Walters A S, Hening W, Rubinstein M, Chokroverty S
Dept. of Neurology, UMDNJ-Robert Wood Johnson Medical School, New Brunswick 08903-0019.
Sleep. 1991 Aug;14(4):339-45.
Neuroleptic-induced akathisia (NIA) is motor restlessness caused by dopamine receptor blocking antipsychotic agents. Nine patients with NIA and 11 patients with idiopathic restless legs syndrome (RLS) were studied polysomnographically. The sleep disturbances were milder in NIA than idiopathic RLS but increased numbers of awakenings and decreased sleep efficiencies were common to both groups. In addition, RLS patients demonstrated prolonged sleep latencies. Periodic movements in sleep (PMS) were present in only 5 of 9 patients with NIA but in all 11 patients with idiopathic RLS. In no NIA patient did we see the multiple, large amplitude, violent, resting myoclonic jerks of the legs that we saw during wakefulness in some of our more severe cases of idiopathic RLS. NIA patients tended to experience inner restlessness and idiopathic RLS patients tended to experience leg paresthesias as an antecedent to motor restlessness. Idiopathic RLS patients had symptoms that were worse at night and in repose far more frequently than patients with NIA. NIA and idiopathic RLS have similarities and differences. Because both NIA and idiopathic RLS are characterized by motor restlessness and sleep disturbances, the pharmacodynamics of antipsychotic medications may give clues as to both the cause and treatment of idiopathic RLS.
抗精神病药所致静坐不能（NIA）是由多巴胺受体阻断型抗精神病药物引起的运动性不安。对9例NIA患者和11例特发性不安腿综合征（RLS）患者进行了多导睡眠图研究。NIA患者的睡眠障碍比特发性RLS患者轻，但两组均常见觉醒次数增加和睡眠效率降低。此外，RLS患者的入睡潜伏期延长。9例NIA患者中只有5例出现睡眠期周期性肢体运动（PMS），而11例特发性RLS患者均出现。在NIA患者中，我们未见到在一些病情较重的特发性RLS患者清醒时所见到的腿部多次、大幅度、剧烈的静息性肌阵挛性抽搐。NIA患者倾向于体验内心不安，而特发性RLS患者在运动性不安之前倾向于体验腿部感觉异常。特发性RLS患者的症状在夜间和休息时比NIA患者更频繁地加重。NIA和特发性RLS既有相似之处，也有不同之处。由于NIA和特发性RLS均以运动性不安和睡眠障碍为特征，抗精神病药物的药效学可能为特发性RLS的病因和治疗提供线索。
