Drug Treatment Available for Patients With Severe Restless Legs Syndrome

Two Forms of the Disease

Despite its exact cause(s) being unknown, RLS has been classified under 2 forms: idiopathic and symptomatic (secondary).^[1]

Most patients have idiopathic disease which is familial in up to 75% of cases (more than 50% have a positive family history that suggests an autosomal dominant inheritance pattern).^[1,3,6] No abnormalities are found on neurological examination in these patients.^[3]

The most important symptomatic form of RLS is that caused by uraemia. Prevalence ranges from 20 to 40% in patients with end-stage renal disease.^[7] In these patients, RLS is known to be associated with the uraemia itself and not to be an adverse effect of haemodialysis.^[1] RLS may also be an early manifestation of iron deficiency, although the mechanism involved is not known.^[8] RLS is seen in 12 to 20% of pregnant women.^[1]

Other causes are as follows:

• peripheral neuropathy [e.g. associated with diabetes mellitus or alcohol (ethanol) toxicity]

• lumbosacral radiculopathy

• hypothyroidism

• hyperthyroidism

• rheumatoid arthritis

• folic acid deficiency

• porphyria.

The last 5 causes listed have been associated only rarely with RLS. In addition, all dopamine D2 receptor blocking drugs (e.g. classical antipsychotic agents, sulpiride and metoclopramide) can evoke RLS, and there are case reports of the condition in patients receiving lithium.^[1]

© 2000 Adis Data Information BV

Cite this: Drug Treatment Available for Patients With Severe Restless Legs Syndrome - Medscape - Jun 19, 2000.