Neuromuscular DiseasesNeuromuscular DiseasesНервно-мышечные болезни2222-87212413-0443Publishing House ABV Press8510.17650/2222-8721-2012-0-3-8-19LECTURES AND REVIEWSЛЕКЦИИ И ОБЗОРЫRestless leg syndrome: pathogenesis, diagnosis and treatment. Literature reviewСиндром беспокойных ног: патогенез, диагностика, лечение. Обзор литературыKovalchukM. O.КовальчукМ. О.
Russian Federation
mafkov@mail.ruKalinkinA. L.КалинкинА. Л.
Russian Federation
Federal Research Clinical Center of Federal Medico‑Biological Agency Center of sleep disorders, MoscowФГБУ «Федеральный научно‑клинический центр специализированных видов медицинской помощи и медицинских технологий» ФМБА России Центр медицины сна, Москва20062012238192002201520022015Copyright ©; 2012, Kovalchuk M.O., Kalinkin A.L.Copyright ©; 2012, Ковальчук М.О., Калинкин А.Л.2012Kovalchuk M.O., Kalinkin A.L.Ковальчук М.О., Калинкин А.Л.https://creativecommons.org/licenses/by/4.0https://nmb.abvpress.ru/jour/article/view/85

Restless leg syndrome (RLS) is a chronic sensory‑motor disorder characterized by sensory discomfort in legs, appearing or worsening during rest in the evening or night time, evoking the urge to move. Despite its wide prevalence (around 5−10% in the population) and essential influence on the quality of life, not all the physicians, specialists of the primary care and even neurologists are common with this disorder. Because of that RLS stays commonly unrecognized.

Синдром беспокойных ног является хроническим сенсомоторным расстройством, которое подразумевает сенсорный дискомфорт в ногах или других частях тела, возникающий или усиливающийся в покое, в вечернее/ночное время, и вызывающий потребность в движении. Несмотря на широкую распространенность (около 5−10 % в популяции) и значимое влияние на качество жизни, врачи общей практики, специалисты первого звена и сами неврологи недостаточно осведомлены о данном заболевании, в связи с чем оно часто остается ошибочно диагностируемым состоянием.

restless leg syndromeperiodic limb movementirondopaminergic medicineсиндром беспокойных ногпериодические движения конечностейдофаминергические препараты1. Willis T. De Animae Brutorum. London, England: Wells and Scott,1672.Willis T. De Animae Brutorum. London, England: Wells and Scott,1672.2. Wittmaack T. Pathologie und therapie der sensebilitat neurosen. Liepzig: Schafer, 1861.Wittmaack T. Pathologie und therapie der sensebilitat neurosen. Liepzig: Schafer, 1861.3. Konofal E., Karroum E., Montplaisir J. et al. Two early descriptions of restless legs syndrome and periodic leg movements by Boissier de Sauvages (1763) and Gilles de la Tourette (1898). Sleep Med 2009; 10(5):586−91.Konofal E., Karroum E., Montplaisir J. et al. Two early descriptions of restless legs syndrome and periodic leg movements by Boissier de Sauvages (1763) and Gilles de la Tourette (1898). Sleep Med 2009; 10(5):586−91.4. Ekbom K.A. Restless legs: a clinical study. Acta Med Scand1945;158 (Suppl):1−122.Ekbom K.A. Restless legs: a clinical study. Acta Med Scand1945;158 (Suppl):1−122.5. Lugaresi E., Cirignotta F., Coccagna G., Montagna P. Nocturnal myoclonus and restless leg syndrome. Adv Neurol 1986; 43:295−307.Lugaresi E., Cirignotta F., Coccagna G., Montagna P. Nocturnal myoclonus and restless leg syndrome. Adv Neurol 1986; 43:295−307.6. Akpinar S. Restless legs syndrome treatment with dopaminergic drugs. Clin