Spinal Cord Stimulation for Restless Legs Syndrome: Case Series and Mechanistic Hypothesis

Adil, Syed M; Han, Jing; Parente, Beth; Hickey, Patrick; Lad, Shivanand P.

doi:10.1159/000494737

Cited by 9 publications

(2 citation statements)

References 13 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Currently, DBS treatment primarily for treatment of RLS is not recommended [155], although further evidence is needed to determine its effect on RLS in patients who receive DBS surgery for treatment of their parkinsonism, which may provide clearer evidence of whether DBS relieves or exacerbates comorbid RLS symptoms. Further prospective clinical research trials will be needed to establish the safety, tolerability, and efficacy of these novel approaches [156].…”

Section: Investigational/emerging Therapiesmentioning

confidence: 99%

Restless Legs Syndrome: Contemporary Diagnosis and Treatment

et al. 2021

View full text Add to dashboard Cite

Restless legs syndrome (RLS) is characterized by an uncomfortable urge to move the legs while at rest, relief upon movement or getting up to walk, and worsened symptom severity at night. RLS may be primary (idiopathic) or secondary to pregnancy or a variety of systemic disorders, especially iron deficiency, and chronic renal insufficiency. Genetic predisposition with a family history is common. The pathogenesis of RLS remains unclear but is likely to involve central nervous system dopaminergic dysfunction, as well as other, undefined contributing mechanisms. Evaluation begins with a thorough history and examination, and iron measures, including ferritin and transferrin saturation, should be checked at presentation and with worsened symptoms, especially when augmentation develops. Augmentation is characterized by more intense symptom severity, earlier symptom occurrence, and often, symptom spread from the legs to the arms or other body regions. Some people with RLS have adequate symptom control with non-pharmacological measures such as massage or temperate baths. First-line management options include iron-replacement therapy in those with evidence for reduced body-iron stores or, alternatively, with prescribed gabapentin or pregabalin, and dopamine agonists such as pramipexole, ropinirole, and rotigotine. Second-line therapies include intravenous iron infusion in those who are intolerant of oral iron and/or those having augmentation with intense, severe RLS symptoms, and opioids including tramadol, oxycodone, and methadone. RLS significantly impacts patients' quality of life and remains a therapeutic area sorely in need of innovation and a further pipeline of new, biologically informed therapies. KeywordsRestless legs syndrome • Periodic limb movement disorder • Periodic leg movements • Cardiovascular risk • Treatment • Dopamine agonist • Alpha-2-delta ligand • Opiate • Iron deficiency.

show abstract

Section: Investigational/emerging Therapiesmentioning

confidence: 99%

Restless Legs Syndrome: Contemporary Diagnosis and Treatment

et al. 2021

View full text Add to dashboard Cite

show abstract

“…194 Invasive neuromodulation like subthalamic DBS showed improvement in patients with RLS secondary to PD in a retrospective study, 195 and promising case reports of spinal cord direct stimulation are also available. 196 These interventional treatments need further investigation to consolidate their role in RLS management.…”

Section: Managementmentioning

confidence: 99%

“Unvoluntary” Movement Disorders: Distinguishing between Tics, Akathisia, Restless Legs, and Stereotypies

2023

View full text Add to dashboard Cite

Tics, stereotypies, akathisia, and restless legs fall at different places on the spectrum of discrete, unwanted and potentially disabling motor routines. Unlike tremor, chorea, myoclonus, or dystonia, this subgroup of abnormal movements is characterized by the subject's variable ability to inhibit or release undesired motor patterns on demand. Though it may be sometimes clinically challenging, it is crucial to distinguish these “unvoluntary” motor behaviors because secondary causes and management approaches differ substantially. To this end, physicians must consider the degree of repetitiveness of the movements, the existence of volitional control, and the association with sensory symptoms, or cognitive-ideational antecedent. This review aims to summarize the current existing knowledge on phenomenology, diagnosis, and treatment of tics, stereotypies, akathisia, and restless leg syndrome.

show abstract