EFNS guidelines on management of restless legs syndrome and periodic limb movement disorder in sleep |
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Authors: | L. Vignatelli M. Billiard P. Clarenbach D. Garcia-Borreguero D. Kaynak V. Liesiene C. Trenkwalder P. Montagna |
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Affiliation: | Department of Neurological Sciences, University of Bologna Medical School, Bologna, Italy;;Faculty of Medicine, Gui de Chauliac Hospital, Montpellier, France;;Neurologische Klinik, EV Johannes-Krankenhaus, Bielefeld, Germany;;Department of Neurology, Fundacion Jimenez Diaz, Sleep Disorders Unit, Universidad Autonoma de Madrid, Madrid, Spain;;Cerrahpasa Faculty of Medicine, Sleep Disorders Unit, Istanbul University, Istanbul, Turkey;;Faculty of Medicine, University of Kaunas, Kaunas, Lithuania;;and Department of Clinical Neurophysiology, University of Goettingen, Goettingen, Germany |
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Abstract: | In 2003, the EFNS Task Force was set up for putting forth guidelines for the management of the Restless Legs Syndrome (RLS) and the Periodic Limb Movement Disorder (PLMD). After determining the objectives for management and the search strategy for primary and secondary RLS and for PLMD, a review of the scientific literature up to 2004 was performed for the drug classes and interventions employed in treatment (drugs acting on the adrenoreceptor, antiepileptic drugs, benzodiazepines/hypnotics, dopaminergic agents, opioids, other treatments). Previous guidelines were consulted. All trials were analysed according to class of evidence, and recommendations formed according to the 2004 EFNS criteria for rating. Dopaminergic agents came out as having the best evidence for efficacy in primary RLS. Reported adverse events were usually mild and reversible; augmentation was a feature with dopaminergic agents. No controlled trials were available for RLS in children and for RLS during pregnancy. The following level A recommendations can be offered: for primary RLS, cabergoline, gabapentin, pergolide, ropinirole, levodopa and rotigotine by transdermal delivery (the latter two for short-term use) are effective in relieving the symptoms. Transdermal oestradiol is ineffective for PLMD. |
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Keywords: | benzodiazepines dopaminergics drugs guidelines periodic limb movement disorder Restless legs syndrome |
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