Restless Legs Syndrome: Diagnosis and Treatment

by Ondo; William G.

• ISBN13: 9780849336140
• ISBN10: 0849336147
• Edition: 1st
• Format: Hardcover
• Copyright: 2006-10-04
• Publisher: CRC Press

Summary

The most authoritative and comprehensive guide on RLS to date, this expertly written source examines the pathogenesis, diagnosis, and treatment of a condition affecting nearly 10% of the population. Ranging from basic science to therapeutics, Restless Legs Syndrome analyzes the many new and emerging medications impacting the management of this disorder and strives to address the explosion of research in the field.

Table of Contents

Preface	v
Contributors	xvii
Section I: Basic Science
Overview of Sleep	1	(14)
Allison V. Chan
Clete A. Kushida
Introduction	1	(1)
Normal Sleep Architecture and Sleep Stages	1	(2)
Ontogeny of Sleep	3	(1)
Adequate Sleep	3	(1)
Sleep Deprivation	4	(1)
Phylogeny of Sleep	5	(1)
Physiological Determinants of Sleep	5	(3)
Biochemical Determinants of Sleep	8	(1)
Sleep Disorders Classification	8	(2)
Summary	10	(1)
References	10	(5)
The Brain's Dopamine Systems and Their Relevance to Restless Legs Syndrome	15	(16)
Alon A. Freeman
David B. Rye
Synthesis and Metabolism of Dopamine	15	(3)
Physiological Effects of Dopamine (Cellular and Subcellular)	18	(1)
Functional Anatomy of Central Dopamine Systems	19	(3)
Circadian and Homeostatic Influences upon Central Dopamine Signaling	22	(1)
Summary: Dopamine in ``State'' Control and Its Relevance to Restless Legs Syndrome/Periodic Limb Movements	23	(2)
References	25	(6)
Circadian Physiology	31	(18)
Mauro Manconi
Luigi Ferini-Strambi
Introduction	31	(1)
Entrainment Effect of Light-Dark Alternation	31	(1)
Suprachiasmatic Nucleus	32	(2)
Melatonin	34	(3)
Circadian and Homeostatic Control of Sleep	37	(1)
Circadian Pattern of Restless Legs Syndrome/Periodic Limb Movements	38	(4)
References	42	(7)
Systemic Iron Regulation	49	(12)
John Beard
Introduction	49	(1)
Regulation of Absorption	50	(3)
Control of Central Nervous System Iron	53	(1)
Iron Losses	54	(4)
References	58	(3)
The Physiology of Restless Legs Syndrome	61	(28)
Stephany Fulda
Thomas-Christian Wetter
Introduction	61	(2)
Pathophysiology of Restless Legs Syndrome	63	(1)
What is the Role of Peripheral Neuropathy in Restless Legs Syndrome?	64	(1)
The Vascular Hypothesis---Exotic but Persisting?	65	(1)
The Spinal Cord	66	(2)
The Brain	68	(4)
Other Systems Relevant to Restless Legs Syndrome	72	(4)
Concluding Remarks	76	(2)
References	78	(11)
Progress in the Animal Models of Restless Legs Syndrome	89	(12)
Weidong Le
Hongru Zhao
William G. Ondo
Introduction	89	(1)
6-Hydroxydopamine--Lesioned Rat Model	89	(1)
6-OHDA-Lesioned and Iron-Deficient Mice	90	(3)
Dopamine D3 Receptor Knockout (D3KO) Mice Model	93	(2)
An Animal Model of Periodic Limb Movements of Sleep	95	(2)
Animal Models of Opioid Dopaminergic Interactions	97	(1)
References	97	(4)
Pathology of Restless Legs Syndrome	101	(10)
James R. Connor
Xinsheng Wang
Introduction	101	(1)
Neuropathological Evaluation	101	(2)
Iron Management Proteins	103	(2)
Proposed Consequences of Insufficient Iron in the Restless Legs Syndrome Substantia Nigra	105	(1)
Conclusion	106	(1)
References	107	(4)
Genetics of Restless Legs Syndrome	111	(14)
Shaoqi Rao
Juliane Winkelmann
Qing K. Wang
Overview	111	(1)
Prevalence and Environmental Factors	111	(1)
Family History	112	(2)
Inheritance Models and Segregation Analysis	114	(1)
Familial Aggregation Analysis	114	(3)
Twin Studies	117	(1)
Linkage Studies	118	(2)
