Periodic limb movement disorder

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Periodic leg movement disorder ( PLMD ), or periodic sleep leg movement ( PLMS ), formerly known as < b> nocturnal myoclonus , is a sleep disorder in which the patient moves the foot unconsciously during sleep, and has motion-related symptoms or problems.

PLMD should not be confused with restless legs syndrome (RLS). RLS occurs when awake and when asleep, and when awake, there is a voluntary response to feelings of discomfort in the legs. PLMD on the other hand is unconscious, and patients often do not realize these movements at all.

Video Periodic limb movement disorder

Symptoms

Patients with PLMD will complain of excessive daytime sleep (EDS), fall asleep during the day, trouble sleeping at night, and trouble sleeping through the night. The patient also displays an involuntary limb movement that occurs at periodic intervals anywhere from 20-40 seconds apart. They often only survive in the first half of the night during the non-REM sleep stage. The movement does not occur during REM due to muscle atonia.

Maps Periodic limb movement disorder

Diagnosis

People with PLMD often do not know the cause of excessive daytime sleepiness and the movement of their limbs is reported by a spouse or sleep partner. PLMD is diagnosed with the help of polysomnogram or PSG. PLMD was diagnosed with the first findings of the PLMS (sleep periodic limb movements) on PSG, then integrated the information with a detailed history of the patient and/or sleep partner. PLMS can range from a small amount of movement in the ankles and toes, to paddle wildly from the four limbs. These movements, which are more common in the leg than the arm, occur between 0.5 and 5 seconds, repeating at intervals of 5 to 90 seconds. The formal diagnosis of the PLMS requires three periods during the night, lasting from several minutes to an hour or more, each containing at least 30 movements followed by partial passion or awakening.

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Cause

It is largely unknown what causes PLMD, but in many cases patients also have other medical problems like Parkinson's disease or narcolepsy. Factors that increase the likelihood of PLMD in the absence of restless leg syndrome include becoming shift workers, snoring, drinking coffee, stress, and hypnotic use, especially in cases of withdrawal of benzodiazepines. For women, the presence of musculoskeletal disease, heart disease, obstructive sleep apnea, cataplexy, physical activity before bed and mental disorders are significantly associated with higher risk of both PLMD syndrome and restless legs.

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Epidemiology

PLMD is estimated to occur in about 4% of adults (ages 15-100), but is more common in older people, especially women, with up to 11% experiencing symptoms. PLMD appears to be associated with restless legs syndrome (RLS) - a study of 133 people found that 80% of those with RLS also had PLMD. But the opposite is not true: many people who have PLMD do not not also have restless leg syndrome.

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Treatment

PLMD is often treated with anti-Parkinson's drugs; it can also respond to anticonvulsants, benzodiazepines, and narcotics. Patients should remain on these medications to experience relief, as there is no known cure for this disorder. PLMs tend to be aggravated by tricyclic antidepressants, SSRIs, stress, and lack of sleep. It is also advisable not to consume caffeine, alcohol, or antidepressants because these substances can worsen the symptoms of PLMD.

Other drugs aimed at reducing or removing foot or arousal jerks may be prescribed. Non-ergot dopaminergic drugs derived (pramipexole and ropinirole) are preferred. Other dopaminergic agents such as co-careldopa, co-beneldopa, pergolide, or lisuride can also be used. These drugs reduce or eliminate both jerked and arasal feet. These medications also work for the treatment of restless leg syndrome.

In one study, co-careldopa was superior to dextropropoxyphene in reducing the number of leg kicks and the number of processions per hour of sleep. However, co-careldopa and, to a lesser extent, pergolide can shift the movement of the foot from night to day. Clonazepam (Clonopin), in a dose of 1 mg has been shown to increase the objective and subjective size of sleep.

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See also

• Hypo thrower

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Reference

Source of the article : Wikipedia