Comella Cynthia L
Department of Neurological Sciences, Rush Medical Center, Chicago, IL 60612, USA.
Neurology. 2002 Feb 26;58(4 Suppl 1):S87-92. doi: 10.1212/wnl.58.suppl_1.s87.
Restless legs syndrome (RLS) is a common neurologic disorder that affects 5 to 10% of the population and increases in prevalence with aging. The clinical hallmarks of RLS include dysesthesias or paresthesias in the legs and sometimes the arms, occurring primarily at rest, which are usually worse in the evening and are alleviated by movement. RLS can be a disabling disorder, causing sleep disturbance at night and excessive sleepiness during the day. Although treatment with levodopa alleviates symptoms, many RLS patients develop rebound (occurrence of symptoms during the night) or augmentation (occurrence of symptoms before levodopa dosing in the evening). Augmentation occurs in up to 82% of patients treated with levodopa, limiting the long-term usefulness of this agent. The direct dopamine receptor agonists are long-acting drugs often administered as a single dose at bedtime. Among these agents, pergolide, pramipexole, ropinirole, and cabergoline have all been shown to alleviate RLS symptoms in 70 to 100% of patients. The most common adverse effect is nausea. Augmentation, although it may be associated with chronic agonist use, is usually mild and responsive to additional dosing. The direct dopamine receptor agonists have largely replaced levodopa as the most effective treatment for RLS.
不宁腿综合征（RLS）是一种常见的神经系统疾病，影响5%至10%的人群，且患病率随年龄增长而增加。RLS的临床特征包括腿部有时还有手臂出现感觉异常或感觉迟钝，主要在休息时发生，通常在晚上更严重，活动后可缓解。RLS可能是一种致残性疾病，导致夜间睡眠障碍和白天过度嗜睡。虽然左旋多巴治疗可缓解症状，但许多RLS患者会出现反跳（夜间出现症状）或症状加重（晚上左旋多巴给药前出现症状）。接受左旋多巴治疗的患者中，症状加重的发生率高达82%，限制了这种药物的长期疗效。直接多巴胺受体激动剂是长效药物，通常在睡前单次给药。在这些药物中，培高利特、普拉克索、罗匹尼罗和卡麦角林均已显示可使70%至100%的患者RLS症状得到缓解。最常见的不良反应是恶心。症状加重虽然可能与长期使用激动剂有关，但通常较轻，增加剂量后可缓解。直接多巴胺受体激动剂已在很大程度上取代左旋多巴，成为RLS最有效的治疗方法。
