Close
New

Medscape is available in 5 Language Editions – Choose your Edition here.

 

Periodic Limb Movement Disorder Treatment & Management

  • Author: Wayne E Anderson, DO, FAHS, FAAN; Chief Editor: Selim R Benbadis, MD  more...
 
Updated: Jul 06, 2016
 

Approach Considerations

A 2012 update of treatment guidelines from the American Academy of Sleep Medicine indicate that although there are no studies of dopaminergic medication effects on periodic limb movement disorder (PLMD), many of the studies of dopaminergic medication effects on restless legs syndrome looked at periodic limb movements of sleep.[29]

Next

Pharmacologic Therapy

According to the American Academy of Sleep Medicine practice parameters, the dopaminergic agents pramixpexole, ropinorole, rotigotine, and the combination of carbidopa/levodopa/entacapone, were shown in some studies to decrease periodic limb movement indices. Gabepentin and pregabalin also showed benefit in studies of subjects with restless legs syndrome.[29]

Previous
Next

Nonpharmacologic Therapy

Some evidence shows that exercise therapy and cognitive-behavioral psychological intervention may provide benefit.[13]

Klassen et al report improvement with deep brain stimulation in Parkinson patients with PLMD.[14]

Previous
 
 
Contributor Information and Disclosures
Author

Wayne E Anderson, DO, FAHS, FAAN Assistant Professor of Internal Medicine/Neurology, College of Osteopathic Medicine of the Pacific Western University of Health Sciences; Clinical Faculty in Family Medicine, Touro University College of Osteopathic Medicine; Clinical Instructor, Departments of Neurology and Pain Management, California Pacific Medical Center

Wayne E Anderson, DO, FAHS, FAAN is a member of the following medical societies: California Medical Association, American Headache Society, San Francisco Medical Society, San Francisco Medical Society, International Headache Society, California Neurology Society, San Francisco Neurological Society, American Academy of Neurology, California Medical Association

Disclosure: Received honoraria from Teva for speaking and teaching; Received grant/research funds from Allergan for other; Received honoraria from Insys for speaking and teaching; Received honoraria from DepoMed for speaking and teaching.

Specialty Editor Board

Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Received salary from Medscape for employment. for: Medscape.

Selim R Benbadis, MD Professor, Director of Comprehensive Epilepsy Program, Departments of Neurology and Neurosurgery, Tampa General Hospital, University of South Florida College of Medicine

Selim R Benbadis, MD is a member of the following medical societies: American Academy of Neurology, American Medical Association, American Academy of Sleep Medicine, American Clinical Neurophysiology Society, American Epilepsy Society

Disclosure: Serve(d) as a director, officer, partner, employee, advisor, consultant or trustee for: Cyberonics; Eisai; Lundbeck; Sunovion; UCB; Upsher-Smith<br/>Serve(d) as a speaker or a member of a speakers bureau for: Cyberonics; Eisai; Glaxo Smith Kline; Lundbeck; Sunovion; UCB<br/>Received research grant from: Cyberonics; Lundbeck; Sepracor; Sunovion; UCB; Upsher-Smith.

Chief Editor

Selim R Benbadis, MD Professor, Director of Comprehensive Epilepsy Program, Departments of Neurology and Neurosurgery, Tampa General Hospital, University of South Florida College of Medicine

Selim R Benbadis, MD is a member of the following medical societies: American Academy of Neurology, American Medical Association, American Academy of Sleep Medicine, American Clinical Neurophysiology Society, American Epilepsy Society

Disclosure: Serve(d) as a director, officer, partner, employee, advisor, consultant or trustee for: Cyberonics; Eisai; Lundbeck; Sunovion; UCB; Upsher-Smith<br/>Serve(d) as a speaker or a member of a speakers bureau for: Cyberonics; Eisai; Glaxo Smith Kline; Lundbeck; Sunovion; UCB<br/>Received research grant from: Cyberonics; Lundbeck; Sepracor; Sunovion; UCB; Upsher-Smith.

