TY - CHAP M1 - Book, Section TI - Chapter 46. Restless Legs Syndrome and Periodic Leg Movements of Sleep A1 - Rye, David B. A1 - Trotti, Lynn Marie A2 - Watts, Ray L. A2 - Standaert, David G. A2 - Obeso, Jose A. PY - 2012 T2 - Movement Disorders, 3e AB - Restless legs syndrome (RLS) is characterized by a compelling, often insatiable, need to move the legs, accompanied by unpleasant sensations located mainly in the ankles and calves. Because symptoms are brought on by inactivity, distress intrudes upon everyday activities such as air travel, car rides, attending school, meetings, or the theatre, and sleep. The first comprehensive description of RLS in 1945 by Ekbom noted its key features: (1) a prevalence of at least 5%; (2) a diurnal preference for the evening and night; (3) a subpopulation with pain; (4) a proclivity to affect pregnant women; (5) heritability; and (6) a favorable response to iron supplementation. A second advance came with recognition that periodic limb movements in sleep (PLMs) are present in the anterior tibialis muscles of the legs in 85–95% of RLS subjects. Coincident with PLMs are elevations of heart rate and blood pressure, and peripheral vasoconstriction that are increasingly viewed as causal to cardio- and cerebrovascular morbidity. A third major advance has come with demonstration that pharmacologic agents acting at D2 and D3 dopamine receptors relieve both the sensory (RLS) and motor (PLMs) symptoms. A fourth advance has been demonstration of brain iron reductions in a subpopulation of RLS cases. The fifth seminal advance has been the identification of five genetic loci in four genes that account for a majority of the population attributable risk of RLS. SN - PB - The McGraw-Hill Companies CY - New York, NY Y2 - 2024/03/28 UR - neurology.mhmedical.com/content.aspx?aid=55804540 ER -