restless legs syndrome

むずむず脚症候群, RLS

WordNet

1. (nautical) the distance traveled by a sailing vessel on a single tack
2. a cloth covering consisting of the part of a pair of trousers that covers a persons leg
3. one of the supports for a piece of furniture
4. a human limb; commonly used to refer to a whole limb but technically only the part of the limb between the knee and ankle
5. a structure in animals that is similar to a human leg and used for locomotion
6. the limb of an animal used for food
7. ceaselessly in motion; "the restless sea"; "the restless wind"
8. lacking or not affording physical or mental rest; "a restless night"; "she fell into an uneasy sleep" (同)uneasy
9. worried and uneasy (同)ungratified, unsatisfied
10. a pattern of symptoms indicative of some disease
11. a complex of concurrent things; "every word has a syndrome of meanings"
12. staying power; "that old Broadway play really has legs"

PrepTutorEJDIC

1. (人・動物の)『脚』 / (ズボン・靴下などの)脚をおおう部分,脚部 / (家具などの)脚,形(機能)が脚に似た物 / (三角形の底辺を除く)一辺 / (旅などの全行程の中の)一区切り,一区間
2. 『落ち着かない』,不安な(uneasy) / 絶えず動いている,静止していない
3. (疾患の徴候となる一群の)症徴候,症候群 / (事件・社会的状態などのパターンを示す)徴候形態

Wikipedia preview

出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2019/05/03 09:25:52」(JST)

wiki en

[Wiki en表示]

For the song "Restless Legs" by Half Man Half Biscuit, see Achtung Bono.

Restless legs syndrome
Other names	Willis–Ekbom disease (WED), Wittmaack–Ekbom syndrome
Sleep pattern of a person with restless legs syndrome (red) versus a healthy sleep pattern (blue).
Specialty	Sleep medicine
Symptoms	Unpleasant feeling in the legs that briefly improves with moving them
Complications	Daytime sleepiness, low energy, irritability, depressed mood
Usual onset	More common with older age
Risk factors	Low iron levels, kidney failure, Parkinson's disease, diabetes mellitus, rheumatoid arthritis, pregnancy, certain medications
Diagnostic method	Based on symptoms after ruling out other possible causes
Treatment	Lifestyle changes, medication
Medication	Levodopa, dopamine agonists, gabapentin
Frequency	2.5–15% (US)

Restless legs syndrome (RLS) is a disorder that causes a strong urge to move one's legs. There is often an unpleasant feeling in the legs that improves somewhat with moving them. This is often described as aching, tingling, or crawling in nature. Occasionally the arms may also be affected. The feelings generally happen when at rest and therefore can make it hard to sleep. Due to the disturbance in sleep, people with RLS may have daytime sleepiness, low energy, irritability, and a depressed mood. Additionally, many have limb twitching during sleep.

Risk factors for RLS include low iron levels, kidney failure, Parkinson's disease, diabetes mellitus, rheumatoid arthritis, and pregnancy. A number of medications may also trigger the disorder including antidepressants, antipsychotics, antihistamines, and calcium channel blockers. There are two main types. One is early onset RLS which starts before age 45, runs in families and worsens over time. The other is late onset RLS which begins after age 45, starts suddenly, and does not worsen. Diagnosis is generally based on a person's symptoms after ruling out other potential causes.

Restless leg syndrome may resolve if the underlying problem is addressed. Otherwise treatment includes lifestyle changes and medication. Lifestyle changes that may help include stopping alcohol and tobacco use, and sleep hygiene. Medications used include levodopa or a dopamine agonist such as pramipexole. RLS affects an estimated 2.5–15% of the American population. Females are more commonly affected than males and it becomes more common with age.

Signs and symptoms

RLS sensations range from pain or an aching in the muscles, to "an itch you can't scratch", a "buzzing sensation", an unpleasant "tickle that won't stop", a "crawling" feeling, or limbs jerking while awake. The sensations typically begin or intensify during quiet wakefulness, such as when relaxing, reading, studying, or trying to sleep.