Genetic Association Studies	120	(1)
Conclusion and Outlook	121	(1)
References	121	(4)
Section II: Clinical Diagnosis
Consequences of Sleep Deprivation	125	(14)
Li Ling Lim
Nancy Foldvary-Schacfer
Introduction	125	(1)
Human Experimental Sleep Deprivation	126	(6)
Animal Sleep Deprivation Studies	132	(1)
Conclusions	133	(1)
References	133	(6)
History of Restless Legs Syndrome	139	(8)
Wayne A. Hening
Early Descriptions of Conditions Resembling Restless Legs Syndrome	139	(1)
The Work of Karl Ekbom	140	(1)
The Naming of Restless Legs	140	(1)
Nocturnal Myoclonus, Now Called Periodic Limb Movements	140	(1)
Early Therapeutic Trials of RLS	141	(1)
The RLS Foundation and the International RLS Study Group	141	(1)
Recent Development on Many Fronts	142	(1)
Summary Thoughts	143	(1)
References	144	(3)
Restless Legs Syndrome: Diagnostic Criteria and Differential Diagnosis	147	(12)
Shahul Hameed
E. K. Tan
Introduction	147	(1)
Diagnostic Criteria	147	(6)
Differential Diagnosis	153	(2)
Evaluation of the Restless Legs Syndrome Patient	155	(1)
Conclusions	156	(1)
References	156	(3)
Occurrence of Restless Legs Syndrome	159	(12)
Jan Ulfberg
Bjorn Bjorvatn
Introduction	159	(1)
The Occurrence of Restless Legs Syndrome---Studies on Populations	160	(2)
Restless Legs Syndrome in Pregnancy	162	(3)
Restless Legs Syndrome and Parkinson's Disease	165	(1)
Restless Legs Syndrome in End-Stage Renal Disease	166	(1)
References	167	(4)
Childhood-Onset Restless Legs Syndrome	171	(8)
Suresh Kotagal
Michael H. Silber
History	171	(1)
Clinical Features	171	(1)
Pathogenesis	172	(3)
Diagnosis	175	(1)
Treatment	175	(2)
Future Directions	177	(1)
References	177	(2)
Periodic Limb Movements and Periodic Limb Movement Disorder	179	(20)
Margaret Park
Cynthia L. Comella
Introduction	179	(3)
Epidemiology of Periodic Limb Movements Disorder	182	(1)
Associated Diseases States	183	(3)
Pathophysiology	186	(2)
Imaging Studies	188	(1)
Treatment	189	(2)
References	191	(8)
Restless Legs Syndrome Effects on Quality of Life	199	(6)
Richard P. Allen
Introduction	199	(1)
Disease-Specific Quality of Life Evaluations of RLS	199	(1)
General Health-Related Quality of Life Evaluations	200	(1)
Treatment Benefits for Quality of Life	201	(1)
Summary	202	(1)
References	202	(3)
Restless Legs Syndrome: Personal Perspectives	205	(6)
Georgianna Bell
The Faces of Restless Legs Syndrome	205	(1)
The RLS Foundation	205	(1)
Marlene's Story: ``Good Physicians Make All the Difference''	206	(1)
Lynne's Story: ``I Want to Live with Them, Not Them Live Around Me''	206	(1)
Clare's Story: ``I Found a Way of Shutting It All Out''	207	(1)
Mike's Story: ``Sleep Deprivation and Work Are an Incompatible Combination''	208	(1)
Sue's Story: ``I Want Better for Them''	208	(1)
Jocelle's Story: ``Never Give Up!''	209	(2)
Section III: Secondary Restless Legs Syndrome
Iron Deficiency---Associated Restless Legs Syndrome	211	(8)
William G. Ondo
Introduction	211	(1)
Central Nervous System Iron Deficiency in RLS	211	(2)
Clinical Experience	213	(1)
Iron Deficiency and Other Associations of Restless Legs Syndrome	214	(1)
Iron Replacement	215	(1)
References	216	(3)
Restless Legs Syndrome and Renal Failure	219	(10)
Kai Ming Chow
David Shu Cheong Hui
Introduction	219	(1)
Epidemiology	219	(2)
Pathogenesis	221	(1)
Diagnosis	222	(2)
Treatment	224	(1)
Prognosis	225	(1)
Summary	226	(1)
References	226	(3)
Restless Legs Syndrome and Neuropathy/Myelopathy	229	(10)
Birgit Hogl
Werner Poewe
Introduction	229	(1)