References
  1. Vetrugno R, D'Angelo R, Montagna P. Periodic limb movements in sleep and periodic limb movement disorder. Neurol Sci. 2007 Jan. 28 Suppl 1:S9-S14. [Medline].

  2. Martinez-Mena JM, Pastor J. [Polyneuropathy in patients with periodic leg movements during sleep]. Rev Neurol. 1998 Nov. 27(159):745-9. [Medline].

  3. Gingras JL, Gaultney JF, Picchietti DL. Pediatric periodic limb movement disorder: sleep symptom and polysomnographic correlates compared to obstructive sleep apnea. J Clin Sleep Med. 2011 Dec 15. 7(6):603-9A. [Medline]. [Full Text].

  4. Hoque R, Chesson AL Jr. Pharmacologically induced/exacerbated restless legs syndrome, periodic limb movements of sleep, and REM behavior disorder/REM sleep without atonia: literature review, qualitative scoring, and comparative analysis. J Clin Sleep Med. 2010 Feb 15. 6(1):79-83. [Medline]. [Full Text].

  5. Voderholzer U, Müller N, Haag C, Riemann D, Straube A. Periodic limb movements during sleep are a frequent finding in patients with Gilles de la Tourette's syndrome. J Neurol. 1997 Aug. 244(8):521-6. [Medline].

  6. Ferri R, Gschliesser V, Frauscher B, Poewe W, Högl B. Periodic leg movements during sleep and periodic limb movement disorder in patients presenting with unexplained insomnia. Clin Neurophysiol. 2009 Feb. 120(2):257-63. [Medline].

  7. Haba-Rubio J, Staner L, Krieger J, Macher JP. What is the clinical significance of periodic limb movements during sleep?. Neurophysiol Clin. 2004 Dec. 34(6):293-300. [Medline].

  8. Nozawa T, Ichikawa H, Takeuchi T. Periodic limb movements and sleep-wake disorder. Psychiatry Clin Neurosci. 1998 Apr. 52(2):192-4. [Medline].

  9. Picchietti DL, Rajendran RR, Wilson MP, Picchietti MA. Pediatric restless legs syndrome and periodic limb movement disorder: Parent-child pairs. Sleep Med. 2009 Mar 20. [Medline].

  10. Walters AS, Silvestri R, Zucconi M, Chandrashekariah R, Konofal E. Review of the possible relationship and hypothetical links between attention deficit hyperactivity disorder (ADHD) and the simple sleep related movement disorders, parasomnias, hypersomnias, and circadian rhythm disorders. J Clin Sleep Med. 2008 Dec 15. 4(6):591-600. [Medline]. [Full Text].

  11. Bae CJ, Lee JK, Foldvary-Schaefer N. The use of sleep studies in neurologic practice. Semin Neurol. 2009 Sep. 29(4):305-19. [Medline].

  12. Picchietti MA, Picchietti DL, England SJ, Waiters AS, Couvadelli BV, Lewin DS, et al. Children show individual night-to-night variability of periodic limb movements in sleep. Sleep. 2009 Apr 1. 32(4):530-5. [Medline]. [Full Text].

  13. Pigeon WR, Yurcheshen M. Behavioral Sleep Medicine Interventions for Restless Legs Syndrome and Periodic Limb Movement Disorder. Sleep Med Clin. 2009 Dec 1. 4(4):487-494. [Medline]. [Full Text].

  14. Klassen BT, Lyons MK, Evidente VG. Bilateral globus pallidus internus deep brain stimulation in Parkinson's disease with periodic limb movement disorder. Turk Neurosurg. 2013. 23(1):104-6. [Medline].

  15. Littner MR, Kushida C, Anderson WM, et al. Practice parameters for the dopaminergic treatment of restless legs syndrome and periodic limb movement disorder. Sleep. 2004 May 1. 27(3):557-9. [Medline].