It is a "spectrum" disease with some people experiencing only a minor annoyance and others having major disruption of sleep and impairments in quality of life.

The sensations—and the need to move—may return immediately after ceasing movement or at a later time. RLS may start at any age, including childhood, and is a progressive disease for some, while the symptoms may remit in others. In a survey among members of the Restless Legs Syndrome Foundation, it was found that up to 45% of patients had their first symptoms before the age of 20 years.

• "An urge to move, usually due to uncomfortable sensations that occur primarily in the legs, but occasionally in the arms or elsewhere."

The sensations are unusual and unlike other common sensations. Those with RLS have a hard time describing them, using words or phrases such as uncomfortable, painful, 'antsy', electrical, creeping, itching, pins and needles, pulling, crawling, buzzing, and numbness. It is sometimes described similar to a limb 'falling asleep' or an exaggerated sense of positional awareness of the affected area. The sensation and the urge can occur in any body part; the most cited location is legs, followed by arms. Some people have little or no sensation, yet still, have a strong urge to move.

• "Motor restlessness, expressed as activity, which relieves the urge to move."

Movement usually brings immediate relief, although temporary and partial. Walking is most common; however, stretching, yoga, biking, or other physical activity may relieve the symptoms. Continuous, fast up-and-down movements of the leg, and/or rapidly moving the legs toward then away from each other, may keep sensations at bay without having to walk. Specific movements may be unique to each person.

• "Worsening of symptoms by relaxation."

Sitting or lying down (reading, plane ride, watching TV) can trigger the sensations and urge to move. Severity depends on the severity of the person's RLS, the degree of restfulness, duration of the inactivity, etc.

• "Variability over the course of the day-night cycle, with symptoms worse in the evening and early in the night."

Some experience RLS only at bedtime, while others experience it throughout the day and night. Most people experience the worst symptoms in the evening and the least in the morning.

• "Restless legs feel similar to the urge to yawn, situated in the legs or arms."

These symptoms of RLS can make sleeping difficult for many patients and a recent poll shows the presence of significant daytime difficulties resulting from this condition. These problems range from being late for work to missing work or events because of drowsiness. Patients with RLS who responded reported driving while drowsy more than patients without RLS. These daytime difficulties can translate into safety, social and economic issues for the patient and for society.

Individuals with RLS have higher rates of depression and anxiety disorders.

Primary and secondary

RLS is categorized as either primary or secondary.

• Primary RLS is considered idiopathic or with no known cause. Primary RLS usually begins slowly, before approximately 40–45 years of age and may disappear for months or even years. It is often progressive and gets worse with age. RLS in children is often misdiagnosed as growing pains.
• Secondary RLS often has a sudden onset after age 40, and may be daily from the beginning. It is most associated with specific medical conditions or the use of certain drugs (see below).

Causes

RLS is often due to iron deficiency (low total body iron status) and this accounts for 20% of cases. A study published in 2007 noted that RLS features were observed in 34% of people having iron deficiency as against 6% of controls.

Other associated conditions include varicose vein or venous reflux, folate deficiency, magnesium deficiency, fibromyalgia, sleep apnea, uremia, diabetes, thyroid disease, peripheral neuropathy, Parkinson's disease, POTS, and certain autoimmune diseases such as Sjögren's syndrome, celiac disease, and rheumatoid arthritis. RLS can also worsen in pregnancy. In a 2007 study, RLS was detected in 36% of people attending a phlebology (vein disease) clinic, compared to 18% in a control group.

ADHD

An association has been observed between attention deficit hyperactivity disorder (ADHD) and RLS or periodic limb movement disorder. Both conditions appear to have links to dysfunctions related to the neurotransmitter dopamine, and common medications for both conditions among other systems, affect dopamine levels in the brain. A 2005 study suggested that up to 44% of people with ADHD had comorbid (i.e. coexisting) RLS, and up to 26% of people with RLS had confirmed ADHD or symptoms of the condition.

