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The retless legs syndrome is a litle-known disease. Furthermore, its pathophysiology remains unkown. This illness is common in Belgium. Most of people who suffer from restless legs do not receive special treatment. However, in some instances, this syndrome causes significant sleep disorders and reduces the quality of life of this patients. To date, only some dopamine agnonists hace received the indication ofr restless legs syndrome. In spite of their effectiveness, dopamine agonists cause many side-effects and their long term effectiveness is unclear. For this reason, other drugs such as anti-epileptic.benzodiazepine and opiates are used to relieve symptomes of restless legs. This dissertation aims to clarify the role of these different drugs in the treatment of restless legs. Le syndrome des jambes sans repos est une maladie peu connue, son mécanisme physiopathologique n'est pas encore élucidé. Cette maladie est courante en Belgique. La plupart des personnes vivant avec un syndrome des jambes sans repos ne reçoivent pas de traitement particulier. Cependant , dans certains cas, le syndrome cause des troubles du sommeil importants et diminue ainsi la qualité de vie des personnes qui en souffrent.Jusqu'à présent, seuls certains agonistes dopaminergiques ont reçus l'indication du syndrome des jambes sans repos. Bien qu'efficace, ces agonistes dopaminergiques causent également de nombreux effets secondaires et leur efficacité à long terme n'est pas claire. C'est pourquoi d'autres médicaments tels que des antiépileptiques, des benzodiazépines et même des opiacés sont utilisés pour soulager les symptômes du syndrome des jambes sans repos.Ce mémoire a pour but de clarifier la place de ces différents médicaments dans la prise en charge du syndrome des jambes sans repos.

Restless Legs Syndrome

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Restless legs syndrome (RLS) is a condition which exact cause remains unknown. Genetic predisposition and dopaminergic transmission disorders might account for the idiopathic syndrome. However, the syndrome may be secondary to specific clinical conditions such as iron deficiency, pregnancy, chronic renal failure or peripheral neuropathy. In addition, certain molecules such as dopamine antagonists, antidepressants, caffeine, nicotine and alcohol may exacerbate or cause RLS. The syndrome is characterized by sensorimotor symptoms that can sometimes be painful; they affect lower limbs and are accompanied by an irresistible urge to move the legs. They occur preferentially at rest, are temporarily relieved by movement and worse at night. Restless legs syndrome causes sleep disturbances, is associated with anxiety and depression, and has a negative effect on quality of life. The diagnosis is clinical and treatment regimens are mainly based on the identification of any possible associated condition to distinguish between primary and secondary RLS as well as determining the frequency and the precise nature of the symptoms to help evaluate which drug is worth using. While the secondary forms are corrected by identifying the causal factor, the primary forms are, first, handled by dopaminergic agents, typically L-dopa or agonists such as pramipexole, ropinirole, rotigotine or pergolide. Benzodiazepines are indicated for mild to moderate forms of RLS and can also be used in association with levodopa or other dopaminergic agents for more severe cases. Clonazepam is the most studied and most commonly used. Opioids, which can rapidly cause addiction, are exclusively used for severe and refractory RLS while the antiepileptic drugs are preferentially used for the painful forms of RLS. Since there is no effective treatment known for RLS, further research on this disease is crucial Le syndrome des jambes sans repos (SJSR) est une affection dont l’étiologie exacte reste inconnue. Des prédispositions génétiques ainsi qu’un trouble de la transmission dopaminergique au niveau central sont les hypothèses du syndrome idiopathique. Toutefois, le syndrome peut être secondaire à des conditions cliniques spécifiques telles que la déficience ferrique, la grossesse, l’insuffisance rénale chronique ou la neuropathie périphérique. En outre, certaines molécules peuvent exacerber ou provoquer un SJSR; les antagonistes dopaminergiques, les antidépresseurs, la caféine, la nicotine et l’alcool. Le syndrome se manifeste par des symptômes sensorimoteurs parfois douloureux qui touchent préférentiellement les membres inférieurs, s’accompagnant d’un besoin irrésistible de bouger les jambes. ils surviennent préférentiellement au repos, sont temporairement soulagés par le mouvement et majorés la nuit. Ces manifestations amènent des perturbations importantes du sommeil nocturne entraînant de ce fait une somnolence diurne excessive et des troubles fonctionnels parfois sévères. Le diagnostic se fait uniquement grâce à l’interrogatoire clinique du patient. Les schémas de traitement reposent essentiellement sur l’identification d’une éventuelle pathologie sous-jacente associée permettant de faire la distinction entre SJSR primaire ou secondaire et la détermination de la fréquence ainsi que la qualité des symptômes pour guider le choix du médicament. Alors que les formes secondaires sont corrigées par identification du facteur causal, les formes primaires sont, en premier lieu, prises en charge par un traitement à visée dopaminergique, typiquement la L-Dopa, ou les agonistes tels que le pramipexole, le ropinirole, la rotigotine ou le pergolide. Les benzodiazépines sont indiquées pour les atteintes légères à modérées ou alors en concomitance avec la lévodopa ou les autres agents dopaminergiques pour les cas plus sévères. Le clonazépam est la benzodiazépine la plus étudiée et la plus couramment utilisée. Les opioïdes, auxquels l’accoutumance peut être rapide, sont réservés aux formes sévères et réfractaires tandis que les antiépileptiques conviennent préférentiellement aux formes douloureuses du syndrome. Comme il n’existe aucun traitement du SJSR efficace pour tous, la poursuite des recherches sur cette affection est capitale

Restless Legs Syndrome --- Pharmaceutical Preparations

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This book reviews our knowledge of akathisia and related syndromes, including Restless Legs Syndrome, other forms of motor restlessness and neuroleptic-induced dysphoria and is a comprehensive account of these important, but insufficiently researched, syndromes. The main focus is on drug-induced akathisia and its various subtypes. The author explores its relationship to the restlessness caused by other neurological disorders, presents a synthesis of the pathophysiological mechanisms of akathisia and provides arguments for operational criteria for the research diagnosis of drug-induced akathisia. Strategies for the measurement of akathisia are discussed, as are treatment approaches and a fascinating appendix contains a translation of Hashovec's account of the first cases in the literature. As the first extended review of scientific and clinical aspects of akathisia and restlessness, this book will be much valued by psychiatrists, neurologists and other physicians seeking a better understanding of these disabling syndromes.

Tardive dyskinesia. --- Restless legs syndrome.

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Sleep disorders. --- Insomnia. --- Sleep apnea syndromes. --- Restless legs syndrome. --- Older people --- United States.

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Written by respected leaders in this field and sponsored by the American Academy of Neurology, Restless Legs Syndrome explains what we know about RLS, including its causes and manifestations, and what can be done to manage it. Topics covered include: # Causes, symptoms, and diagnosis # Treatments, including drug and non-pharmacologic therapy # RLS in children # Personal relationships and RLS # Resources # Lifestyle changes, dealing with daily activities, RLS triggers, and much more

Restless legs syndrome. --- Asthenia crurum paresthetica --- Ekbom syndrome --- Ekbom's syndrome --- Restless leg syndrome --- Wittmaack-Ekbom syndrome --- Insomnia --- Movement disorders