  16. Hening WA, Allen RP, Earley CJ, et al. An update on the dopaminergic treatment of restless legs syndrome and periodic limb movement disorder. Sleep. 2004 May 1. 27(3):560-83. [Medline].

  17. [Guideline] Aurora RN, Kristo DA, Bista SR, Rowley JA, Zak RS, Casey KR, et al. The treatment of restless legs syndrome and periodic limb movement disorder in adults-an update for 2012: practice parameters with an evidence-based systematic review and meta-analyses: an American Academy of Sleep Medicine Clinical Practice Guideline. Sleep. 2012 Aug 1. 35(8):1039-62. [Medline]. [Full Text].

  18. Inami Y, Horiguchi J, Nishimatsu O, et al. A polysomnographic study on periodic limb movements in patients with restless legs syndrome and neuroleptic-induced akathisia. Hiroshima J Med Sci. 1997 Dec. 46(4):133-41. [Medline].

  19. Horiguchi J, Inami Y, Sasaki A, et al. Periodic leg movements in sleep with restless legs syndrome: effect of clonazepam treatment. Jpn J Psychiatry Neurol. 1992 Sep. 46(3):727-32. [Medline].

  20. Pieta J, Millar T, Zacharias J, et al. Effect of pergolide on restless legs and leg movements in sleep in uremic patients. Sleep. 1998 Sep 15. 21(6):617-22. [Medline].

  21. Picchietti DL, England SJ, Walters AS, et al. Periodic limb movement disorder and restless legs syndrome in children with attention-deficit hyperactivity disorder. J Child Neurol. 1998 Dec. 13(12):588-94. [Medline].

  22. Armstrong C. AASM Updates Treatment Guidelines for Restless Legs Syndrome and Periodic Limb Movement Disorder. Am Fam Physician. 2013 Feb 15. 87(4):290-2. [Medline].

  23. Iriarte J, Urrestarazu E, Alegre M, et al. Oscillatory cortical changes during periodic limb movements. Sleep. 2004 Dec 15. 27(8):1493-8. [Medline].

  24. Mello MT, Silva AC, Rueda AD, et al. Correlation between K complex, periodic leg movements (PLM), and myoclonus during sleep in paraplegic adults before and after an acute physical activity. Spinal Cord. 1997 Apr. 35(4):248-52. [Medline].

  25. Ulfberg J, Jonsson R, Lindberg E, et al. [Restless legs. A much neglected syndrome]. Lakartidningen. 1999 Mar 10. 96(10):1183-4, 1187-8. [Medline].

  26. [Guideline] Vignatelli L, Billiard M, Clarenbach P. EFNS guidelines on management of restless legs syndrome and periodic limb movement disorder in sleep. Eur J Neurol. 2006 Oct. 13(10):1049-65. [Medline].

  27. Wetter TC, Pollmacher T. Restless legs and periodic leg movements in sleep syndromes. J Neurol. 1997 Apr. 244(4 Suppl 1):S37-45. [Medline].

  28. Hornyak M, Feige B, Riemann D, Voderholzer U. Periodic leg movements in sleep and periodic limb movement disorder: prevalence, clinical significance and treatment. Sleep Med Rev. 2006 Jun. 10(3):169-77. [Medline].

  29. Aurora RN, Kristo DA, Bista SR, Rowley JA, Zak RS, Casey KR, et al. The treatment of restless legs syndrome and periodic limb movement disorder in adults--an update for 2012: practice parameters with an evidence-based systematic review and meta-analyses: an American Academy of Sleep Medicine Clinical Practice Guideline. Sleep. 2012 Aug 1. 35(8):1039-62. [Medline]. [Full Text].

  30. Moore H 4th, Leary E, Lee SY, Carrillo O, Stubbs R, Peppard P, et al. Design and validation of a periodic leg movement detector. PLoS One. 2014. 9 (12):e114565. [Medline].

Previous
Next
 
 
 
 
All material on this website is protected by copyright, Copyright © 1994-2016 by WebMD LLC. This website also contains material copyrighted by 3rd parties.