Medications

Certain medications may cause or worsen RLS, or cause it secondarily, including:

• Certain antiemetics (antidopaminergic ones)
• Certain antihistamines (especially the sedating, first generation H1 antihistamines often in over-the-counter cold medications)
• many antidepressants (both older TCAs and newer SSRIs)
• antipsychotics and certain anticonvulsants.
• a rebound effect of sedative-hypnotic drugs such as a benzodiazepine withdrawal syndrome from discontinuing benzodiazepine tranquillizers or sleeping pills.
• alcohol withdrawal can also cause restless legs syndrome and other movement disorders such as akathisia and parkinsonism usually associated with antipsychotics
• opioid withdrawal is associated with causing and worsening RLS.

Both primary and secondary RLS can be worsened by surgery of any kind; however, back surgery or injury can be associated with causing RLS.

The cause vs. effect of certain conditions and behaviors observed in some patients (ex. excess weight, lack of exercise, depression or other mental illnesses) is not well established. Loss of sleep due to RLS could cause the conditions, or medication used to treat a condition could cause RLS.

Genetics

More than 60% of cases of RLS are familial and are inherited in an autosomal dominant fashion with variable penetrance.

Research and brain autopsies have implicated both dopaminergic system and iron insufficiency in the substantia nigra. Iron is well understood to be an essential co-factor for the formation of L-dopa, the precursor of dopamine.

Six genetic loci found by linkage are known and listed below. Other than the first one, all of the linkage loci were discovered using an autosomal dominant model of inheritance.

• The first genetic locus was discovered in one large French Canadian family and maps on chromosome 12q. This locus was discovered using an autosomal recessive inheritance model. Evidence for this locus was also found using a transmission disequilibrium test (TDT) in 12 Bavarian families.
• The second RLS locus maps to chromosome 14q and was discovered in one Italian family. Evidence for this locus was found in one French Canadian family. Also, an association study in a large sample 159 trios of European descent showed some evidence for this locus.
• This locus maps to chromosome 9p and was discovered in two unrelated American families. Evidence for this locus was also found by the TDT in a large Bavarian family, in which significant linkage to this locus was found.
• This locus maps to chromosome 20p and was discovered in a large French Canadian family with RLS.
• This locus maps to chromosome 2p and was found in three related families from population isolated in South Tyrol.
• The sixth locus is located on chromosome 16p12.1 and was discovered by Levchenko et al. in 2008.

Three genes, MEIS1, BTBD9 and MAP2K5, were found to be associated to RLS. Their role in RLS pathogenesis is still unclear. More recently, a fourth gene, PTPRD was found to be associated to RLS

There is also some evidence that periodic limb movements in sleep (PLMS) are associated with BTBD9 on chromosome 6p21.2, MEIS1, MAP2K5/SKOR1, and PTPRD. The presence of a positive family history suggests that there may be a genetic involvement in the etiology of RLS.

Mechanism

Most research on the disease mechanism of restless legs syndrome has focused on the dopamine and iron system. These hypotheses are based on the observation that iron and levodopa, a prodrug of dopamine that can cross the blood–brain barrier and is metabolized in the brain into dopamine (as well as other mono-amine neurotransmitters of the catecholamine class) can be used to treat RLS, levodopa being a medicine for treating hypodopaminergic (low dopamine) conditions such as Parkinson's disease, and also on findings from functional brain imaging (such as positron emission tomography and functional magnetic resonance imaging), autopsy series and animal experiments. Differences in dopamine- and iron-related markers have also been demonstrated in the cerebrospinal fluid of individuals with RLS. A connection between these two systems is demonstrated by the finding of low iron levels in the substantia nigra of RLS patients, although other areas may also be involved.

Diagnosis

There are no specific tests for RLS, but non-specific laboratory tests are used to rule out other causes such as vitamin deficiencies. According to the National Institutes of Health's National Institute of Neurological Disorders and Stroke, four symptoms are used to confirm the diagnosis:

• A strong urge to move the limbs, usually associated with unpleasant or uncomfortable sensations.
• It starts or worsens during inactivity or rest.
• It improves or disappears (at least temporarily) with activity.
• It worsens in the evening or night.
• These symptoms are not caused by any medical or behavioral condition.