Polyneuropathy, Radiculopathy, and Peripheral Nerve Lesions	229	(5)
Possible Interpretations of the Evidence	234	(1)
References	235	(4)
Restless Legs Syndrome in Pregnancy	239	(8)
Luigi Ferini-Strambi
Mauro Manconi
Introduction	239	(1)
Epidemiology	240	(1)
Clinical Course	241	(1)
Etiopathogenetic Hypotheses	242	(2)
Treatment	244	(1)
References	245	(2)
Restless Legs Syndrome and Parkinson's Disease	247	(8)
Vandana Dhawan
K. Ray Chaudhuri
Background	247	(1)
Pathophysiology	247	(2)
Clinical Surveys	249	(2)
Conclusions	251	(1)
References	252	(3)
Iatrogenic Restless Legs Syndrome	255	(14)
Changkook Yang
John W. Winkelman
Introduction	255	(1)
Antidepressants	256	(2)
Antipsychotics	258	(2)
Histamine-Receptor Antagonists	260	(1)
Lithium	261	(1)
Antiepileptics	261	(1)
Smoking	261	(1)
Caffeine	262	(1)
Alcohol	262	(1)
Miscellaneous	262	(1)
Augmentation	263	(1)
Conclusion	263	(1)
References	264	(5)
Other Restless Legs Syndrome Associations	269	(6)
Irfan Lalani
William G. Ondo
Introduction	269	(1)
Rheumatological Disorders	269	(1)
Ataxia	270	(1)
Tremor	271	(1)
Tourette's Syndrome	271	(1)
Multiple Sclerosis	272	(1)
Sleep Apnea	272	(1)
Miscellaneous Associations	273	(1)
Conclusion	273	(1)
References	273	(2)
Section IV: Treatment of Restless Legs Syndrome
Treatment Overview	275	(12)
William G. Ondo
Scales for Restless Legs Syndrome	275	(3)
Treatment Overview	278	(2)
References	280	(2)
Appendix A	282	(2)
Appendix B	284	(1)
Appendix C	285	(2)
Dopaminergic Therapy for Restless Legs Syndrome	287	(18)
Philip M. Becker
Introduction	287	(1)
Proposed Therapeutic Action	287	(1)
Pharmacology of Common Dopaminergic Agents	288	(9)
Investigational Dopamine Agonists	297	(1)
Augmentation Due to Dopaminergic Therapy	298	(1)
Conclusion	299	(1)
References	300	(5)
Dopaminergic Augmentation	305	(10)
Diego Garcia-Borreguero
Oscar Larrosa
Renata Egatz
Belen Cabrero
Patrick Troster
Introduction	305	(1)
Clinical Description and Significance	305	(2)
Augumentation Under Dopaminergic Agents	307	(1)
Augmentation Under Nondopaminergic Agents	307	(1)
The Pathophysiology of Augmentation	307	(2)
Measurement of Augmentation	309	(1)
Differential Diagnosis of Augmentation	310	(2)
Treatment of Augmentation	312	(1)
References	312	(3)
Opioids and the Restless Legs Syndrome: Treatment and Pathogenetic Considerations	315	(10)
Arthur S. Walters
Introduction	315	(1)
Therapeutic Trials of Opioids in Restless Legs Syndrome/Periodic Limb Movements	315	(2)
Overall Therapeutic Recommendations	317	(1)
Role of the Endogenous Opiate System in the Pathogenesis of the Restless Legs Syndrome/Periodic Limb Movements	318	(2)
Implications of the Receptor Blocking Studies	320	(1)
Other Evidence Supporting a Role of the Endogenous Opiate System in the Pathogenesis of Restless Legs Syndrome	320	(2)
References	322	(3)
Iron Therapy in Restless Legs Syndrome	325	(10)
Charlene E. Gamaldo
Christopher J. Earley
Introduction	325	(1)
Oral Iron Therapy	325	(3)
Intravenous Iron Therapy	328	(4)
Follow-up	332	(1)
References	332	(3)
Other Therapies in Restless Legs Syndrome	335	(10)
Joohi Shahed
William G. Ondo
Introduction	335	(1)
Antiepileptics	335	(3)
Clonidine	338	(1)
Benzodiazepines	338	(1)
Other Drugs	339	(1)
Nonpharmacologic Therapies	340	(1)
Conclusions	341	(1)
References	341	(4)
Section V: Future Directions in Restless Legs Syndrome
Future Directions	345	(6)
William G. Ondo
Introduction	345	(1)
Diagnosis	345	(1)
Epidemiology	346	(1)
Disease Associations	347	(1)
Pathology	347	(1)
Treatment	348	(1)
Summary	349	(1)
References	349	(2)
Index	351