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RLS (Restless Legs Syndroom, ook bekend onder de naam ziekte van Willis-Ekbom) kenmerkt zich door een irriterend, branderig, kruipend gevoel, meestal in de kuiten, dat bij de patiënt een onweerstaanbare drang tot bewegen oproept. De aandoening kan zich ook in de voeten en armen voordoen. Soms is er sprake van echte pijn. De irritatie in de ledematen treedt vooral op tijdens rustperiodes. Met name ‘s avonds en ‘s nachts nemen de klachten toe.

De symptomen zijn te bestrijden door dopamine agonisten (1e keuze: pramipexol, ropinirol, rotigotine).
In het verleden werd vaak hydrokinine (Inhibin) voorgeschreven. In Leiden (LUMC) is onderzoek gedaan naar de werking ervan bij RLS/PLMD, met als conclusie dat hydrokinine niet beter werkt voor RLS dan een placebo. (NTvG, 07/91)

[wpspoiler name=”Onderzoek betreffende Pregabaline, feb 2014″]
http://wedinfo.blogspot.com/2014/02/study-sheds-light-on-treatment-for.html

Willis-Ekbom Disease Foundation

Study sheds light on treatment for Willis-Ekbom disease (restless legs syndrome): Pregabalin (Lyrica) found as effective as FDA-approved pramipexole (Mirapex) without causing the worsening of symptoms that commonly occurs with pramipexole.

Rochester, Minn. – February 20, 2014 – A large-scale study of treatment for Willis-Ekbom disease (restless legs syndrome, or WED/RLS) published February 14 in the New England Journal of Medicine shows that the drug pregabalin (Lyrica) controls symptoms as well as pramipexole (Mirapex), but with significantly lower incidence of augmentation. Augmentation is a worsening of symptoms with long-term use, and occurs in about one third of WED/RLS patients who take the intermediate-acting dopamine drugs pramipexole and ropinirole (Requip). Both pramipexole and ropinirole are FDA approved for treating WED/RLS and commonly used as first-line therapy.

“Over the long term, the most commonly used treatments for WED/RLS make a bad disease worse,” saysRichard P. Allen, PhD, who is first author of the report. Allen is an associate professor in the Department of Neurology at Johns Hopkins University past chair of the WED Foundation’s medical advisory board.

“This study is an important contribution to our knowledge of the treatment of a widespread and very serious medical condition,” said Karla Dzienkowski, executive director of the Willis-Ekbom Disease Foundation, headquartered in Rochester, Minn.

WED/RLS is a disease that produces an overwhelming evening and nighttime urge to move the legs. It wreaks havoc on sleep, disrupts quality of life, and is associated with increased risk of cardiovascular disease. Clinically significant WED/RLS affects from 2 to 3 percent of adults and progressively worsens over time.
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[wpspoiler name=”Wetenschappelijke onderzoeken naar RLS te vinden in pubmed”]

http://www.ncbi.nlm.nih.gov/pubmed/?term=restless+legs+syndrome

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[wpspoiler name=”The long-term treatment of restless legs syndrome/Willis–Ekbom disease:  a report from the International Restless Legs Syndrome Study Group, mei 2013″ ]

Diego Garcia-Borreguero, Ralf Kohnen, Michael H. Silber, John W. Winkelman, Christopher J. Earley, Birgit Högl, Mauro Manconi, Jacques Montplaisir, Yuichi Inoue, Richard P. Allen

Received 25 January 2013; received in revised form 29 May 2013; accepted 31 May 2013.

Abstract   Full Text   PDF   References   Supplemental Materials

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[wpspoiler name=”Abstract Dissociation of periodic leg movements from arousals in restless legs syndrome, Annals of Neurology 2012, Volume 71″ ]

Objective:

The purpose of this study was to characterize the nature of the relation between periodic leg movements during sleep (PLMS) and cortical arousals to contribute to the debate on the clinical significance and treatment of PLMS.

Methods:

A prospective, placebo-controlled, single-blind, parallel group study was carried out including 46 drug-naive patients with idiopathic restless legs syndrome (RLS). Each patient underwent 2 consecutive full-night polysomnographic studies. The first night was the baseline night. Prior to the second night, 1 group received a single oral dose of 0.25mg pramipexole, whereas a second group received a single oral dose of 0.5mg clonazepam, and the remaining patients received placebo. Sleep stages, cyclic alternating pattern (CAP), and leg movement activity were scored following standard criteria; symptoms of RLS were also assessed.

Results:

Pramipexole suppressed PLMS without affecting electroencephalographic (EEG) instability (CAP) and arousals (corresponding to CAP A3 and, partially, A2 subtypes), whereas clonazepam did the opposite, reducing non-rapid eye movement sleep EEG instability without effects on PLMS. Both drugs were effective on sensory RLS symptoms.