Differential diagnosis

Other conditions that can produce similar symptoms include: akathisia and nocturnal leg cramps.

Peripheral artery disease and arthritis can also cause leg pain but this usually gets worse with movement.

Prevention

Other than preventing the underlying causes, generally no method of preventing RLS has been established or studied. If RLS is due to specific treatable causes (specific medications or treatable conditions), then treatment of those causes may also remove or reduce RLS. Otherwise, medical responses focus on treating the condition, either symptomatically or by targeting lifestyle changes and bodily processes capable of modifying its expression or severity.

Treatment

If RLS is not linked to an underlying cause, its frequency may be reduced by lifestyle modifications such as adopting improving sleep hygiene, regular exercise, and stopping smoking. Medications used may include dopamine agonists or gabapentin in those with daily restless legs syndrome, and opioids for treatment of resistant cases.

Treatment of RLS should not be considered until possible medical causes are ruled out, especially venous disorders. Secondary RLS may be cured if precipitating medical conditions (anemia, venous disorder) are managed effectively. Secondary conditions causing RLS include iron deficiency, varicose veins, and thyroid problems.

Physical measures

Stretching the leg muscles can bring temporary relief. Walking and moving the legs, as the name "restless legs" implies, brings temporary relief. In fact, those with RLS often have an almost uncontrollable need to walk and therefore relieve the symptoms while they are moving. Unfortunately, the symptoms usually return immediately after the moving and walking ceases. A vibratory counter-stimulation device has been found to help some people with primary RLS to improve their sleep.

Iron

There is some evidence that intrevenous iron supplementation moderately improves restlessness for people with RLS.

Medications

For those whose RLS disrupts or prevents sleep or regular daily activities, medication may be useful. Evidence supports the use of dopamine agonists including: pramipexole, ropinirole, rotigotine, and cabergoline. They reduce symptoms, improve sleep quality and quality of life. Levodopa is also effective. One review found pramipexole to be better than ropinirole.

There are, however, issues with the use of dopamine agonists including augmentation. This is a medical condition where the drug itself causes symptoms to increase in severity and/or occur earlier in the day. Dopamine agonists may also cause rebound when symptoms increase as the drug wears off. In many cases, the longer dopamine agonists have been used the higher the risk of augmentation and rebound as well as the severity of the symptoms. Also, a recent study indicated that dopamine agonists used in restless leg syndrome can lead to an increase in compulsive gambling.

• Gabapentin or pregabalin, a non-dopaminergic treatment for moderate to severe primary RLS
• Opioids are only indicated in severe cases that do not respond to other measures due to their high rate of side effects.

Benzodiazepines, such as diazepam or clonazepam, are not generally recommended, and their effectiveness is unknown. They however are sometimes still used as a second line, as add on agents. Quinine is not recommended due to its risk of serious side effects involving the blood.

Prognosis

RLS symptoms may gradually worsen with age, though more slowly for those with the idiopathic form of RLS than for patients who also have associated medical condition. Nevertheless, current therapies can control the disorder, minimizing symptoms and increasing periods of restful sleep. In addition, some patients have remissions, periods in which symptoms decrease or disappear for days, weeks, or months, although symptoms usually eventually reappear. Being diagnosed with RLS does not indicate or foreshadow another neurological disease.

Epidemiology

RLS affects an estimated 2.5–15% of the American population. A minority (around 2.7% of the population) experience daily or severe symptoms. RLS is twice as common in women as in men, and Caucasians are more prone to RLS than people of African descent. RLS occurs in 3% of individuals from the Mediterranean or Middle Eastern region, and in 1–5% of those from the Far East, indicating that different genetic or environmental factors, including diet, may play a role in the prevalence of this syndrome.

With age, RLS becomes more common, and RLS diagnosed at an older age runs a more severe course.

