Restless legs syndrome: differential diagnosis and management with pramipexole

Francesca Brindani, Francesca Vitetta, Franco GemignaniDepartment of Neurosciences, University of Parma, ItalyAbstract: Restless legs syndrome (RLS) is a condition characterized by discomfort at rest and urge to move focused on the legs. RLS may occur as an idiopathic, often hereditary condition (pr...

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Autores principales:	Francesca Brindani, Francesca Vitetta, Franco Gemignani
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2009
Materias:	Restless leg syndrome - pramipexole - small fiber neuropathy Geriatrics RC952-954.6
Acceso en línea:	https://doaj.org/article/be01782e86414c57ab76b8848ab61c03
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spelling	oai:doaj.org-article:be01782e86414c57ab76b8848ab61c032021-12-02T04:41:48ZRestless legs syndrome: differential diagnosis and management with pramipexole1178-1998https://doaj.org/article/be01782e86414c57ab76b8848ab61c032009-06-01T00:00:00Zhttps://www.dovepress.com/restless-legs-syndrome-differential-diagnosis-and-management-with-pram-peer-reviewed-article-CIAhttps://doaj.org/toc/1178-1998Francesca Brindani, Francesca Vitetta, Franco GemignaniDepartment of Neurosciences, University of Parma, ItalyAbstract: Restless legs syndrome (RLS) is a condition characterized by discomfort at rest and urge to move focused on the legs. RLS may occur as an idiopathic, often hereditary condition (primary RLS), or in association with medical conditions (secondary RLS) including iron deficiency, uremia, and polyneuropathy. Current understanding of the pathophysiology of RLS points to the involvement of three interrelated components: dopaminergic dysfunction, impaired iron homeostasis, and genetic mechanisms. The diagnosis of RLS is made according to the consensus criteria by a National Institutes of Health panel: 1) an urge to move the legs, usually accompanied by uncomfortable sensations; 2) beginning or worsening during rest; 3) relieved by movement; and 4) worse, or only occurring, in the evening or at night. The differential diagnosis of RLS aims to: 1) distinguish RLS from other disorders with RLS-like symptoms and 2) identify secondary forms, with investigation of underlying diseases. The treatment of RLS demands a clinical evaluation to rule out and cure causes of secondary RLS, including iron supplementation when deficient, and to eliminate the triggering factors. The presence of neuropathy should be especially investigated in nonhereditary, late-onset RLS, in view of a possible treatment of the underlying disease. The first line treatment for idiopathic RLS is represented by dopamine agonists, in particular nonergot-derived ropinirole and pramipexole, whereas ergot dopamine agonists (cabergoline and pergolide) are no longer in first-line use given the risks of cardiac valvulopathy. Although no comparative trials have been published, a meta-analysis of pramipexole versus ropinirole suggests differences in efficacy and tolerability favoring pramipexole.Keywords: restless legs syndrome, pramipexole, dopamine, agonists, small fiber neuropathyFrancesca BrindaniFrancesca VitettaFranco GemignaniDove Medical PressarticleRestless leg syndrome - pramipexole - small fiber neuropathyGeriatricsRC952-954.6ENClinical Interventions in Aging, Vol Volume 4, Pp 305-313 (2009)
institution	DOAJ
collection	DOAJ
language	EN
topic	Restless leg syndrome - pramipexole - small fiber neuropathy Geriatrics RC952-954.6
spellingShingle	Restless leg syndrome - pramipexole - small fiber neuropathy Geriatrics RC952-954.6 Francesca Brindani Francesca Vitetta Franco Gemignani Restless legs syndrome: differential diagnosis and management with pramipexole
description	Francesca Brindani, Francesca Vitetta, Franco GemignaniDepartment of Neurosciences, University of Parma, ItalyAbstract: Restless legs syndrome (RLS) is a condition characterized by discomfort at rest and urge to move focused on the legs. RLS may occur as an idiopathic, often hereditary condition (primary RLS), or in association with medical conditions (secondary RLS) including iron deficiency, uremia, and polyneuropathy. Current understanding of the pathophysiology of RLS points to the involvement of three interrelated components: dopaminergic dysfunction, impaired iron homeostasis, and genetic mechanisms. The diagnosis of RLS is made according to the consensus criteria by a National Institutes of Health panel: 1) an urge to move the legs, usually accompanied by uncomfortable sensations; 2) beginning or worsening during rest; 3) relieved by movement; and 4) worse, or only occurring, in the evening or at night. The differential diagnosis of RLS aims to: 1) distinguish RLS from other disorders with RLS-like symptoms and 2) identify secondary forms, with investigation of underlying diseases. The treatment of RLS demands a clinical evaluation to rule out and cure causes of secondary RLS, including iron supplementation when deficient, and to eliminate the triggering factors. The presence of neuropathy should be especially investigated in nonhereditary, late-onset RLS, in view of a possible treatment of the underlying disease. The first line treatment for idiopathic RLS is represented by dopamine agonists, in particular nonergot-derived ropinirole and pramipexole, whereas ergot dopamine agonists (cabergoline and pergolide) are no longer in first-line use given the risks of cardiac valvulopathy. Although no comparative trials have been published, a meta-analysis of pramipexole versus ropinirole suggests differences in efficacy and tolerability favoring pramipexole.Keywords: restless legs syndrome, pramipexole, dopamine, agonists, small fiber neuropathy
format	article
author	Francesca Brindani Francesca Vitetta Franco Gemignani
author_facet	Francesca Brindani Francesca Vitetta Franco Gemignani
author_sort	Francesca Brindani
title	Restless legs syndrome: differential diagnosis and management with pramipexole
title_short	Restless legs syndrome: differential diagnosis and management with pramipexole
title_full	Restless legs syndrome: differential diagnosis and management with pramipexole
title_fullStr	Restless legs syndrome: differential diagnosis and management with pramipexole
title_full_unstemmed	Restless legs syndrome: differential diagnosis and management with pramipexole
title_sort	restless legs syndrome: differential diagnosis and management with pramipexole
publisher	Dove Medical Press
publishDate	2009
url	https://doaj.org/article/be01782e86414c57ab76b8848ab61c03
work_keys_str_mv	AT francescabrindani restlesslegssyndromedifferentialdiagnosisandmanagementwithpramipexole AT francescavitetta restlesslegssyndromedifferentialdiagnosisandmanagementwithpramipexole AT francogemignani restlesslegssyndromedifferentialdiagnosisandmanagementwithpramipexole
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Restless legs syndrome: differential diagnosis and management with pramipexole

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