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01-11-2014 | Fibromyalgia (M Peres, Section Editor)

Restless Legs Syndrome and Pain Disorders: What’s in common?

Authors: Leonardo Ierardi Goulart, Raimundo Nonato Delgado Rodrigues, Mario Fernando Prieto Peres

Published in: Current Pain and Headache Reports | Issue 11/2014

Abstract

Between 10 % and 30 % of the population report chronic pain. More than half of these also have sleep complaints. From considering these data, it can be inferred there is a significant overlapping between these conditions. Restless Legs Syndrome/Willis-Ekbom Disease (RLS/WED) is characterized by complaints of an “urge to move” frequently associated with dysesthesias. From that perspective, these sensations can also have painful characteristics. By the same token, the presence of comorbid diseases as predicted by a higher prevalence RLS/WED, have many of them with pain as an important complaint. Pain is a multidimensional response involving several levels of expression ranging from somatosensory to emotional. The potential shared mechanisms between RLS/WED and pain may involve sleep deprivation/fragmentation effect, inducing an increase in markers of inflammation and reduction in pain thresholds. These are modulated by several different settings of neurotransmitters with a huge participation of monoaminergic dysfunctional circuits. A thorough comprehension of these mechanisms is of utmost importance for the correct approach and treatment choices.

Moldofsky H. Sleep and pain. Sleep Med Rev. 2001;5:385–96.PubMedCrossRef

Riley 3rd JL, Benson MB, Gremillion HA, Myers CD, Robinson ME, Smith Jr CL, et al. Sleep disturbance in orofacial pain patients: pain-related or emotional distress? Cranio: the journal of craniomandibular practice. 2001;19:106–13.

Theadom A, Cropley M, Humphrey K-L. Exploring the role of sleep and coping in quality of life in fibromyalgia. J Psychosom Res. 2007;62:145–51.PubMedCrossRef

Taylor DJ, Mallory LJ, Lichstein KL, Durrence HH, Riedel BW, Bush AJ. Comorbidity of chronic insomnia with medical problems. Sleep. 2007;30:213–8.PubMed

Edwards RR, Almeida DM, Klick B, Haythornthwaite JA, Smith MT. Duration of sleep contributes to next-day pain report in the general population. Pain. 2008;137:202–7.PubMedCrossRefPubMedCentral

Lautenbacher S, Kundermann B, Krieg J-C. Sleep deprivation and pain perception. Sleep Med Rev. 2006;10:357–69.PubMedCrossRef

Sutton BC, Opp MR. Musculoskeletal sensitization and sleep: chronic muscle pain fragments sleep of mice without altering its duration. Sleep. 2014;37:505–13.PubMedPubMedCentral

Tang NK, Sanborn AN. Better Quality Sleep Promotes Daytime Physical Activity in Patients with Chronic Pain?A Multilevel Analysis of the Within-Person Relationship. PLoS ONE. 2014;9:e92158.PubMedCrossRefPubMedCentral

Schuh-Hofer S, Wodarski R, Pfau DB, Caspani O, Magerl W, Kennedy JD, et al. One night of total sleep deprivation promotes a state of generalized hyperalgesia: A surrogate pain model to study the relationship of insomnia and pain. Pain. 2013;154:1613–21.PubMedCrossRef

10.

Earley CJ, Silber MH. Restless legs syndrome: understanding its consequences and the need for better treatment. Sleep Med. 2010;11:807–15.PubMedCrossRef

11.

