Restless legs syndrome is characterized by uncomfortable feelings in the legs associated with an urge to move the legs in order to seek relief. Symptoms typically begin soon after lying down for sleep. The main disability is interference with sleep. Many patients have periodic movements of sleep, involuntary flexion jerks, and spasms of the legs. The disorder is thought to be related to impaired brain dopaminergic neurotransmission, although some evidence suggests an abnormality of the endogenous opioid system. There is a strong genetic influence, and some gene loci linked to the condition have been identified. Restless legs syndrome is associated with certain medical conditions, including anemia, iron deficiency, chronic renal failure/renal dialysis, pregnancy, lumbar spine disease, and Parkinson’s disease. Tolerance is a common problem with pharmacotherapy for restless legs syndrome, and augmentation can be a major complication, particularly with dopaminergic therapy.
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