Interpretation:

This study demonstrates that a selective pharmacological approach can disconnect PLMS from arousal events, suggesting an indirect relation between each other. These results might weaken the hypothesis of a direct pathological role of PLMS in sleep disruption and can be important for the discussion on the existence of a distinct entity called periodic limb movements disorder. Moreover, the study opens the doors to the possibility of a joint treatment for RLS targeting sensory and motor symptoms, as well as sleep instability.

Mauro Manconi MD1,*, Raffaele Ferri MD2, Marco Zucconi MD3, Claudio L. Bassetti MD1, Stephany Fulda PhD1, Debora Aricò PsyD, PhD2, Luigi Ferini-Strambi MD3 Article first published online: 20 JUN 2012
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[wpspoiler name=”Nieuwe richtlijn voor behandeling restless legs syndrome” ]

De European Federation of Neurological Societies (EFNS) heeft in samenwerking met de European Neurological Society en de European Sleep Research Society nieuwe richtlijnen gepubliceerd voor de behandeling van het restless legs syndrome (RLS) in het vakblad Annals of Neurology.

Volgende geneesmiddelen worden aanbevolen voor een kortdurende behandeling van RLS: rotigotine, ropinirol, pramipexol, gabapentine enacarbil, gabapentine en pregabaline.

Voor landurige behandeling wordt alleen rotigotine als effectief beschouwd, gabapentine enacarbil als waarschijlijk effectief, en ropinirol, pramipexol en gabapentine als mogeljk effectief. Cabergoline wordt niet aanbevolen omwille van het risico op ernstige bijwerkingen.

verschenen op : 02-01-2013 (www.gezondheid.be)
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[wpspoiler name=”TREATMENT OF RLS AND PLMS DISORDER IN ADULTS: PRACTICE PARAMETERS” ]

SLEEP, Vol. 35, No. 8, 2012[/wpspoiler]

[wpspoiler name=”Restless legs syndrome-associated MEIS1 risk variant influences iron homeostasis, Annals of Neurology 2011, Volume 70″ ]

Abstract

Restless legs syndrome (RLS) is a frequent sleep disorder that is linked to disturbed iron homeostasis. Genetic studies identified MEIS1 as an RLS-predisposing gene, where the RLS risk haplotype is associated with decreased MEIS1 mRNA and protein expression. We show here that RNA interference treatment of the MEIS1 worm orthologue increases ferritin expression in Caenorhabditis elegans and that the RLS-associated haplotype leads to increased expression of ferritin and DMT1 in RLS brain tissues. Additionally, human cells cultured under iron-deficient conditions show reduced MEIS1 expression. Our data establish a link between the RLS MEIS1 gene and iron metabolism.

Hélène Catoire PhD1, Patrick A. Dion PhD1,2, Lan Xiong MD, PhD1,3, Mourabit Amari MD1, Rebecca Gaudet MSc1, Simon L. Girard MSc1, Anne Noreau MSc1, Claudia Gaspar PhD1,2, Gustavo Turecki MD, PhD4, Jacques Y. Montplaisir MD, PhD5,6, J. Alex Parker PhD1,2, Guy A. Rouleau MD, PhD1,3,7,*
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[wpspoiler name=”Long-term safety and efficacy of rotigotine transdermal patch for moderate-to-severe idiopathic restless legs syndrome”]

The Lancet Neurology, Volume 10, Issue 8, Pages 710 – 720, August 2011 doi:10.1016/S1474-4422(11)70127-2[/wpspoiler]

[wpspoiler name=”Algorithms for the diagnosis and treatment of restless legs syndrome in primary care”]

BMC Neurology 2011, 11:28 doi:10.1186/1471-2377-11-28[/wpspoiler]

[wpspoiler name=”Rotigotine in the Long-Term Treatment of Severe RLS with Augmentation: A Series of 28 Cases”]

Sleep Disorders Volume 2011 (2011), Article ID 468952, 6 pages doi:10.1155/2011/468952[/wpspoiler]

[wpspoiler name=”Ropinirole (Requip®) and Pramipexole (Mirapex®) for the Treatment of Primary Restless Legs Syndrome” ]

 World of Drug Information Volume 19 Issue 1 March 2008[/wpspoiler]

[wpspoiler name=”Long-term Treatment of Restless Legs Syndrome With Dopamine Agonists” ]

Arch Neurol. 2004;61(9):1393-1397. doi:10.1001/archneur.61.9.1393[/wpspoiler]

[wpspoiler name=”NTVG,  Geen verschil in werkzaamheid tussen hydrokinine en placebo bij het restless legs-syndroom, 29-04-1991″ ]

 Ned Tijdschr Geneeskd. 1991;135:759-63, Onderzoek naar de werkzaamheid van hydrokinine bij het restless legs-syndroom[/wpspoiler]