Eckeli ALA, Gitaí LLGL, Dach FF, Ceretta HH, Sander HHH, Passos ADCA, et al. Prevalence of restless legs syndrome in the rural town of Cassia dos Coqueiros in Brazil. Sleep Med. 2011;12:762–7.PubMedCrossRef

12.•

Garcia-Borreguero D, Williams A-M. An update on restless legs syndrome (Willis-Ekbom disease): clinical features, pathogenesis and treatment. Curr Opin Neurol. 2014;27:493–501. This is the latest general guideline.PubMedCrossRef

13.••

Allen RP, Picchietti DL, Garcia-Borreguero D, Ondo WG, Walters AS, Winkelman JW, et al. Restless legs syndrome/Willis-Ekbom disease diagnostic criteria: updated International Restless Legs Syndrome Study Group (IRLSSG) consensus criteria - history, rationale, description, and significance. Sleep Med. 2014;15:860–73. This is the latest consensus.PubMedCrossRef

14.•

Ohayon MM, O'Hara R, Vitiello MV. Epidemiology of restless legs syndrome: a synthesis of the literature. Sleep Med Rev. 2012;16:283–95. This is the latest epidemiology review.PubMedCrossRefPubMedCentral

15.

Nomura T, Inoue Y, Kusumi M, Uemura Y, Nakashima K. Prevalence of restless legs syndrome in a rural community in Japan. Mov Disord. 2008;23:2363–9.PubMedCrossRef

16.

Chen N-H, Chuang L-P, Yang C-T, Kushida CA, Hsu S-C, Wang P-C, et al. The prevalence of restless legs syndrome in Taiwanese adults. Psychiatry Clin Neurosci. 2010;64:170–8.PubMedCrossRef

17.

Winkler AS, Trendafilova A, Meindl M, Kaaya J, Schmutzhard E, Kassubek J. Restless legs syndrome in a population of northern Tanzania: a community-based study. Mov Disord. 2010;25:596–601.PubMedCrossRef

18.

Allen RP, Walters AS, Montplaisir J, Hening W, Myers A, Bell TJ, et al. Restless legs syndrome prevalence and impact: REST general population study. Arch Intern Med. 2005;165:1286–92.PubMedCrossRef

19.•

Dauvilliers Y, Winkelmann J. Restless legs syndrome: update on pathogenesis. Curr Opin Pulm Med. 2013;19:594–600. This is an updated compilation.PubMedCrossRef

20.•

Karroum EG, Golmard J-L, Leu-Semenescu S, Arnulf I. Sensations in restless legs syndrome. Sleep Med. 2012;13:402–8. Sensory descriptors in RLS are noted.PubMedCrossRef

21.

Karroum E, Leu-Semenescu S, Arnulf I. Topographical caracterisation of the painful restless legs syndrome. Sleep Med. 2013;14s:e166.CrossRef

22.

Montplaisir J, Lorrain D, Godbout R. Restless legs syndrome and periodic leg movements in sleep: the primary role of dopaminergic mechanism. Eur Neurol. 1991;31:41–3.PubMedCrossRef

23.

Hornyak M, Feige B, Riemann D, Voderholzer U. Periodic leg movements in sleep and periodic limb movement disorder: prevalence, clinical significance and treatment. Sleep Med Rev. 2006;10:169–77.PubMedCrossRef

24.

Scholle S, Scholle HC. Leg movements and periodic leg movements during sleep in the development across childhood and adolescence from 1 to 18 years. Sleep Med. 2014;28:1–16.

25.••

Manconi M, Ferri R, Zucconi M, Bassetti CL, Fulda S, Aricò D, et al. Dissociation of periodic leg movements from arousals in restless legs syndrome. Ann Neurol. 2012;71:834–44. This study relates the different mechanisms between PLM and PLMD.PubMedCrossRef

26.

Picchietti D. Periodic limb movements in sleep: irrelevant epiphenomenon, marker for a potential problem, or a disorder? J Clin Sleep Med. 2006;2:446–7.PubMed

27.

American Academy of Sleep Medicine. International Classification of Sleep Disorders. 3rd ed. Darien, IL: American Academy of Sleep Medicine; 2014.

28.

Montplaisir J, Boucher S, Poirier G, Lavigne G, Lapierre O, Lespérance P. Clinical, polysomnographic, and genetic characteristics of restless legs syndrome: a study of 133 patients diagnosed with new standard criteria. Mov Disord. 1997;12:61–5.PubMedCrossRef

29.