RLS is even more common in individuals with iron deficiency, pregnancy, or end-stage kidney disease. Poor general health is also linked.

Neurologic conditions linked to RLS include Parkinson's disease, spinal cerebellar atrophy, spinal stenosis, lumbosacral radiculopathy and Charcot–Marie–Tooth disease type 2. Approximately 80–90% of people with RLS also have periodic limb movement disorder (PLMD), which causes slow "jerks" or flexions of the affected body part. These occur during sleep (PLMS = periodic limb movement while sleeping) or while awake (PLMW—periodic limb movement while waking).

The National Sleep Foundation's 1998 Sleep in America poll showed that up to 25 percent of pregnant women developed RLS during the third trimester.

History

The first known medical description of RLS was by Sir Thomas Willis in 1672. Willis emphasized the sleep disruption and limb movements experienced by people with RLS. Initially published in Latin (De Anima Brutorum, 1672) but later translated to English (The London Practice of Physick, 1685), Willis wrote:

“ Wherefore to some, when being abed they betake themselves to sleep, presently in the arms and legs, leapings and contractions on the tendons, and so great a restlessness and tossings of other members ensue, that the diseased are no more able to sleep, than if they were in a place of the greatest torture. ”

The term "fidgets in the legs" has also been used as early as the early nineteenth century.

Subsequently, other descriptions of RLS were published, including those by Francois Boissier de Sauvages (1763), Magnus Huss (1849), Theodur Wittmaack (1861), George Miller Beard (1880), Georges Gilles de la Tourette (1898), Hermann Oppenheim (1923) and Frederick Gerard Allison (1943). However, it was not until almost three centuries after Willis, in 1945, that Karl-Axel Ekbom (1907–1977) provided a detailed and comprehensive report of this condition in his doctoral thesis, Restless legs: clinical study of hitherto overlooked disease. Ekbom coined the term "restless legs" and continued work on this disorder throughout his career. He described the essential diagnostic symptoms, differential diagnosis from other conditions, prevalence, relation to anemia, and common occurrence during pregnancy.

Ekbom's work was largely ignored until it was rediscovered by Arthur S. Walters and Wayne A. Hening in the 1980s. Subsequent landmark publications include 1995 and 2003 papers, which revised and updated the diagnostic criteria. Journal of Parkinsonism and RLS is the first peer-reviewed, online, open access journal dedicated to publishing research about Parkinson's disease and was founded by a Canadian neurologist Dr. Abdul Qayyum Rana.

Nomenclature

For decades the most widely used name for the disease was restless legs syndrome, and it is still the most commonly used. In 2013 the Restless Legs Syndrome Foundation renamed itself the Willis–Ekbom Disease Foundation, and it encourages the use of the name Willis–Ekbom disease; its reasons are quoted as follows:

“ The name Willis–Ekbom disease:

• Eliminates incorrect descriptors—the condition often involves parts of the body other than legs
• Promotes cross-cultural ease of use
• Responds to trivialization of the disease and humorous treatment in the media
• Acknowledges the first known description by Sir Thomas Willis in 1672 and the first detailed clinical description by Dr. Karl Axel Ekbom in 1945.

”

A point of confusion is that RLS and delusional parasitosis are entirely different conditions that have both been called "Ekbom syndrome", as both syndromes were described by the same person, Karl-Axel Ekbom. Today, calling WED/RLS "Ekbom syndrome" is outdated usage, as the unambiguous names (WED or RLS) are preferred for clarity.

Controversy

Some doctors express the view that the incidence of restless leg syndrome is exaggerated by manufacturers of drugs used to treat it. Others believe it is an underrecognized and undertreated disorder. Further, GlaxoSmithKline ran advertisements that, while not promoting off-license use of their drug (ropinirole) for treatment of RLS, did link to the Ekbom Support Group website. That website contained statements advocating the use of ropinirole to treat RLS. The ABPI ruled against GSK in this case.

