Restless Leg Syndrome

Exam Cram

• Suggestion that it can have an autosomal dominant inheritance

• Presentation: restless legs

• Management: 

  1. Replace iron deficiency

  2. Gabapentinoids

  3. Dopamine agonists (non ergot derived, e.g. ropinirole, pramipexole, rotigotine)

     • • Can make symptoms worse in 5%

       • Rotigotine increases risk of gambling

Med Reg Notes

Associations

• Hyperuricaemia

• Deficiency of folate, B12 and magnesium

• Polyneuropathy

• Diabetes mellitus & hypothyroidism

• Parkinsonism

• Rheumatoid arthritis, Sjogren's syndrome

• Amyloidosis

Akathesia

Akathesia is restless caused by dopamine blockade by dopamine antagonists and is part of the extra pyramidal side effects. In summary there isn't great evidence around its management but after changing anti-psychotic- betablockers, benzodiazepines, benztropine and mirtazapine have been used. There is overlap in terms of symptoms however the having different managements points towards different underlying disease processes. 

Resources and References

1. Patel J, Marwaha R. Akathisia. [Updated 2023 Jul 24]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK519543/

Written 2024