Spotlight on Sleep-related movement disorders

Movement disorders are classically thought to resolve during sleep. Sleep-related movement disorders, however, are a subset that are characterized by their presence in sleep.

In this article, Dr. Lauren Talman and Dr. Stephanie Bissonnette of Boston Medical Center discuss these sleep-related movement disorders based on the International Classification of Sleep Disorders-3rd Edition (ICSD-3). These disorders include restless legs syndrome, periodic limb movement disorder, sleep-related leg cramps, sleep-related bruxism, sleep-related rhythmic movement disorder, benign sleep myoclonus of infancy, propriospinal myoclonus at sleep onset, sleep-related movement disorders due to medical disorders, and sleep-related movement disorders due to medication or other substance.

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Spotlight on Periodic limb movements

Periodic limb movements in sleep consist of flexion movements at the ankles, knees, and hips and sometimes the arms, recurring every 5 to 90 seconds, especially during light NREM sleep stages. Though an almost obligate accompaniment of restless legs syndrome and frequently associated with various neurologic and physical diseases, they are, however, also widely prevalent among the general population.

In this article, Dr. Federica Provini and Dr. Giacomo Chiaro MD, both of the University of Bologna, examine the clinical significance of periodic limb movements in sleep and advances in understanding the pathophysiology of this disorder. They review the treatment options now available, emphasizing that among the different therapeutic strategies, dopaminergic agents in particular have been shown effective in controlled trials. Finally, they discuss the possible role of periodic limb movement disorder as a cardiovascular risk.

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Spotlight on Restless legs syndrome

The sensory symptoms of restless legs syndrome are paresthesias and dysesthesias in the calves and legs. Descriptions of these phenomena include words such as aching, pulling, drawing, numbness, tingling, prickling, creeping, or crawling. The unpleasant sensations occur during rest and inactivity, and are worse in the late evening and when attempting to sleep. In this clinical summary, Dr. Pinky Agarwal of the Booth Gardner Parkinson Center at Evergreen Hospital Medical Center, Dr. Narendra Vaish of GenomeRx, LLC, and Dr. Sindhu R Srivatsal of the University of Washington Medical Center discuss the genetics, clinical features, diagnosis and differential diagnosis, etiology, pathophysiology, management, and prognosis of this common disorder. Management of special conditions, such as restless legs syndrome in pregnancy, are addressed as well. The current update includes recent literature on insights into the etiopathogenesis of restless legs syndrome.

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