Neuropharmacol 1987;10(1):69−79.Akpinar S. Restless legs syndrome treatment with dopaminergic drugs. Clin Neuropharmacol 1987;10(1):69−79.7. Diagnostic classification teering committee, Thorpy MG (Chairman). International classification of sleepDiagnostic classification teering committee, Thorpy MG (Chairman). International classification of sleepdisorders: Diagnostic and coding manual. Rochester, Minnesota: American sleep disorders association, 1995.8. The International Restless Legs Syndrome Study Group (Arthur S Walters, MD‑group organizer and correspondent). Towards a better definition of the restless legs syndrome. Mov Disord 1995;10:634−42.The International Restless Legs Syndrome Study Group (Arthur S Walters, MD‑group organizer and correspondent). Towards a better definition of the restless legs syndrome. Mov Disord 1995;10:634−42.9. Allen R.P., Picchietti D., Hening W.A. et al. Restless legs syndrome: diagnostic criteria, special considerations, and epidemiology. A report from the restless legs syndrome diagnosis and epidemiology workshop at the National Institutes of Health. Sleep Med 2003;4(2):101−19.Allen R.P., Picchietti D., Hening W.A. et al. Restless legs syndrome: diagnostic criteria, special considerations, and epidemiology. A report from the restless legs syndrome diagnosis and epidemiology workshop at the National Institutes of Health. Sleep Med 2003;4(2):101−19.10. Garcia‑Borreguero D., Stillman P., Benes H. et al. Algorithms for the diagnosis and treatment of restless leg syndrome in primary care. BMC Neurology 2011;11:28.Garcia‑Borreguero D., Stillman P., Benes H. et al. Algorithms for the diagnosis and treatment of restless leg syndrome in primary care. BMC Neurology 2011;11:28.11. Zucconi M., Ferini‑Strambi L. Epidemiology and clinical findings of restless legs syndrome. Sleep Med 2004;5(3):293−9.Zucconi M., Ferini‑Strambi L. Epidemiology and clinical findings of restless legs syndrome. Sleep Med 2004;5(3):293−9.12. Tachibana N., Tanigawa T. Prevalence and clinical characteristics of restless legs syndrome among Japanese industrial workers. Neurology 2003;60(Suppl 1):A38.Tachibana N., Tanigawa T. Prevalence and clinical characteristics of restless legs syndrome among Japanese industrial workers. Neurology 2003;60(Suppl 1):A38.13. Picchietti M.A., Picchietti D.L. Advances in pediatric restless legs syndrome: Iron, genetics, diagnosis and treatment. Sleep Med 2010;11(7):643−51.Picchietti M.A., Picchietti D.L. Advances in pediatric restless legs syndrome: Iron, genetics, diagnosis and treatment. Sleep Med 2010;11(7):643−51.14. Picchietti D., Allen R.P., Walters A.S. et al. Restless legs syndrome: prevalence and impact in children and adolescents — The Peds REST study. Pediatrics 2007;120:253−66.Picchietti D., Allen R.P., Walters A.S. et al. Restless legs syndrome: prevalence and impact in children and adolescents — The Peds REST study. Pediatrics 2007;120:253−66.15. Allen R.P., Walters A.S., Montplaisir J. et al. Restless legs syndrome prevalence and impact: REST general population study. Arch Intern Med 2005;165(11):1286−92.Allen R.P., Walters A.S., Montplaisir J. et al. Restless legs syndrome prevalence and impact: REST general population study. Arch Intern Med 2005;165(11):1286−92.16. Hening W., Walters A.S., Allen R.P. et al. Impact, diagnosis and treatment of Restless Legs Syndrome in a primary care