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不宁腿综合征。病理生理学、诊断与治疗。

Restless legs syndrome. Pathophysiology, diagnosis and treatment.

作者信息

Castillo-Álvarez Federico, Marzo-Sola María Eugenia

机构信息

Servicio de Neurología, Hospital Universitario San Pedro, Logroño, La Rioja, España.

Servicio de Neurología, Hospital Universitario San Pedro, Logroño, La Rioja, España.

出版信息

Med Clin (Barc). 2025 Jan 24;164(2):84-90. doi: 10.1016/j.medcli.2024.05.026. Epub 2024 Aug 28.

Abstract

Restless legs syndrome is the most prevalent sleep-related movement disorder, affecting 5-10% of the population, characterized by an urge to move that appears during rest or is exacerbated by rest, primarily in the lower extremities, that occurs in the evening or night and that disappears during movement or is improved by movement. Restless legs syndrome significantly impacts sleep, mood, and quality of life. Its pathophysiology involves a complex interplay of genetic and environmental factors, as well as comorbidities, leading to alterations in brain iron resulting in dysfunction in dopaminergic, adenosine, and glutamatergic pathways. Treatment typically includes iron supplementation and symptomatic therapy, traditionally utilizing dopamine agonists. However, their long-term use may exacerbate symptoms, relegating them to second-line treatment after ligands α2δ of calcium channels.

摘要

不宁腿综合征是最常见的与睡眠相关的运动障碍,影响5%至10%的人口,其特征是在休息时出现或因休息而加重的活动冲动,主要发生在下肢,在傍晚或夜间出现,在活动时消失或因活动而改善。不宁腿综合征会显著影响睡眠、情绪和生活质量。其病理生理学涉及遗传和环境因素以及合并症之间的复杂相互作用,导致脑铁改变,进而引起多巴胺能、腺苷能和谷氨酸能通路功能障碍。治疗通常包括补充铁剂和对症治疗,传统上使用多巴胺激动剂。然而,长期使用这些药物可能会加重症状,使其在钙通道配体α2δ之后成为二线治疗药物。

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