Peripheral hypoxia in restless legs syndrome (Willis-Ekbom disease)
Khichar PurnaramShubhakaran, Associate Professor Neurology
Published June 27, 2014
Salminen et al. described the important pathophysiology of restless legs syndrome (RLS). [1] Documented decreased blood and oxygen supply in RLS was reverted with pramipexole. Prevalence of RLS is 2-3% and increases to 10% in elderly. Various co-morbid conditions confound the illness, support vascular theory, and support cumulative effect of co-morbid conditions in RLS. [2]
This study will likely provide answers on the disputed nature of RLS (i.e. a sleep, movement, or pain disorder). [3] A recent study showed superiority of pregabalin in efficacy for treating RLS. Whether pregabalin corrects vascular compromise or acts as a neuropathic pain suppressant is still unclear. [4] The use of pregabalin in later cases should be prohibited except in symptomatic treatment as adverse effects are more common with pregabalin compared to pramipexole(61% vs 52%), especially dizziness and somnolence. Pregabalin enhances sleep while treating RLS, giving favor to RLS as a sleep disorder. [5]
Pregabalin is not USFDA approved for RLS, but guidelines list it as a first-line treatment. RLS response to pregabalin favors some components of channelopathy.
1. Salminen AV, Rimpila V, Polo O. Peripheral Hypoxia in restless leg syndrome(Willis-Ekbom disease). Neurology 2014;82:1856- 1861.
2. Szentkir?lyi A, V?lzke H, Hoffmann W, Trenkwalder, Berger K.
Multi-morbidity and the risk of restless legs syndrome in 2 prospective cohort studies. Neurology 2014;82:2026-2033.
3. Winkelman JW. Is restless leg syndrome a sleep disorder? Neurology 2013;80:2000-2001.
4.Allen RP, Chen C, Garcia Borreguero D, et al. Comparision of pregabalin with pramipexole For restless leg syndrome. N Engl J Med 2014;370:621-631.
5. Aurora RN, Kristo DA, Bista SR, et al. The treatment of restless leg syndrome and periodic limb movement disorder in adults- An update for 2012: Practice parameters with an evidence based systematic review and meta-analysis: An American academy of sleep medicine clinical practice guideline. Sleep 2012;35:1039-1062.
For disclosures, please contact the editorial office at journal@neurology.org.
Salminen et al. described the important pathophysiology of restless legs syndrome (RLS). [1] Documented decreased blood and oxygen supply in RLS was reverted with pramipexole. Prevalence of RLS is 2-3% and increases to 10% in elderly. Various co-morbid conditions confound the illness, support vascular theory, and support cumulative effect of co-morbid conditions in RLS. [2]
This study will likely provide answers on the disputed nature of RLS (i.e. a sleep, movement, or pain disorder). [3] A recent study showed superiority of pregabalin in efficacy for treating RLS. Whether pregabalin corrects vascular compromise or acts as a neuropathic pain suppressant is still unclear. [4] The use of pregabalin in later cases should be prohibited except in symptomatic treatment as adverse effects are more common with pregabalin compared to pramipexole(61% vs 52%), especially dizziness and somnolence. Pregabalin enhances sleep while treating RLS, giving favor to RLS as a sleep disorder. [5]
Pregabalin is not USFDA approved for RLS, but guidelines list it as a first-line treatment. RLS response to pregabalin favors some components of channelopathy.
1. Salminen AV, Rimpila V, Polo O. Peripheral Hypoxia in restless leg syndrome(Willis-Ekbom disease). Neurology 2014;82:1856- 1861.
2. Szentkir?lyi A, V?lzke H, Hoffmann W, Trenkwalder, Berger K. Multi-morbidity and the risk of restless legs syndrome in 2 prospective cohort studies. Neurology 2014;82:2026-2033.
3. Winkelman JW. Is restless leg syndrome a sleep disorder? Neurology 2013;80:2000-2001.
4.Allen RP, Chen C, Garcia Borreguero D, et al. Comparision of pregabalin with pramipexole For restless leg syndrome. N Engl J Med 2014;370:621-631.
5. Aurora RN, Kristo DA, Bista SR, et al. The treatment of restless leg syndrome and periodic limb movement disorder in adults- An update for 2012: Practice parameters with an evidence based systematic review and meta-analysis: An American academy of sleep medicine clinical practice guideline. Sleep 2012;35:1039-1062.
For disclosures, please contact the editorial office at journal@neurology.org.