THERAPY OF IDIOPATHIC AND UREMIC RESTLESS LEGS SYNDROME

Sensory and motor symptoms of the limbs, motor restlessness and an urg e to move only at rest are the characteristics of the restless legs sy ndrome (RLS), which often leads to severe sleep disturbances. The clin ical diagnosis can be made on the basis of the typical history, normal neurological findings and, in some cases, a positive family history, and can be confirmed by polysomnography. The indication for treatment depends on the patient's discomfort and the severity of the sleep dist urbances. L-DOPA is the treatment of first choice both in idiopathic a nd uremic RLS. A bedtime dose of 100-200 mg L-DOPA standard plus decar boxylase inhibitor is effective against mild and moderate sleep distur bances in RLS. Titration of the dosage and additional treatment with s ustained-release preparations of L-DOPA should be applied individually . Opioids and dopamine agonists are effective alternative treatments i n idiopathic RLS. Benzodiazepines are indicated only in individual cas es. Besides L-DOPA, uremic RLS patients can be treated with opioids an d benzodiazepines. Various approaches in the treatment of idiopathic a nd uremic RLS are reviewed and the practical management of therapy is outlined.