EFNS guidelines on management of restless legs syndrome and periodic limb movement disorder in sleep

Vignatelli, Luca; Billiard, Michel; Clarenbach, P.; Garcı́a-Borreguero, Diego; Kaynak, Derya; Liesienė, Vanda; Trenkwalder, Claudia; Montagna, Pasquale

doi:10.1111/j.1468-1331.2006.01410.x

Cited by 132 publications

(86 citation statements)

References 227 publications

(75 reference statements)

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“…[918][919][920][921][922][923][924] Lower doses are generally recommended, as they are effective and higher doses increase the risk of augmentation. 925 There is a particular risk of augmentation with levodopa, which may relate to its short half-life.…”

mentioning

confidence: 99%

The scientific and clinical basis for the treatment of Parkinson disease (2009)

Olanow¹,

Stern²,

Sethi³

2009

Neurology

760

658

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Parkinson disease (PD) is an age-related neurodegenerative disorder that affects as many as 1-2% of persons aged 60 years and older. With the aging of the population, the frequency of PD is expected to increase dramatically in the coming decades. Current therapy is largely based on a dopamine replacement strategy, primarily using the dopamine precursor levodopa. However, chronic treatment is associated with the development of motor complications, and the disease is inexorably progressive. Further, advancing disease is associated with the emergence of features such as freezing, falling, and dementia which are not adequately controlled with dopaminergic therapies. Indeed, it is now appreciated that these nondopaminergic features are common and the major source of disability for patients with advanced disease. Many different therapeutic agents and treatment strategies have been evaluated over the past several years to try and address these unmet medical needs, and many promising approaches are currently being tested in the laboratory and in the clinic. As a result, there are now many new therapies and strategic approaches available for the treatment of the different stages of PD, with which the treating physician must be familiar in order to provide patients with optimal care. This monograph provides an overview of the management of PD patients, with an emphasis on pathophysiology, and the results of recent clinical trials. It is intended to provide physicians with an understanding of the different treatment options that are available for managing the different stages of the disease and the scientific rationale of the different approaches. 1 PD is the second most common neurodegenerative disorder, with an average age at onset of about 60 years. An estimated 5 million people throughout the world have PD, with 1 million individuals each in the United States and in Europe with the disorder. PD affects approximately 0.3% of the population and 1% to 2% of those older than 60 years.2 With the aging of the population and the substantial increase in the number of at-risk individuals older than 60 years, it is anticipated that the prevalence of PD will increase dramatically in the coming decades.

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mentioning

confidence: 99%

The scientific and clinical basis for the treatment of Parkinson disease (2009)

Olanow¹,

Stern²,

Sethi³

2009

Neurology

760

658

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“…Son yıllarda pregabalin kullanımı ile alakalı çalış-malarda yapılmaktadır, ancak pregabalinin şu an için uluslararası tedavi kılavuzlarında adı geçmemektedir. [3,4] Önerilen antiepileptik ilaçlar arasında gabapentinin etkinliğini ortaya koyan birçok çalışma olmasına rağmen VPA ve CBZ hakkın-daki çalışmalar sınırlıdır ve geçmiş tarihe dayanmaktadır. Şu ana kadar CBZ hakkında 1983 ve 1984 yıllarında toplam 187 hasta üzerinde yapılmış iki çalışma vardır.…”

Section: Discussionunclassified

“…HBS'nin tedavisi ile ilişki-li olarak 2006 yılında Avrupa Nöroloji Birliği (EFNS) ve 2008 yılında da Hareket Bozukluları Derneği (MDS) tedavi kılavuz-ları yayınlamıştır. [3,4] EFNS'nin kılavuzunda CBZ ve VPA, etki etmesi muhtemel (Level B) ilaç katagorisinde değerlendiri-lirken, [3] MDS'nin kılavuzunda etkili olarak belirtilmişlerdir.…”

Section: Introductionunclassified

Restless Legs Syndrome among the epilepsy patient who took carbamazepine or valproic acid monotherapy