population: REST (RLS epidemiology, symptoms and treatment) primary care study. Sleep Med 2004;5:237−46.Hening W., Walters A.S., Allen R.P. et al. Impact, diagnosis and treatment of Restless Legs Syndrome in a primary care population: REST (RLS epidemiology, symptoms and treatment) primary care study. Sleep Med 2004;5:237−46.17. O'Keeffe S.T., Egan D., Myers A. et al. The frequency and impact of restless legs syndrome in primary care. Ir Med J. 2007; 100(7):539−42.O'Keeffe S.T., Egan D., Myers A. et al. The frequency and impact of restless legs syndrome in primary care. Ir Med J. 2007; 100(7):539−42.18. Trenkwalder C., Paulus W. Why do restless legs occur at rest? — pathophysiology of neuronal structures in RLS. Neurophysiology of RLS (part 2). Clin Neurophysiol 2004;115:1975−88.Trenkwalder C., Paulus W. Why do restless legs occur at rest? — pathophysiology of neuronal structures in RLS. Neurophysiology of RLS (part 2). Clin Neurophysiol 2004;115:1975−88.19. Barrière G., Cazalets J.R., Bioulac B. et al. The restless legs syndrome. Prog Neurobiol 2005;77(3):139−65.Barrière G., Cazalets J.R., Bioulac B. et al. The restless legs syndrome. Prog Neurobiol 2005;77(3):139−65.20. Ondo W.G., He Y., Rajasekaran S., Le W.D. Clinical correlates of 6‑hydroxydopamine injections into A11 dopaminergic neurons in rats: a possible model for restless legs syndrome. Mov Disord 2000;15(1):154−8.Ondo W.G., He Y., Rajasekaran S., Le W.D. Clinical correlates of 6‑hydroxydopamine injections into A11 dopaminergic neurons in rats: a possible model for restless legs syndrome. Mov Disord 2000;15(1):154−8.21. Etgen T., Draganski B., Ilg C. et al. Bilateral thalamic gray matter changes in patients with restless legs syndrome. Neuroimage 2005;24(4):1242−7.Etgen T., Draganski B., Ilg C. et al. Bilateral thalamic gray matter changes in patients with restless legs syndrome. Neuroimage 2005;24(4):1242−7.22. Alberts J.L., Adler C.H., Saling M. et al. Prehension patterns in restless legs syndrome patients. Parkinsonism Relat Disord 2001; 7(2):143−8.Alberts J.L., Adler C.H., Saling M. et al. Prehension patterns in restless legs syndrome patients. Parkinsonism Relat Disord 2001; 7(2):143−8.23. Earley C.J., Allen R.P., Beard J.L. Insight into the pathophysiology of restless legs syndrome. J Neurosci Res 2000; 62(5):623−8.Earley C.J., Allen R.P., Beard J.L. Insight into the pathophysiology of restless legs syndrome. J Neurosci Res 2000; 62(5):623−8.24. Connor J.R., Ponnuru P., Wang X.S. et al. Profile of altered brain iron acquisition in restless legs syndrome. Brain 2011; 134(Pt 4):959−68.Connor J.R., Ponnuru P., Wang X.S. et al. Profile of altered brain iron acquisition in restless legs syndrome. Brain 2011; 134(Pt 4):959−68.25. Allen R.P., Earley C.J. Restless legs syndrome: a review of clinical and pathophysiologic features. J ClinAllen R.P., Earley C.J. Restless legs syndrome: a review of clinical and pathophysiologic features. J ClinNeurophysiol 2001;18(2):128−47.26. Pereira J.C. Jr, Pradella‑Hallinan M., Lins Pessoa H. Imbalance between thyroid hormones and the dopaminergic system might be central to the pathophysiology of restless legs syndrome: a hypothesis. Clinics (Sao Paulo) 2010;65(5):548−54.Pereira J.C. Jr, Pradella‑Hallinan M., Lins Pessoa H. Imbalance between thyroid hormones and the dopaminergic system might be central to the pathophysiology of restless legs syndrome: a hypothesis. Clinics (Sao Paulo) 2010;65(5):548−54.27. Hening W.A., Walters A.S., Wagner M. et al. Circadian rhythm of motor restlessness and sensory symptoms in the idiopathic restless legs syndrome. Sleep 1999; 22(7):901−12.Hening W.A., Walters A.S., Wagner M. et al. Circadian rhythm of motor restlessness and sensory symptoms in the idiopathic restless legs syndrome. Sleep 1999; 22(7):901−12.28. Tyvaert L., Laureau E., Hurtevent J.