Szentkirályi A, Völzke H, Hoffmann W, Trenkwalder C, Berger K. Multimorbidity and the risk of restless legs syndrome in 2 prospective cohort studies. Neurology. 2014;82:2026–33.PubMedCrossRef

30.

Scholz J, Woolf CJ. The neuropathic pain triad: neurons, immune cells and glia. Nat Neurosci. 2007;10:1361–8.PubMedCrossRef

31.

Lötsch J, Walter C, Felden L, Preibisch C, Nöth U, Martin T, et al. Extended cortical activations during evaluating successive pain stimuli. Soc Cogn Affect Neurosci. 2012;7:698–707.PubMedCrossRefPubMedCentral

32.

Graven-Nielsen T, Mense S. The peripheral apparatus of muscle pain: evidence from animal and human studies. Clin J Pain. 2001;17:2–10.PubMedCrossRef

33.

Latremoliere A, Woolf CJ. Central sensitization: a generator of pain hypersensitivity by central neural plasticity. J Pain. 2009;10:895–926.PubMedCrossRefPubMedCentral

34.

Cui W, Yu X, Zhang H. The serotonin transporter gene polymorphism is associated with the susceptibility and the pain severity in idiopathic trigeminal neuralgia patients. J Headache Pain. 2014;15:42.PubMedCrossRefPubMedCentral

35.

Hasvik E, Iordanova Schistad E, Grøvle L, Julsrud Haugen A, Røe C, Gjerstad J. Subjective health complaints in patients with lumbar radicular pain and disc herniation are associated with a sex - OPRM1 A118G polymorphism interaction: a prospective 1-year observational study. BMC Musculoskelet Disord. 2014;15:161.PubMedCrossRefPubMedCentral

36.

Walters AS, LeBrocq C, Dhar A, Hening W, Rosen R, Allen RP, et al. Validation of the International Restless Legs Syndrome Study Group rating scale for restless legs syndrome. Sleep Med. 2003;4:121–32.PubMedCrossRef

37.••

Stiasny-Kolster K, Pfau DB, Oertel WH, Treede R-D, Magerl W. Hyperalgesia and functional sensory loss in restless legs syndrome. Pain. 2013;154:1457–63. Different levels of pain modulation in RLS are related.PubMedCrossRef

38.

Polydefkis M, Allen RP, Hauer P, Earley CJ, Griffin JW, McArthur JC. Subclinical sensory neuropathy in late-onset restless legs syndrome. Neurology. 2000;55:1115–21.PubMedCrossRef

39.

Holman AJ, Myers RR. A randomized, double-blind, placebo-controlled trial of pramipexole, a dopamine agonist, in patients with fibromyalgia receiving concomitant medications. Arthritis Rheum. 2005;52:2495–505.PubMedCrossRef

40.•

Ku J, Cho YW, Lee YS, Moon H-J, Chang H, Earley CJ, et al. Functional connectivity alternation of the thalamus in restless legs syndrome patients during the asymptomatic period: a resting-state connectivity study using functional magnetic resonance imaging. Sleep Med. 2014;15:289–94. This is new functional evidence on the central sensitivity processing in RLS patients.PubMedCrossRef

41.

Clemens S, Rye D, Hochman S. Restless legs syndrome: revisiting the dopamine hypothesis from the spinal cord perspective. Neurology. 2006;67:125–30.PubMedCrossRef

42.•

Sutton BC, Opp MR. Sleep fragmentation exacerbates mechanical hypersensitivity and alters subsequent sleep-wake behavior in a mouse model of musculoskeletal sensitization. Sleep. 2014;37:515–24. New evidence about a traditional theory is related.PubMedPubMedCentral

43.•

Stehlik R, Ulfberg J, Hedner J, Grote L. High prevalence of restless legs syndrome among women with multi-site pain: A population-based study in Dalarna, Sweden. Eur J Pain. 2014 Apr 3. This is an epidemiological study on fibromyalgia and RLS.

44.

