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When restless legs syndrome turns malignant.
Sleep Med. 14, 575-577 (2013)
Usually symptoms of restless legs syndrome (RLS) respond well to treatment with dopaminergic drugs, opiates, or anticonvulsant medications. Yet sometimes symptoms can be severe and become refractory, even to high-dose combination therapy. Here we present two cases of familial RLS with rigorous and unusual motor and sensory symptoms in the form of episodes of myoclonic hyperkinesias and painful sensations in addition to more characteristic features of RLS. Stepwise reduction of all RLS-and antidepressant medication down to opiate monotherapy-and subsequent opiate rotation led to an improvement of symptoms. Yet in both cases, reintroduction of low-dose dopaminergic drugs was necessary to achieve satisfactory treatment effect. We have termed this form of RLS refractory to multiple combinations of all classes of commonly used drugs malignant RLS. Therapeutically simplification and reduction of the drug scheme and opiate rotation should be considered in malignant RLS.
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Publication type
Article: Journal article
Document type
Scientific Article
Keywords
Restless legs syndrome; Malignant restless legs syndrome; Paroxysmal myoclonic attacks; Opiate rotation; De-escalation of therapy; Multidrug therapy; DOUBLE-BLIND; AUGMENTATION; TRAMADOL; PLACEBO
Language
english
Publication Year
2013
HGF-reported in Year
2013
ISSN (print) / ISBN
1389-9457
e-ISSN
1878-5506
Journal
Sleep Medicine
Quellenangaben
Volume: 14,
Issue: 6,
Pages: 575-577
Publisher
Elsevier
Reviewing status
Peer reviewed
Institute(s)
Institute of Human Genetics (IHG)
POF-Topic(s)
30501 - Systemic Analysis of Genetic and Environmental Factors that Impact Health
Research field(s)
Genetics and Epidemiology
PSP Element(s)
G-500700-001
PubMed ID
23643657
WOS ID
WOS:000319502300016
Scopus ID
84876815335
Erfassungsdatum
2013-06-28