Kouri Ioanna, Junna Mithri R, Lipford Melissa C
Center for Sleep Medicine, Mayo Clinic, Rochester, Minnesota, U.S.A.; and.
Department of Neurology, Mayo Clinic, Rochester, Minnesota, U.S.A.
J Clin Neurophysiol. 2023 Mar 1;40(3):215-223. doi: 10.1097/WNP.0000000000000934. Epub 2022 Mar 15.
This article summarizes restless legs syndrome (RLS), periodic limb movements of sleep, and periodic limb movement disorder. RLS is a common sleep disorder with a prevalence of 5% to 15% in the general population. RLS can present in childhood, and incidence increases with age. RLS can be idiopathic or secondary to iron deficiency, chronic renal failure, peripheral neuropathy, and medications such as antidepressants (with higher rates for mirtazapine and venlafaxine, while bupropion may reduce symptoms at least in the short term), dopamine antagonists (neuroleptic antipsychotic agents and antinausea medications), and possibly antihistamines. Management includes pharmacologic agents (dopaminergic agents, alpha-2 delta calcium channel ligands, opioids, benzodiazepines) and nonpharmacologic therapies (iron supplementation, behavioral management). Periodic limb movements of sleep are an electrophysiologic finding commonly accompanying RLS. On the other hand, most individuals with periodic limb movements of sleep do not have RLS. The clinical significance of the movements has been argued. Periodic limb movement disorder is a distinct sleep disorder that arises in individuals without RLS and is a diagnosis of exclusion.
本文总结了不宁腿综合征（RLS）、睡眠期周期性肢体运动及周期性肢体运动障碍。RLS是一种常见的睡眠障碍，在普通人群中的患病率为5%至15%。RLS可在儿童期出现，且发病率随年龄增长而增加。RLS可为特发性，或继发于缺铁、慢性肾衰竭、周围神经病变以及某些药物，如抗抑郁药（米氮平和文拉法辛的发病率较高，而安非他酮至少在短期内可能减轻症状）、多巴胺拮抗剂（抗精神病药物和止吐药），以及可能的抗组胺药。治疗方法包括药物治疗（多巴胺能药物、α-2δ钙通道配体、阿片类药物、苯二氮䓬类药物）和非药物治疗（补充铁剂、行为管理）。睡眠期周期性肢体运动是一种通常与RLS伴发的电生理表现。另一方面，大多数有睡眠期周期性肢体运动的个体并无RLS。这些运动的临床意义一直存在争议。周期性肢体运动障碍是一种在无RLS的个体中出现的独特睡眠障碍，是一种排除性诊断。