Viola-Saltzman M, Watson NF, Bogart A, Goldberg J, Buchwald D. High prevalence of restless legs syndrome among patients with fibromyalgia: a controlled cross-sectional study. J Clin Sleep Med. 2010;6:423–7.PubMedPubMedCentral

45.

Isaac M, Franca P, Rafael R, Alonso H, Gabriela P, Maria IL. Sleep disorders in Venezuelan fibromyalgia patients. Sleep Med. 2013;14:e215.CrossRef

46.

Civelek GM, Ciftkaya PO, Karatas M. Evaluation of restless legs syndrome in fibromyalgia syndrome: An analysis of quality of sleep and life. J Back Musculoskelet Rehabil. 2014. doi:10.3233/BMR-140478.PubMed

47.

Wood PB, Patterson JC, Sunderland JJ, Tainter KH, Glabus MF, Lilien DL. Reduced presynaptic dopamine activity in fibromyalgia syndrome demonstrated with positron emission tomography: a pilot study. J Pain. 2007;8:51–8.PubMedCrossRef

48.

Sörensen J, Bengtsson A, Bäckman E, Henriksson KG, Bengtsson M. Pain analysis in patients with fibromyalgia. Effects of intravenous morphine, lidocaine, and ketamine. Scand J Rheumatol. 1995;24:360–5.PubMedCrossRef

49.

Ortancil O, Sanli A, Eryuksel R, Basaran A, Ankarali H. Association between serum ferritin level and fibromyalgia syndrome. Eur J Clin Nutr. 2010;64:308–12.PubMedCrossRef

50.

Winkelman JW, Gagnon A, Clair AG. Sleep Medicine. Sleep Medicine. Elsevier B.V; 2013 Oct 1; 14:934–42.

51.

Rhode AM, Hösing VG, Happe S, Biehl K, Young P, Evers S. Comorbidity of migraine and restless legs syndrome–a case-control study. Cephalalgia. 2007;27:1255–60.PubMedCrossRef

52.

Ferreira KS, Eckeli A, Dach F, Speciali JG. Comorbidities, medications and depressive symptoms in patients with restless legs syndrome and migraine. Arq Neuropsiquiatr. 2013;71:87–91.PubMedCrossRef

53.

Zanigni S, Giannini G, Melotti R, Pattaro C, Provini F, Cevoli S, et al. Association between restless legs syndrome and migraine: a population-based study. Eur J Neurol. 2014;21:1205–10.PubMedCrossRef

54.

Gozubatik-Celik G, Benbir G, Tan F, Karadeniz D, Goksan B. The prevalence of migraine in restless legs syndrome. Headache. 2014;54:872–7.PubMedCrossRef

55.

Schürks M, Winter AC, Berger K, Buring JE, Kurth T. Migraine and restless legs syndrome in women. Cephalalgia. 2012;32:382–9.PubMedCrossRefPubMedCentral

56.

Winter AC, Schürks M, Berger K, Buring JE, Gaziano JM, Kurth T. Migraine and restless legs syndrome in men. Cephalalgia. 2013;33:130–5.PubMedCrossRefPubMedCentral

57.

Akerman S, Goadsby PJ. Dopamine and migraine: biology and clinical implications. Cephalalgia. 2007;27:1308–14.PubMedCrossRef

58.

Young WB, Piovesan EJ, Biglan KM. Restless legs syndrome and drug-induced akathisia in headache patients. CNS Spectr. 2003;8:450–6.PubMed

59.

Suzuki K, Suzuki S, Miyamoto M, Miyamoto T, Numao A, Watanabe Y, et al. Does pramipexole treatment improve headache in patients with concomitant migraine and restless legs syndrome? Tremor Other Hyperkinet Mov. 2013;3:1–6.

60.

Schwedt TJ, Chong CD, Chiang C-C, Baxter L, Schlaggar BL, Dodick DW. Enhanced pain-induced activity of pain-processing regions in a case-control study of episodic migraine. Cephalalgia. 2014 Mar 13.

61.