‑P. et al. A‑delta and C‑fibres function in primary. Clin Neurophysiology 2009; 39:267−74.Tyvaert L., Laureau E., Hurtevent J.‑P. et al. A‑delta and C‑fibres function in primary. Clin Neurophysiology 2009; 39:267−74.29. Winkelmann J. The genetics of restless legs syndrome. Sleep Med 2002;3(Suppl):9−12.Winkelmann J. The genetics of restless legs syndrome. Sleep Med 2002;3(Suppl):9−12.30. Allen R.P., Earley C.J. Defining the phenotype of the restless legs syndrome (RLS) using age‑of‑symptom‑onset. Sleep Med 2000;1(1):11−9.Allen R.P., Earley C.J. Defining the phenotype of the restless legs syndrome (RLS) using age‑of‑symptom‑onset. Sleep Med 2000;1(1):11−9.31. Winkelmann J., Muller‑Myhsok B., Wittchen H.U. et al. Complex segregation analysis of restless legs syndrome provides evidence for an autosomal dominant mode of inheritance in early age at onset families. Ann Neurol 2002;52(3):297−302.Winkelmann J., Muller‑Myhsok B., Wittchen H.U. et al. Complex segregation analysis of restless legs syndrome provides evidence for an autosomal dominant mode of inheritance in early age at onset families. Ann Neurol 2002;52(3):297−302.32. Kemlink D., Polo O., Frauscher B. et al. Replication of restless legs syndrome loci in three European populations. J Med Genet 2009;46(5):315−8.Kemlink D., Polo O., Frauscher B. et al. Replication of restless legs syndrome loci in three European populations. J Med Genet 2009;46(5):315−8.33. Earley C.J., Connor J.R., Beard J.L. et al. Abnormalities in CSF concentrations of ferritin and transferrin in restless legs syndrome. Neurology 2000;54(8):1698−700.Earley C.J., Connor J.R., Beard J.L. et al. Abnormalities in CSF concentrations of ferritin and transferrin in restless legs syndrome. Neurology 2000;54(8):1698−700.34. O'Keeffe S.T., Gavin K., Lavan J.N. Iron status and restless legs syndrome in the elderly. Age Ageing 1994;23(3):200−3.O'Keeffe S.T., Gavin K., Lavan J.N. Iron status and restless legs syndrome in the elderly. Age Ageing 1994;23(3):200−3.35. Lee K.A., Zaffke M.E., Baratte‑Beebe K. Restless legs syndrome and sleep disturbance during pregnancy: the role of folate and iron. J Womens Health Gend Based Med 2001; 10(4):335−41.Lee K.A., Zaffke M.E., Baratte‑Beebe K. Restless legs syndrome and sleep disturbance during pregnancy: the role of folate and iron. J Womens Health Gend Based Med 2001; 10(4):335−41.36. Mathis J. Update on restless legs. Swiss Med Wkly 2005;135(47−48):687−96.Mathis J. Update on restless legs. Swiss Med Wkly 2005;135(47−48):687−96.37. Salvi F., Montagna P., Plasmati R. et al. Restless legs syndrome and nocturnal myoclonus: initial clinical manifestation of familial amyloid polyneuropathy. J Neurol Neurosurg Psychiatry 1990;53(6):522−5.Salvi F., Montagna P., Plasmati R. et al. Restless legs syndrome and nocturnal myoclonus: initial clinical manifestation of familial amyloid polyneuropathy. J Neurol Neurosurg Psychiatry 