Wijemanne Subhashie, Jankovic Joseph
Parkinson's Disease Center and Movement Disorders Clinic, Baylor College of Medicine, Houston, Texas, USA.
Parkinson's Disease Center and Movement Disorders Clinic, Baylor College of Medicine, Houston, Texas, USA.
Sleep Med. 2015 Jun;16(6):678-90. doi: 10.1016/j.sleep.2015.03.002. Epub 2015 Mar 10.
Restless legs syndrome (RLS) is a circadian disorder of sensory-motor integration that may be related to genetically determined dysregulation of iron transport across the blood-brain barrier. Dopamine agonists (DAs) have been considered the first-line therapy, but with the growing appreciation of problems associated with long-term treatment, particularly augmentation and impulse control disorder, alpha-2-delta drugs, such as gabapentin, are now considered the first line of treatment in patients with troublesome RLS. Opioids can be considered as an alternative therapy, particularly in patients with DA-related augmentation. In more severe cases, a combination therapy may be required. Intravenous iron therapy may be considered on those patients with refractory RLS.
不安腿综合征（RLS）是一种感觉运动整合的昼夜节律紊乱，可能与遗传决定的铁穿过血脑屏障的转运失调有关。多巴胺激动剂（DAs）曾被视为一线治疗药物，但随着对长期治疗相关问题（尤其是症状加重和冲动控制障碍）的认识不断增加，α-2-δ类药物，如加巴喷丁，现在被认为是RLS症状严重患者的一线治疗药物。阿片类药物可被视为一种替代疗法，尤其是在与多巴胺激动剂相关的症状加重患者中。在更严重的情况下，可能需要联合治疗。对于难治性RLS患者可考虑静脉铁剂治疗。