Kruit MC, Launer LJ, Overbosch J, van Buchem MA, Ferrari MD. Iron accumulation in deep brain nuclei in migraine: a population-based magnetic resonance imaging study. Cephalalgia. 2009;29:351–9.PubMedCrossRefPubMedCentral

62.

Cho YW, Na GY, Lim JG, Kim S-H, Kim HS, Earley CJ, et al. Prevalence and clinical characteristics of restless legs syndrome in diabetic peripheral neuropathy: comparison with chronic osteoarthritis. Sleep Med. 2013;14:1387–92.PubMedCrossRef

63.

Gemignani F, Brindani F, Vitetta F, Marbini A. Restless legs syndrome and painful neuropathy-retrospective study. A role for nociceptive deafferentation? Pain Med. 2009;10:1481–6.PubMedCrossRef

64.

Aigner M, Prause W, Freidl M, Weiss M, Izadi S, Bach M, et al. High prevalence of restless legs syndrome in somatoform pain disorder. Eur Arch Psychiatry Clin Neurosci. 2007;257:54–7.PubMedCrossRef

65.

Sun Y-MJ, Hoang T, Neubauer JA, Walters AS. Opioids protect against substantia nigra cell degeneration under conditions of iron deprivation: a mechanism of possible relevance to the Restless Legs Syndrome (RLS) and Parkinson's disease. J Neurol Sci. 2011;304:93–101.PubMedCrossRef

66.

Walters AS, HENING W. Clinical presentation and neuropharmacology of restless legs syndrome. Clin Neuropharmacol. 1987;10:225–37.PubMedCrossRef

67.

Winkelmann J, Schadrack J, Wetter T, Zieglgänsberger W, Trenkwalder C. Opioid and dopamine antagonist drug challenges in untreated restless legs syndrome patients. Sleep Med. 2001;2:57–61.PubMedCrossRef

68.

Jhoo JH, Yoon I-Y, Kim YK, Chung S, Kim J-M, Lee SB, et al. Availability of brain serotonin transporters in patients with restless legs syndrome. Neurology. 2010;74:513–8.PubMedCrossRef

69.

Smith NL. Serotonin mechanisms in pain and functional syndromes: management implications in comorbid fibromyalgia, headache, and irritable bowl syndrome - case study and discussion. J Pain Palliat Care Pharmacother. 2004;18:31–45.PubMedCrossRef

70.•

Allen RP, Barker PB, Horská A, Earley CJ. Thalamic glutamate/glutamine in restless legs syndrome: increased and related to disturbed sleep. Neurology. 2013;80:2028–34. Here is new evidence on neurotransmitter mechanisms in RLS.PubMedCrossRefPubMedCentral

71.

Gerdle B, Ghafouri B, Ernberg M, Larsson B. Chronic musculoskeletal pain: review of mechanisms and biochemical biomarkers as assessed by the microdialysis technique. J Pain Res. 2014;7:313–26.PubMedCrossRefPubMedCentral

72.

Carneiro AMD, Airey DC, Thompson B, Zhu C-B, Lu L, Chesler EJ, et al. Functional coding variation in recombinant inbred mouse lines reveals multiple serotonin transporter-associated phenotypes. Proc Natl Acad Sci U S A. 2009;106:2047–52.PubMedCrossRefPubMedCentral

73.

Dowling P, Klinker F, Amaya F, Paulus W, Liebetanz D. Iron-deficiency sensitizes mice to acute pain stimuli and formalin-induced nociception. J Nutr. 2009;139:2087–92.PubMedCrossRef

74.•

Winkelman JW, Schoerning L, Platt S, Jensen JE. Restless legs syndrome and central nervous system gamma-aminobutyric acid: preliminary associations with periodic limb movements in sleep and restless leg syndrome symptom severity. Sleep Med. 2014;12:1–17. Preliminary data is presented on the connections between RLS, PLM, and painful component in RLS.CrossRef

75.

