Highlights & Basics
- Periodic limb movement disorder (PLMD) is characterized by periodic limb movements of sleep (PLMS). These repetitive limb movements (mostly of the legs) occur mainly during non-rapid eye movement (non-REM) sleep and involve dorsiflexion of the toes and ankles and occasionally flexion of the hip and knee.
- PLMD is diagnosed when the periodic limb movement of sleep index (PLMS-I; the number of periodic limb movements per hour of sleep) is >15 and results in clinically significant sleep disturbance or daytime impairment. The diagnosis is confirmed by polysomnography, and other causes of sleep-wake disturbance must be excluded.
- May be either primary (idiopathic) or associated with conditions such as restless legs syndrome, obstructive sleep apnea syndrome, REM sleep behavior disorder, narcolepsy, congestive heart failure, essential hypertension, end-stage renal disease, spinal cord injury, syringomyelia, alcohol dependence, Parkinson disease, and Tourette syndrome.
- May be related to intake of medications including lithium, tricyclic antidepressants, and selective serotonin-reuptake inhibitors.
- Evidence from randomized controlled trials for the treatment of primary PLMD is lacking. Reassurance and lifestyle measures are sufficient for many patients. PLMD associated with other conditions is managed by treating the underlying cause and the cessation any causative drugs.
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Citations
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