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Periodic limb movement disorder

Overview of Periodic Limb Movement Disorder (PLMD) – Signs and symptoms include excessive daytime sleepiness, trouble falling asleep, and involuntary limb movements during non-REM sleep […]

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Overview of Periodic Limb Movement Disorder (PLMD)
– Signs and symptoms include excessive daytime sleepiness, trouble falling asleep, and involuntary limb movements during non-REM sleep stages.
– Causes are unknown but may be associated with medical conditions like Parkinson’s disease, certain medications, and low ferritin levels.
– Diagnosis involves establishing a cause-effect relationship between PLMS and sleep disturbances through polysomnography and other tests.
– PLMD is classified in the International Classification of Sleep Disorders (ICSD-3) under Sleep-Related Movement Disorders.

Treatment of Periodic Limb Movement Disorder
– Effective treatments include dopaminergic agents like pramipexole and ropinirole, as well as oral iron supplements for patients with low ferritin levels.
– Adverse effects may include triggering restless leg syndrome and cortical arousals.
– Treatment aims to alleviate symptoms and improve sleep quality based on individual patient needs and medical history.
– Medications like clonazepam and non-ergot derived dopaminergic meds are preferred, while caffeine, alcohol, and certain antidepressants should be avoided.

Epidemiology and Medications for PLMD
– PLMD occurs in approximately 4% of adults aged 15-100, with a higher prevalence in elderly females.
– 80% of people with Restless Leg Syndrome (RLS) also have PLMS, and it is uncommon in childhood.
– Medications like tricyclic antidepressants and SSRIs can exacerbate PLMs, while dopaminergic agents are preferred for treatment.
– Clonazepam in 1mg doses can improve sleep measures, and clinical monitoring is recommended with any pharmacological use.

Additional Treatment Options and Related Conditions
– Other medications aim to reduce leg jerks or arousals, with options like co-careldopa being superior to dextropropoxyphene in reducing leg kicks.
– Magnesium supplementation is hypothesized to improve PLMD, but evidence on pharmacological treatment efficacy is insufficient.
– PLMD is associated with RLS and linked to lower quality of life in children with monosymptomatic nocturnal enuresis.

References
– Various studies and guidelines on PLMD and RLS treatment, prevalence, characteristics, and medication use are available for further research and understanding.

Periodic limb movement disorder (Wikipedia)

Periodic limb movement disorder (PLMD) is a sleep disorder where the patient moves limbs involuntarily and periodically during sleep, and has symptoms or problems related to the movement. PLMD should not be confused with restless legs syndrome (RLS), which is characterized by a voluntary response to an urge to move legs due to discomfort. PLMD on the other hand is involuntary, and the patient is often unaware of these movements altogether. Periodic limb movements (PLMs) occurring during daytime period can be found but are considered as a symptom of RLS; only PLMs during sleep can suggest a diagnosis of PLMD.

Periodic limb movement disorder
SpecialtyNeurology Edit this on Wikidata

Periodic limb movement disorder is characterized by recurrent episodes of frequent limb movements while sleeping. It mostly happens in the lower parts of the body like the toes, ankles, knees and hips. It can also, in some cases, appear in the upper extremities of the body. These movements can lead the patient to wake up, and if so, sleep interruption can be the origin of excessive daytime sleepiness.

PLMD is characterized by increased periodic limb movements during sleep, which must coexist with a sleep disturbance or other functional impairment, in an explicit cause-effect relationship. Usually, these involuntary movements come from lower extremities (including toes, ankles, knees, and hips), although they can also be observed in upper extremities, occasionally. PLMs seem to be common features within many people, and identifying whether or not these movements are clinically relevant for a distinct diagnosis of PLMD remains a challenge for clinical and scientific fields. Moreover, diagnosis of PLMD cannot be used when narcolepsy, restless legs syndrome (RLS), REM sleep behaviour disorder (RBD) or untreated obstructive sleep apnea (OSA) is already diagnosed, since abnormal movements during sleep are frequent in these disorders.

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