Vignatelli L, Billiard M, Clarenbach P, Garcia-Borreguero D, Kaynak D, Liesiene V, Trenkwalder C, Montagna P
Department of Neurological Sciences, University of Bologna Medical School, Bologna, Italy.
Eur J Neurol. 2006 Oct;13(10):1049-65. doi: 10.1111/j.1468-1331.2006.01410.x.
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.
2003年，欧洲神经科学联合会（EFNS）成立了特别工作组，以制定不宁腿综合征（RLS）和周期性肢体运动障碍（PLMD）的管理指南。在确定管理目标以及原发性和继发性RLS及PLMD的检索策略后，对截至2004年科学文献中用于治疗的药物类别和干预措施（作用于肾上腺素能受体的药物、抗癫痫药物、苯二氮卓类/催眠药、多巴胺能药物、阿片类药物、其他治疗方法）进行了综述。参考了以往的指南。所有试验均根据证据等级进行分析，并根据2004年EFNS评级标准形成建议。多巴胺能药物在原发性RLS的疗效方面有最佳证据。报告的不良事件通常较轻且可逆；多巴胺能药物会出现症状增剧现象。尚无针对儿童RLS和孕期RLS的对照试验。可提供以下A级建议：对于原发性RLS，卡麦角林、加巴喷丁、培高利特、罗匹尼罗、左旋多巴和经皮给药的罗替戈汀（后两种用于短期使用）可有效缓解症状。经皮雌二醇对PLMD无效。
