Vellieux G, d'Ortho M-P
Université de Paris, NeuroDiderot, Inserm, 75019 Paris, France; Centre du sommeil, service de physiologie-explorations fonctionnelles, AP-HP, hôpital de Bichat, 46, rue Henri-Huchard, 75018 Paris, France.
Université de Paris, NeuroDiderot, Inserm, 75019 Paris, France; Centre du sommeil, service de physiologie-explorations fonctionnelles, AP-HP, hôpital de Bichat, 46, rue Henri-Huchard, 75018 Paris, France.
Rev Med Interne. 2020 Apr;41(4):258-264. doi: 10.1016/j.revmed.2020.01.001. Epub 2020 Jan 29.
Restless legs syndrome, also called Willis-Ekbom disease, is a frequent sensorimotor disease, more often encountered in women than men. It is characterized by an urge to move legs, during the evening or the beginning of the night, increased by rest and relieved by movement. Two forms are classically distinguished: primary restless legs syndrome occurring in young adults with family history and secondary forms occurring in older adults with comorbidities such as iron deficiency, chronic renal failure or neurological diseases (affecting central or peripheral nervous system). The clinical impact of the urge to move the legs may be major, including in particular sleep disorders which can profoundly alter the quality of life. Pathophysiology of restless legs syndrome still remains partially understood and probably relies on dopamine metabolism abnormality secondary to cerebral iron deficiency in genetically susceptible patients. That's why, besides nutritional and sleep hygiene advices, treatment of restless legs syndrome includes iron supplementation if there is an iron deficiency. Pharmacological treatment, for severe to very severe forms, includes use of dopamine agonists, antiepileptic drugs or opioids. These medications have numerous side effects and each prescription has to be individually customized for each patient.
不宁腿综合征,也称为威利氏-埃克博姆病,是一种常见的感觉运动疾病,女性比男性更常出现。其特征是在傍晚或夜间开始时出现腿部活动的冲动,休息时加重,活动后缓解。通常分为两种类型:原发性不宁腿综合征发生在有家族病史的年轻人中,继发性不宁腿综合征发生在有缺铁、慢性肾衰竭或神经系统疾病(影响中枢或周围神经系统)等合并症的老年人中。腿部活动冲动的临床影响可能很大,尤其包括睡眠障碍,这会严重改变生活质量。不宁腿综合征的病理生理学仍部分未明,可能依赖于遗传易感性患者因脑铁缺乏继发的多巴胺代谢异常。这就是为什么除了营养和睡眠卫生建议外,如果存在缺铁,不宁腿综合征的治疗还包括补充铁剂。对于重度至极重度类型,药物治疗包括使用多巴胺激动剂、抗癫痫药物或阿片类药物。这些药物有许多副作用,每个处方都必须针对每个患者单独定制。