Restless legs syndrome

• Published in: Journal of neurology, neurosurgery and psychiatry neurosurgery and psychiatry, 2001-08, Vol.71 (2), p.143-146
• Main Authors: CHAUDHURI, K RAY, APPIAH-KUBI, L S, TRENKWALDER, C
• Format: Article
• Language: English
• Subjects: Age; Analysis; Attention deficit hyperactivity disorder; Demographic aspects; Diabetes; Dopamine; Drug dosages; Family medical history; Humans; Hypotheses; Hypothyroidism; Iron; Metabolism; Narcotics; Older people; Parkinson's disease; Population; Prevalence studies (Epidemiology); Restless Legs Syndrome; Rheumatoid arthritis; Sleep; Studies
• ISSN: 0022-3050; 1468-330X
• DOI: 10.1136/jnnp.71.2.143

A metabolic basis of secondary RLS has been postulated and a common association of RLS is iron deficiency anaemia. 20 Studies of CSF concentrations of ferritin and transferrin in RLS have shown reduced CSF ferritin and increased transferrin concentrations in idiopathic RLS assuming a low brain iron content in RLS. 20 Serum iron concentrations exhibit circadian variation with up to a 50% drop in iron concentration at night when the symptoms of RLS are most obvious. 21 Furthermore, iron is also required as a cofactor for hydroxylation of tyrosine hydroxylase, which is the rate limiting enzyme for dopamine production. 22 Other metabolic correlates may be hypothyroidism 23 and diabetes mellitus. 5 24 Restless legs syndrome has also been reported to occur in up to 25% of patients with primary diagnosis of rheumatoid arthritis and Sjogren's syndrome although the association remains controversial. 25 The issue of coexistence of RLS and Parkinson's disease is controversial and currently being investigated. Open label studies with gabapentin also showed subjective improvement of RLS symptoms between doses of 300 to 2000 mg/day. [...]there seems to be some benefit from antiepileptic drugs, particularly with painful RLS although this may not include improvement of PLMS.