External links

Classification	D ICD-10: G25.8 ICD-9-CM: 333.94 OMIM: 102300 608831 MeSH: D012148 DiseasesDB: 29476
External resources	MedlinePlus: 000807 eMedicine: neuro/509 Patient UK: Restless legs syndrome

• Restless legs syndrome at Curlie
• "National Institutes of Health: What is Restless Legs Syndrome?".
• "Restless Legs Syndrome Information Page: National Institute of Neurological Disorders and Stroke (NINDS)".

UpToDate Contents

全文を閲覧するには購読必要です。 To read the full text you will need to subscribe.

• 1. Treatment of restless legs syndrome/Willis-Ekbom disease and periodic limb movement disorder in adults
• 2. Clinical features and diagnosis of restless legs syndrome/Willis-Ekbom disease and periodic limb movement disorder in adults
• 3. 小児におけるむずむず脚（レストレスレッグス）症候群/Willis-Ekbom症候群と周期性四肢運動障害 restless legs syndrome willis ekbom disease and periodic limb movement disorder in children
• 4. 妊娠中および授乳中のむずむず脚症候群／Willis-Ekbom病 restless legs syndrome willis ekbom disease during pregnancy and lactation
• 5. Insomnia in patients with a substance use disorder

English Journal

• Association between restless legs syndrome and CLOCK and NPAS2 gene polymorphisms in schizophrenia.

• Jung JS1, Lee HJ, Cho CH, Kang SG, Yoon HK, Park YM, Moon JH, Yang HJ, Song HM, Kim L.
• Chronobiology international.Chronobiol Int.2014 Aug;31(7):838-44. doi: 10.3109/07420528.2014.914034. Epub 2014 May 14.
• Previous studies have suggested that there is a genetic basis to restless legs syndrome (RLS) development. Occurrence of antipsychotic-induced RLS could also be due to differences in genetic susceptibility. We investigated whether CLOCK and NPAS2 gene polymorphisms are associated with RLS in schizop
• PMID 24824748

• An update on restless legs syndrome (Willis-Ekbom disease): clinical features, pathogenesis and treatment.

• Garcia-Borreguero D1, Williams AM.
• Current opinion in neurology.Curr Opin Neurol.2014 Aug;27(4):493-501. doi: 10.1097/WCO.0000000000000117.
• PURPOSE OF REVIEW: In recent years, there have been a number of advances in the field of restless legs syndrome (RLS) or Willis-Ekbom disease (WED). Here, we review recent studies pertaining to the diagnosis and clinical features, pathogenesis, and treatment of RLS/WED.RECENT FINDINGS: Recent studie
• PMID 24978636

• The impact of sleep on soldier performance.

• Williams SG1, Collen J, Wickwire E, Lettieri CJ, Mysliwiec V.
• Current psychiatry reports.Curr Psychiatry Rep.2014 Aug;16(8):459. doi: 10.1007/s11920-014-0459-7.
• The military population is particularly vulnerable to a multitude of sleep-related disorders owing to the type of work performed by active duty servicemembers (ADSMs). Inadequate sleep, due to insufficient quantity or quality, is increasingly recognized as a public health concern. Traditionally, ADS
• PMID 24942599

Japanese Journal

• ストレス時の多飲による意識障害と全身痛を主症状とする中枢感作性症候群の治療経験

• 日本ペインクリニック学会誌 advpub(0), 2016
• NAID 130005110399

• 不眠症 (特集 失敗から学ぶ精神科臨床)

• 精神科 = Psychiatry 27(6), 410-415, 2015-12
• NAID 40020672838

• Restless legs syndrome symptom during the daytime in Japanese population

• 東京医科大学雑誌 = The Journal of Tokyo Medical University 73(4), 435, 2015-10-30
• NAID 120005709272

Related Links

• Restless legs syndromeとは - goo Wikipedia (ウィキペディア)

Signs and symptoms [edit] The sensations—and the need to move—may return immediately after ceasing movement or at a later time. WED/RLS may start at any age, including childhood, and is a progressive disease for some ...

