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[继发性不宁腿综合征]

[Secondary restless legs syndrome].

作者信息

Oka Yasunori, Ioue Yuichi

机构信息

Japan Somnology Center, Neuropsychiatric Research Institute, 1-17-7-301 Yoyogi, Shibuya-ku, Tokyo 151-0053, Japan.

出版信息

Brain Nerve. 2009 May;61(5):539-47.

Abstract

Restless legs syndrome (RLS) is known to occur secondary to various medical conditions such as iron deficiency, pregnancy, end-stage renal disease, and neuropathy. Secondary RLS usually occurs later in the life and in the absence of a family history of RLS. Diagnosis of secondary RLS may be difficult, particularly in patients with neurological comorbidities. Sensory disturbance due to neurological disorder may mimic the symptoms of RLS symptom. In distinguishing between RLS and RLS mimics, neurophysiological findings, in addition to a detailed neurological examination, are helpful. Treatment of secondary RLS often requires management of the background medical condition. Iron supplementation is useful in patients with iron deficiency. Dopamine agonists are usually effective for both primary and secondary RLS; however, an increased dose of dopamine agonist may be necessary in some secondary RLS cases, particularly in uremic RLS. In patients with end-stage renal disease on hemodialysis, management of daytime symptoms, particularly during the hemodialysis sessions, may be necessary. Secondary RLS is still an unrecognized and underdiagnosed disorder. Medical practitioners should be aware of comorbid RLS in patients with neurological conditions that could be the cause of RLS.

摘要

已知不宁腿综合征(RLS)继发于多种医学状况,如缺铁、妊娠、终末期肾病和神经病变。继发性RLS通常在生命后期出现,且无RLS家族史。继发性RLS的诊断可能困难,尤其是在伴有神经科合并症的患者中。神经疾病引起的感觉障碍可能会模仿RLS症状。在区分RLS和类似RLS的情况时,除了详细的神经科检查外,神经生理学检查结果也很有帮助。继发性RLS的治疗通常需要对基础医学状况进行处理。缺铁患者补充铁剂有用。多巴胺激动剂通常对原发性和继发性RLS均有效;然而,在一些继发性RLS病例中,尤其是尿毒症性RLS,可能需要增加多巴胺激动剂的剂量。对于接受血液透析的终末期肾病患者,可能需要处理日间症状,尤其是在血液透析期间。继发性RLS仍然是一种未被认识和诊断不足的疾病。医生应意识到在可能是RLS病因的神经疾病患者中存在合并的RLS。

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