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Restless Legs Syndrome

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Sleep Disorders in Adolescents

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Abstract

Restless legs syndrome (RLS) is an under-recognized neurologic sensorimotor disorder, affecting approximately 2% of male and female adolescents. It is characterized by an urge to move the legs, usually associated with leg discomfort. The symptoms occur at rest, are relieved by movement, and are most severe in the evening and at night. RLS varies in severity, with some adolescents experiencing mild, infrequent symptoms and others having severe, daily symptoms.

The pathophysiology of RLS remains poorly understood. The clinical manifestations of RLS are likely mediated by genetic and environmental influences, including central nervous system dopamine dysfunction and brain iron deficiency. RLS can occur as a primary and secondary condition. Common secondary etiologies are iron deficiency, pregnancy, chronic renal failure, chronic neurologic disorders, and some medications. Early recognition and treatment of RLS is important, as it can influence sleep, daily activities, mood, and vitality.

Non-pharmacologic therapies are the initial step in the treatment of RLS in adolescents. These focus on correction of contributing factors, such as appropriate bedtime habits, use of local comfort aids for leg discomfort, and elimination of unnecessary medications. Pharmacological therapies are considered in moderate to severe RLS with significant functional impact. There are no Food and Drug Administration (FDA) approved medications for the treatment of RLS in adolescents; however, the medical literature supports the careful use of certain medications, including iron and folic acid supplementation, dopaminergic agents (e.g., carbidopa-levodopa), dopamine agonists (e.g., ropinirole, pramipexole), benzodiazepines (e.g., clonazepam), anticonvulsants (e.g., gabapentin), and others including clonidine.

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Abbreviations

CKD:

Chronic Kidney Disease

FDA:

Food and Drug Administration

RLS:

Restless Legs Syndrome

SSRI:

Serotonin-Specific Reuptake Inhibitor

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None of the authors have any financial support or conflicts of interest to disclose.

No off label use of drugs or products have been discussed in the manuscript.

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Authors and Affiliations

  1. Pulmonary, Critical Care, and Sleep Medicine, New York University Langone Medical Center, New York, NY, USA

    Mandana Mahmoudi M.D.

  2. Department of Neurology, NYU Langone Medical Center and NYU School of Medicine, 223 East 34th Street, New York, NY, USA

    Sanjeev V. Kothare M.D.

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  1. Mandana Mahmoudi M.D.
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Correspondence to Sanjeev V. Kothare M.D. .

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Editors and Affiliations

  1. NYU Comprehensive Epilepsy Center, NYU Langone Medical Center, New York, New York, USA

    Sanjeev V. Kothare

  2. Langone Comprehensive Epilepsy-Sleep Ctr, New York University Langone Medical Ctr., New York, New York, USA

    Rebecca Quattrucci Scott

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Mahmoudi, M., Kothare, S.V. (2017). Restless Legs Syndrome. In: Kothare, S., Quattrucci Scott, R. (eds) Sleep Disorders in Adolescents. Springer, Cham. https://doi.org/10.1007/978-3-319-41742-4_3

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  • DOI: https://doi.org/10.1007/978-3-319-41742-4_3

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