• Restless Leg Syndrome Organization

© 2013 Restless Legs Syndrome Foundation, Inc. All Rights Reserved. Read our privacy statement. 20/11 21:58, Asia One US to screen obese pilots, controllers for sleep apnea... 18/11 18:12, C-Health Sleep and 18/11 18/11 ...

Related Pictures

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★リンクテーブル★

リンク元	「むずむず脚症候群」「エクボム症候群」「RLS」「restless legs」
関連記事	「leg」「restless」「restless legs」「syndrome」

「むずむず脚症候群」

　　[★]

英

restless legs syndrome, RLS

同

下肢静止不能症候群、ムズムズ脚症候群、レストレスレッグ症候群

関

下肢静止不能、エクボム症候群。睡眠障害

概念

• 入眠前の不快な足の感覚によって特徴づけられ、足を動かさずにはいられなくなるような衝動を生じる

疫学

• 40-50歳で急激に上昇する
• 20歳(10%)-90歳(30%)まで漸増する

病型

• 原発性：遺伝性を有するもの
• 二次性

• 鉄欠乏性貧血
• 終末期腎疾患
• 妊娠
• 末梢神経障害
• パーキンソン病
• その他

診断

• 確定診断のためには睡眠ポリグラフ検査(polysomnography PSG)が必要であるが、臨床診断のために診断基準が公開されている

診断基準

2003 NIH International RLS Study Group(IRLSSG)による

• 1．脚を動かしたいという強い欲求が存在し、また通常その欲求が、不快な下肢の異常感覚に伴って生じる
• 2．静かに横になったり座ったりしている状態で出現、増悪する
• 3．歩いたり下肢を伸ばすなどの運動によって改善する
• 4．日中より夕方・夜間に増強する

診断を補助する特徴

• 1．家族歴
• 2．ドパミン作動薬による効果
• 3．睡眠時のperiodic leg movementsが睡眠ポリグラフ検査上有意に多く出現

鑑別診断

• 鉄欠乏、パーキンソン病、人工透析患者、妊娠、リウマチ性疾患、糖尿病、多発ニューロパチー
• 抗精神病薬に伴うアカシジア：落ちつきのなさが特徴であり、じっとしていることができないが、不快な異常感覚を伴わず、概日リズムもなく、運動も全身性であることなどから鑑別
• 夜間の有痛性筋痙攣
• painful legs and moving toes syndrome 痛む脚と動く趾症候群：足趾に出現し、痛みに伴いゆっくりとした指の動きを不随意に呈し、概日リズムもなく、動かしたい衝動ではないことから鑑別

治療

確立された治療法はない

非薬物療法

• 足の運動、マッサージにより症状が軽減する

薬物療法

日本神経治療学会 - 標準的神経治療より

• ドパミンアゴニスト

• 非麦角系

• プラミペキソール
• ロピニロール
• タリペキソール

• 麦角系

• カベルゴリン

• L-DOPA/DCI製剤

• ベンゾジアゼピン系薬物：クロナゼパム
• 抗けいれん薬：ガバペンチン
• オピオイド
• 鉄剤

KPS.835

• ベンゾジアゼピン系薬、レボドパ、あへん類、プロプラノロール、バルプロ酸、カルバマゼピン

参考

• 日本神経治療学会 - 標準的神経治療

https://www.jsnt.gr.jp/guideline/img/restless.pdf

国試

• 105I017、112A026

「エクボム症候群」

　　[★]

英

Ekbom syndrome

同

下肢静止不能症候群 restless legs syndrome

「RLS」

　　[★] むずむず脚症候群 restless legs syndrome

「restless legs」

　　[★]

下肢静止不能

関

restless legs syndrome

「leg」

　　[★]

• 脚、下肢

関

lower extremity、peduncle、pedunculi、pedunculus

　 　 　 　 　 　 　

「restless」

　　[★]

• adj.

• 不隠な

関

(n.)agitation, (n.)restlessness

　 　 　 　

「restless legs」

　　[★]

下肢静止不能

関

restless legs syndrome

「syndrome」

　　[★]

• n.

• 症候群