1990;53(6):522−5.38. Callaghan N. Restless legs syndrome in uremic neuropathy. Neurology 1966; 16(4):359−61.Callaghan N. Restless legs syndrome in uremic neuropathy. Neurology 1966; 16(4):359−61.39. Ondo W., Tan E.K., Mansoor J. Rheumatologic serologies in secondary restless legs syndrome. Mov Disord 2000;15(2):321−3.Ondo W., Tan E.K., Mansoor J. Rheumatologic serologies in secondary restless legs syndrome. Mov Disord 2000;15(2):321−3.40. Earley C.J. Clinical practice. Restless legs syndrome. N Engl J Med 2003; 348(21):2103−9.Earley C.J. Clinical practice. Restless legs syndrome. N Engl J Med 2003; 348(21):2103−9.41. Левин О.С. Синдром беспокойных ног. Диагностика и лечение экстрапирамидных расстройств. Под ред. В.Н. Штока. М., 2000. С. 124−38.Левин О.С. Синдром беспокойных ног. Диагностика и лечение экстрапирамидных расстройств. Под ред. В.Н. Штока. М., 2000. С. 124−38.42. Tan E.K., Lum S.Y., Wong M.C. Restless legs syndrome in Parkinson's disease. J Neurol Sci 2002;196(1−2):33−6.Tan E.K., Lum S.Y., Wong M.C. Restless legs syndrome in Parkinson's disease. J Neurol Sci 2002;196(1−2):33−6.43. Ondo W.G., Vuong K.D., Jankovic J. Exploring the relationship between Parkinson disease and restless legs syndrome. Arch Neurol 2002;59(3):421−4.Ondo W.G., Vuong K.D., Jankovic J. Exploring the relationship between Parkinson disease and restless legs syndrome. Arch Neurol 2002;59(3):421−4.44. Hartmann M., Pfister R., Pfadenhauer K. Restless legs syndrome associated with spinal cord lesions. J Neurol Neurosurg Psychiatry 1999;66(5):688−9.Hartmann M., Pfister R., Pfadenhauer K. Restless legs syndrome associated with spinal cord lesions. J Neurol Neurosurg Psychiatry 1999;66(5):688−9.45. Walters A., Silvestri R., Zucconi M. Review of the Possible Relationship and Hypothetical Links Between Attention Deficit Hyperactivity Disorder (ADHD) and the Simple Sleep Related Movement Disorders, Parasomnias, Hypersomnias, and Circadian Rhythm Disorder. J Clin Sleep Med 2008;4(6).Walters A., Silvestri R., Zucconi M. Review of the Possible Relationship and Hypothetical Links Between Attention Deficit Hyperactivity Disorder (ADHD) and the Simple Sleep Related Movement Disorders, Parasomnias, Hypersomnias, and Circadian Rhythm Disorder. J Clin Sleep Med 2008;4(6).46. Wang S.J., Chen P.K., Fuh J.L. Comorbidities of migraine. Front Neurol 2010;1:16.Wang S.J., Chen P.K., Fuh J.L. Comorbidities of migraine. Front Neurol 2010;1:16.47. Symvoulakis E., Anyfantakis D., Lionis C. Restless legs syndrome: literature review. Sao Paulo Med J 2010; 128(3):167−70.Symvoulakis E., Anyfantakis D., Lionis C. Restless legs syndrome: literature review. Sao Paulo Med J 2010; 128(3):167−70.48. Crochard A., El Hasnaoui A., Pouchain D. et al. Diagnostic indicators of restless legs syndrome in primary care consultations: the DESYR study. Mov Disord 2007;22(6):791−7.Crochard A., El Hasnaoui A., Pouchain D. et al. Diagnostic indicators of restless legs syndrome in primary care consultations: the DESYR study. Mov Disord 2007;22(6):791−7.49. Fukunishi I., Kitaoka T., Shirai T. et al. Facial paresthesias resembling restless legs syndrome in a patient on hemodialysis. Nephron 1998;79(4):485.Fukunishi I., Kitaoka T., Shirai T. et al. Facial paresthesias resembling restless legs syndrome in a patient on hemodialysis. Nephron 1998;79(4):485.50. Chabli A., Michaud M., Montplaisir J. Periodic