An update on restless legs syndrome (Willis-Ekbom disease): clinical features, pathogenesis and treatment

作者：Garcia Borreguero Diego^*; Williams Anne Marie

来源：Current Opinion in Neurology, 2014, 27(4): 493-501.

DOI：10.1097/WCO.0000000000000117

• diagnosis and clinical features
• pathophysiology
• restless legs syndrome (Willis-Ekbom disease)
• treatment guidelines

Purpose of review
In recent years, there have been a number of advances in the field of restless legs syndrome (RLS) or Willis-Ekbom disease (WED). Here, we review recent studies pertaining to the diagnosis and clinical features, pathogenesis, and treatment of RLS/WED.
Recent findings
Recent studies have added a temporal dimension to RLS/WED epidemiology by examining both the incidence and persistence rates in different populations. Diagnostic criteria have been modified to increase sensitivity, and new guidelines take into account recently published studies of different drug classes.
Summary
Recent epidemiological findings have shown that RLS/WED is a common neurological disorder that affects up to 5% of the adult population in Western countries. In moderate and severe cases, RLS/WED has a strong impact on sleep and quality of life and can involve an increased cardiovascular risk. Diagnosis is made clinically by confirming the presence of the five essential criteria. However, in difficult cases objective tests such as the multiple suggested immobilization test (m-SIT) can be used. The pathophysiology is partially known, with several risk polymorphisms (BTBD-9 (BTB (POZ) domain containing 9), MEIS-1 (Meis homeobox 1), protein tyrosine phosphatase, receptor type, D, and others) playing an important role, along with dopaminergic and iron dysfunctions. The disorder frequently requires long-term treatment with low-dose dopamine agonists or alpha 2 delta ligands. Dopamine agonists are usually effective but the main complication, RLS/WED augmentation, can arise.

• 出版日期2014-8