Restless Leg Syndrome

Definition: also known as Wittmaack-Ekbom's syndrome, and colloquially as "the jimmylegs" is a condition that is characterized by an irresistible urge to move one's body to stop uncomfortable or odd sensations. It most commonly affects the legs, but can also affect the arms or torso and even phantom limbs.[1] Moving the affected body part modulates the sensations, providing temporary relief.

RLS causes a sensation in the legs or arms that can most closely be compared to a burning, itching, or tickling sensation in the muscles. Some controversy surrounds the marketing of drug treatments for RLS. It is a 'spectrum' disease with some people experiencing only a minor annoyance and others experiencing major issues.

Why RLS and PLMs Get Worse With Treatment

"Rebound and Augmentation in RLS: Reports in the literature indicate treatment of RLS with dopaminergic medications can result in a shifting of symptoms to the early morning hours, referred to as rebound. Rebound was not reported in the clinical trials of MIRAPEX tablets but the trials were generally not of sufficient duration to capture this phenomenon. Augmentation has also been described during therapy for RLS. Augmentation refers to the earlier onset of symptoms in the evening (or even the afternoon), increase in symptoms, and spread of symptoms to involve other extremities. In a controlled trial of MIRAPEX tablets for RLS, approximately 20% of both the MIRAPEX- and placebo-treated patients reported at least a 2-hour earlier onset of symptoms during the day by the end of 3 months of treatment. The frequency and severity of augmentation and/or rebound after longer-term use of MIRAPEX tablets and the appropriate management of these events have not been adequately evaluated in controlled clinical trials." (Mirapex package insert)

No evidence of augmentation with rotigotine treatment in a 6-month, multicenter, double blind, placebo-controlled RLS trial W.A. Hening, R. Allen, J.W. Winkelman, E. Schollmayer (Piscataway, NJ)

http://www.emea.europa.eu/humandocs/PDF ... -19-AR.pdf

Anne-Marie Williams and Diego Garcia-Borreguero Current Treatment Options in Neurology 2009, 11(5):327–332 Management of restless legs syndrome augmentation

Sources

Johns Hopkins Powerpoint Presentation

Study

... m003-1.doc Study

Treatment of Restless Legs Syndrome: An Evidence-Based Review and Implications for Clinical Practice