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Praktische Diagnostik und Therapie des Restless-legs-Syndroms

Practical guidelines for diagnosis and therapy of restless legs syndrome

Zusammenfassung

Das Restless-legs-Syndrom (RLS) ist die häufigste neurologische Schlaferkrankung und betrifft etwa 10 % der kaukasischen Bevölkerung. Die Erkrankung ist durch schmerzhafte Missempfindungen der Beine gekennzeichnet, die insbesondere am Abend und in der Nacht sowie bei Inaktivität auftreten, mit daraus resultierendem Bewegungsdrang und Schlafstörungen. Als Folge kommt es zu einer deutlichen Beeinträchtigung im Alltag sowie Minderung der Lebensqualität bei den Betroffenen. Adäquate Therapien stehen insbesondere mit dopaminergen und bisher nicht zugelassenen opioidergen und antikonvulsiven Substanzen zur Verfügung. Voraussetzung hierfür ist jedoch, dass die entsprechenden Patienten identifiziert und einer Therapie zugeführt werden, was v. a. im ambulanten Sektor häufig nicht der Fall ist. Mögliche Gründe für die erschwerte Diagnostik sind der noch nicht ausreichende Bekanntheitsgrad der Erkrankung, die häufige Überlappung mit Komorbiditäten sowie eine Imitation durch andere Erkrankungen, sog. „RLS mimics“. Ziel der vorliegenden Arbeit ist es daher, konkrete Anleitungen bei der Diagnosestellung und Therapie des RLS zur Verfügung zu stellen.

Summary

Restless legs syndrome (RLS) is the most common neurological sleep disorder affecting 10 % of the Caucasian population. The disorder is characterized by painful sensations in the lower limbs, especially during the evening, at night and during rest, resulting in an urge to move the legs and insomnia. As a result the quality of life is significantly reduced. Dopaminergic agents, opioids and anticonvulsants have proven to be effective for RLS with only the former being currently licensed; however, affected patients have to be identified, which is not always the case, especially in outpatient settings. Possible impediments to the adequate management of patients with RLS may include a lack of awareness, comorbidities and other medical conditions mimicking RLS. To overcome some of these difficulties practical guidelines for the diagnosis and therapy of RLS are provided.

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Einhaltung ethischer Richtlinien

Interessenkonflikt. M. Krenzer gibt an, dass in der Vergangenheit eine Förderung durch Boehringer Ingelheim (BIF MD Fellowship) bestand. W.H. Oertel gibt an, im Besitz von Aktien (Roche) und beratend für Desitin, Proteosys, Novartis und Orion Pharma tätig zu sein. Er ist im Beratungsausschuss bei Bayer-Schering, Bioprojet, Boehringer Ingelheim, Merck-Serono, Mundipharma, Novartis, Orion Pharma, Schwarz Pharma Neuroscience/(UCB), Teva tätig und erhielt Honorare von Boehringer Ingelheim, Desitin, GlaxoSmithKline, Novartis, Orion Pharma, Schwarz Pharma Neuroscience/(UCB) und Teva. Weiterhin besteht finanzielle Förderung durch die Deutsche Forschungsgemeinschaft (DFG). C. Trenkwalder gibt an, dass Interessenkonflikte bez. der vorliegenden Arbeit Vifor, UCB, Mundipharma und Boehringer Ingelheim betreffen.

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Correspondence to C. Trenkwalder.

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Krenzer, M., Oertel, W. & Trenkwalder, C. Praktische Diagnostik und Therapie des Restless-legs-Syndroms. Nervenarzt 85, 9–18 (2014). https://doi.org/10.1007/s00115-013-3888-3

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  • DOI: https://doi.org/10.1007/s00115-013-3888-3

Schlüsselwörter

  • Restless-legs-Syndrom
  • Diagnostik
  • Therapie
  • Schmerz
  • Dopamin

Keywords

  • Restless legs syndrome
  • Diagnosis
  • Therapy
  • Pain
  • Dopamine