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.^[25]

Pharmacologic Therapy

According to the American Academy of Sleep Medicine practice parameters, the dopaminergic agents pramipexole, ropinirole, 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 (RLS).^[25]

Nonpharmacologic Therapy

Some evidence shows that exercise therapy and cognitive-behavioral psychological intervention may provide benefit in periodic limb movement disorder (PLMD).^[26]

Klassen et al report improvement with deep brain stimulation in Parkinson patients with PLMD.^[27]

Although often suggested based on anecdotal evidence, magnesium supplementation has not been shown to provide significant relief of symptoms in patients with PLMD or restless legs syndrome (RLS).^[28]

Medication

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Author

Deepak K Gupta, MD Assistant Professor of Neurological Sciences, The Robert Larner, MD, College of Medicine at The University of Vermont; Movement Disorders Neurologist, Binter Center for Parkinson’s Disease and Movement Disorders, University of Vermont Medical Center

Disclosure: Nothing to disclose.

Coauthor(s)

Magalie E Carey, BS MD Candidate, The Robert Larner, MD, College of Medicine at The University of Vermont

Disclosure: Nothing to disclose.

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.

Chief Editor

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

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

Disclosure: Serve(d) as a director, officer, partner, employee, advisor, consultant or trustee for: Alliance, Bioserenity, Ceribell, Eisai, Greenwich, LivaNova, Neurelis, Neuropace, Nexus, RSC, SK life science, Sunovion<br/>Serve(d) as a speaker or a member of a speakers bureau for: Alliance, Aquestive, Bioserenity, Eisai, Greenwich, LivaNova, Neurelis, SK life science, Sunovion<br/>Received research grant from: Cerevel, LivaNova, Greenwich, SK biopharmaceuticals, Takeda.

Additional Contributors

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: American Academy of Neurology, American Headache Society, California Medical Association, California Neurology Society, International Headache Society, San Francisco Medical Society, San Francisco Neurological Society

Disclosure: Nothing to disclose.

Sections Periodic Limb Movement Disorder
Overview
Presentation
DDx
Workup
Treatment
Medication
Questions & Answers
References

Periodic Limb Movement Disorder Treatment & Management

Approach Considerations

Pharmacologic Therapy

Nonpharmacologic Therapy

References

Tables

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