Kocatürk¹,

Kutlu²,

Kocatürk³

et al. 2013

Epilepsi

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SummaryObjectives: Restless legs syndrome (RLS) is a common sensory-motor disorder. RLS is characterized by intense restlessness and unpleasant sensation deep inside the legs. The aim of this study was to determine the prevalence of RLS among the epileptic patients who took carbamazepine (CBZ) or valproic acid (VPA) monotherapy and the findings were compared normal subjects and general population. Methods: Patients who took VPA and CBZ monotherapy and followed up at least six months in our department were included in this study. The diagnosis of RLS was made according to the International Restless Legs Syndrome Study Group criteria. Findings were compared with age-sex matched normal subjects and general population. Results: Ninety-two patients were included in this study. Fifty-seven of them were taking VPA and remaining thirty-five were taking CBZ. We found RLS in two (2.2%) of them (one of them taking VPA, the other CBZ). The percentage of RLS in normal subject was 6%. However, this difference was not statistically significant. Conclusion: We interpret this result as indirect evidence of treatment of RLS symptoms with CBZ and VA therapy when the finding was compared with general population and normal subjects.Key words: Epilepsy; restless legs syndrome; carbamazepine; valproic acid. ÖzetAmaç: Huzursuz bacak sendromu (HBS) sık görülen sensorimotor bir bozukluktur. HBS özellikle gece ve istirahatte olan bacağın derinlerinde hissedilen rahatsız edici, huzur bozucu bir hisle karakterizedir. Bu çalışmada karbamazepin (CBZ) ve valproik asit (VPA) monoterapisi alan epilepsi hastalarında huzursuz bacak sendromu sıklığı araştırıldı, normal bireyler ve genel popülasyon ile kıyaslandı. Gereç ve Yöntem:Karbamazepin ve VPA monoterapisi alan ve en az altı ay bölümümüzde takip edilen hastalar çalışmaya dahil edildi. HBS tanısı Uluslararası Huzursuz Bacak Sendromu Çalışma Grubu kriterlerine göre yapıldı. Bulgular yaş, cinsiyet karşılaştırmalı normal kişilerle ve genel popülasyon verileriyle karşılaştırıldı. Bulgular: Doksan iki hasta çalışmaya alındı. Bu hastalardan 57'si VPA, 35'i CBZ kullanmaktaydı. HBS iki (%2.2) hastada bulundu (biri VPA, diğeri CBZ kullanıyordu). Çalışmamızda normal kişilerde ise HBS oranı %6 idi. Bununla beraber, bu fark istatistiksel olarak anlamlı değildi.Sonuç: Bulgular normal kişiler ve genel popülasyonla karşılaştırıldığında, bu sonuçları CBZ ve VPA tedavisinin HBS tedavisindeki indirekt etkisine bağlayabiliriz.Anahtar sözcükler: Epilepsi; huzursuz bacak sendromu; karbamazepin; valproik asit.

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“…They improve sleep disorders by improving nocturnal mobility and quality of sleep [Pahwa et al 2007;Morgan and Sethi, 2006;Reuter et al 1999;Askenasy and Yahr, 1985]. Dopaminergic agonists are also the treatment of choice for restless legs syndrome, and dramatic benefits have been observed with bedtime doses of numerous dopamine agonists, including pergolide, pramipexole, ropinirole, cabergoline and rotigotine [Vignatelli et al 2006;Winkelman et al 2006;Stiasny-Kolster et al 2004;Walters et al 2004]. However, at higher doses dopaminergic drugs, including levodopa and dopaminergic agonists, can cause sleep fragmentation and daytime somnolence, resulting in sleep attacks and injuries, and worsening restless legs syndrome by augmentation [Olanow et al 2009;Micallef et al 2009;Ferreira et al 2000;Schapira, 2000;Frucht et al1999;Allen and Earley, 1996].…”

Section: Sleepmentioning

confidence: 99%

Nonmotor outcomes in Parkinson’s disease: is deep brain stimulation better than dopamine replacement therapy?

Borgohain¹,

Kandadai²,

Jabeen³

et al. 2011

Ther Adv Neurol Disord

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Nonmotor symptoms are an integral part of Parkinson's disease and cause significant morbidity. Pharmacological therapy helps alleviate the disease but produces nonmotor manifestations. While deep brain stimulation (DBS) has emerged as the treatment of choice for motor dysfunction, the effect on nonmotor symptoms is not well known. Compared with pharmacological therapy, bilateral subthalamic nucleus (STN)-DBS or globus pallidum interna (GPi)-DBS has significant beneficial effects on pain, sleep, gastrointestinal and urological symptoms. STN-DBS is associated with a mild worsening in verbal fluency while GPi-DBS has no effect on cognition. STN-DBS may improve cardiovascular autonomic disturbances by reducing the dose of dopaminergic drugs. Because the motor effects of STN-DBS and GPi-DBS appear to be similar, nonmotor symptoms may determine the target choice in surgery of future patients.Keywords: Parkinson's disease, deep brain stimulation, dopaminergic drugs, globus pallidum interna deep brain stimulation, nonmotor symptoms, pharmacological therapy, subthalamic nucleus deep brain stimulation IntroductionThe pathology of Parkinson's disease (PD) extends far beyond the nigrostriatal system and results in nonmotor symptoms coexisting with motor symptoms. Nonmotor symptoms can precede motor symptoms by years and are common in all stages of PD.They cause significant morbidity [Lim and Lang, 2010] and are often under recognized by health professionals [Parsons et al. 2006]. They can be divided into four domains: neuropsychiatric, autonomic, sleep and sensory dysfunction [Lim and Lang, 2010].

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EFNS guidelines on management of restless legs syndrome and periodic limb movement disorder in sleep

Cited by 132 publications

References 227 publications

The scientific and clinical basis for the treatment of Parkinson disease (2009)

The scientific and clinical basis for the treatment of Parkinson disease (2009)

Restless Legs Syndrome among the epilepsy patient who took carbamazepine or valproic acid monotherapy

Nonmotor outcomes in Parkinson’s disease: is deep brain stimulation better than dopamine replacement therapy?

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