arm movements in patients with the restless legs syndrome. Eur Neurol 2000; 44(3):133−8.Chabli A., Michaud M., Montplaisir J. Periodic arm movements in patients with the restless legs syndrome. Eur Neurol 2000; 44(3):133−8.51. Bassetti C.L., Mauerhofer D., Gugger M. et al. Restless leg syndrome: a prospective clinical stydy of 55 patients. Eur Neurol 2001;45(2):67−7.Bassetti C.L., Mauerhofer D., Gugger M. et al. Restless leg syndrome: a prospective clinical stydy of 55 patients. Eur Neurol 2001;45(2):67−7.52. Калинкин А.Л., Баделина Е.В. Синдром беспокойных ног и синдром периодических движений нижних конечностей. Функц диагностика 2004 (4):89−93.Калинкин А.Л., Баделина Е.В. Синдром беспокойных ног и синдром периодических движений нижних конечностей. Функц диагностика 2004 (4):89−93.53. Michaud M., Lavigne G., Desautels A. et al. Effects of immobility on sensory and motor symptoms of restless legs syndrome. Mov Disord 2002;17(1):112−5.Michaud M., Lavigne G., Desautels A. et al. Effects of immobility on sensory and motor symptoms of restless legs syndrome. Mov Disord 2002;17(1):112−5.54. Silber M.H., Ehrenberg B.L., Allen RP. et al. An algorithm for the management of restless legs syndrome. Mayo Clin Proc 2004;79(7):916−22.Silber M.H., Ehrenberg B.L., Allen RP. et al. An algorithm for the management of restless legs syndrome. Mayo Clin Proc 2004;79(7):916−22.55. Hening W.A. Current guidelines and standards of practice for restless legs syndrome. Am J Med 2007;Hening W.A. Current guidelines and standards of practice for restless legs syndrome. Am J Med 2007;120(1 Suppl 1):22−7.(1 Suppl 1):22−7.56. Hening W.A., Allen R.P., Earley C.J. et al. Restless Legs Syndrome Task Force of the Standards of Practice Committee of the American Academy of Sleep Medicine. An update on the dopaminergic treatment of restless legs syndrome and periodic limb movement disorder. Sleep 2004;27(3):560−83.Hening W.A., Allen R.P., Earley C.J. et al. Restless Legs Syndrome Task Force of the Standards of Practice Committee of the American Academy of Sleep Medicine. An update on the dopaminergic treatment of restless legs syndrome and periodic limb movement disorder. Sleep 2004;27(3):560−83.57. Allen R., Chen C., Soaita A. et al. A randomized, double‑blind, 6‑week, dose‑ranging study of pregabalin in patients with restless legs syndrome. Sleep Med 2010;11(6):512−9.Allen R., Chen C., Soaita A. et al. A randomized, double‑blind, 6‑week, dose‑ranging study of pregabalin in patients with restless legs syndrome. Sleep Med 2010;11(6):512−9.58. Левин О.С. Подходы к диагностике и лечению синдрома беспокойных ног. Трудный пациент 2009;(4−5):4−10.Левин О.С. Подходы к диагностике и лечению синдрома беспокойных ног. Трудный пациент 2009;(4−5):4−10.59. Earley C.J. The importance of oral iron therapy in restless legs syndrome. Sleep Med 2009;10(9):945−6.Earley C.J. The importance of oral iron therapy in restless legs syndrome. Sleep Med 2009;10(9):945−6.60. Allen R.P., Adler C.H., Du W. et al. Clinical efficacy and safety of IV ferric carboxymaltose (FCM) treatment of RLS: a multi‑centred, placebo-controlled preliminary clinical trial. Sleep Med 2011;12(9):906−13.Allen R.P., Adler C.H., Du W. et al. Clinical efficacy and safety of IV ferric carboxymaltose (FCM) treatment of RLS: a multi‑centred, placebo-controlled preliminary clinical trial. Sleep Med 2011;12(9):906−13.