to bed. Generally idiopathic, but also seen in patients with a wide variety of chronic illnesses (e.g., Parkinson’s, anemia, diabetes, COPD, thyroid disease, connective tissue diseases, neuropathies) and as a side effect of drugs (e.g., caffeine, lithium, calcium channel blockers).
Paresthesias are most severe when the legs are at rest (e.g., while sitting or lying), especially at night as patients try to sleep, and are relieved by continued movement of the legs.
Patients may also have periodic limb movements of sleep (PLMS)—frequent stereotypical movements of the leg.
Neurologic exam is normal unless RLS is related to an underlying neurologic disorder.
TREATMENT
Dopaminergic medications administered before bedtime (e.g., levodopa/carbidopa, pramipexole) are the standard treatment for RLS. Other useful agents include benzodiazepines, narcotics, and gabapentin.
meduploader - 05-29-09 14:48
Characterized by intense, uncomfortable paresthesias of the legs (often described as a “crawling” or “creeping” sensation) that are relieved by leg movement and are worse at night upon going to bed. Generally idiopathic, but also seen in patients with a wide variety of chronic illnesses (e.g., Parkinson’s, anemia, diabetes, COPD, thyroid disease, connective tissue diseases, neuropathies) and as a side effect of drugs (e.g., caffeine, lithium, calcium channel blockers).
Paresthesias are most severe when the legs are at rest (e.g., while sitting or lying), especially at night as patients try to sleep, and are relieved by continued movement of the legs.
Patients may also have periodic limb movements of sleep (PLMS)—frequent stereotypical movements of the leg.
Neurologic exam is normal unless RLS is related to an underlying neurologic disorder.
TREATMENT
Dopaminergic medications administered before bedtime (e.g., levodopa/carbidopa, pramipexole) are the standard treatment for RLS. Other useful agents include benzodiazepines, narcotics, and gabapentin.
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