Schenck CH, Mahowald MW. Long-term, nightly benzodiazepine treatment of injurious parasomnias and other disorders of disrupted nocturnal sleep in 170 adults. Am J Med. 1996;100:333–7.PubMedCrossRef

76.

Woolf CJ. Central sensitization: implications for the diagnosis and treatment of pain. Pain. 2011;152:S2–S15.PubMedCrossRefPubMedCentral

77.

Shinpo K, Kikuchi S, Sasaki H, Moriwaka F, Tashiro K. Effect of 1,25-dihydroxyvitamin D(3) on cultured mesencephalic dopaminergic neurons to the combined toxicity caused by L-buthionine sulfoximine and 1-methyl-4-phenylpyridine. J Neurosci Res. 2000;62:374–82.PubMedCrossRef

78.

Nakamura K, Wang W, Kang UJ. The role of glutathione in dopaminergic neuronal survival. J Neurochem. 1997;69:1850–8.PubMedCrossRef

79.

Oran M, Unsal C, Albayrak Y, Tulubas F, Oguz K, Avci O, et al. Possible association between vitamin D deficiency and restless legs syndrome. NDT. 2014;10:953–8.CrossRef

80.

Känel von R, Müller-Hartmannsgruber V, Kokinogenis G, Egloff N. Vitamin D and Central Hypersensitivity in Patients with Chronic Pain. Pain Med. 2014. doi:10.1111/pme.12454.

81.

Cayir A, Turan MI, Tan H. Effect of vitamin D therapy in addition to amitriptyline on migraine attacks in pediatric patients. Braz J Med Biol Res. 2014;47:349–54.PubMedCrossRefPubMedCentral

82.

Wepner F, Scheuer R, Schuetz-Wieser B, Machacek P, Pieler-Bruha E, Cross HS, et al. Effects of vitamin D on patients with fibromyalgia syndrome: A randomized placebo-controlled trial. Pain. 2014;155:261–8.PubMedCrossRef

83.

Mottaghi T, Khorvash F, Askari G, Maracy MR, Ghiasvand R, Maghsoudi Z, et al. The relationship between serum levels of vitamin D and migraine. J Res Med Sci. 2013;18:S66–70.PubMedPubMedCentral

84.

Zandifar A, Masjedi SS, Banihashemi M, Asgari F, Manouchehri N, Ebrahimi H, et al. Vitamin D status in migraine patients: a case-control study. Biomed Res Int. 2014:1-7.

85.

Michaud M, Dumont M, Selmaoui B, Paquet J, Fantini ML, Montplaisir J. Circadian rhythm of restless legs syndrome: relationship with biological markers. Ann Neurol. 2004;55:372–80.PubMedCrossRef

86.

Whittom S, Dumont M, Petit D, Desautels A, Adam B, Lavigne G, et al. Effects of melatonin and bright light administration on motor and sensory symptoms of RLS. Sleep Med. 2010;11:351–5.PubMedCrossRef

87.

Kunz D, Bes F. Exogenous melatonin in periodic limb movement disorder: an open clinical trial and a hypothesis. Sleep. 2001;24:183–7.PubMed

88.

Comai S, Gobbi G. Unveiling the role of melatonin MT2 receptors in sleep, anxiety and other neuropsychiatric diseases: a novel target in psychopharmacology. J Psychiatry Neurosci. 2014;39:6–21.PubMedCrossRefPubMedCentral

89.

Zurowski D, Nowak L, Machowska A, Wordliczek J, Thor PJ. Exogenous melatonin abolishes mechanical allodynia but not thermal hyperalgesia in neuropathic pain. The role of the opioid system and benzodiazepine-gabaergic mechanism. J Physiol Pharmacol. 2012;63:641–7.PubMed

90.

Ambriz-Tututi M, Rocha-González HI, Cruz SL, Granados-Soto V. Melatonin: a hormone that modulates pain. Life Sci. 2009;84:489–98.PubMedCrossRef

91.

Pang SF, Wan Q, Brown GM. Melatonin receptors in the spinal cord. Biol Signals. 1997;6:272–83.PubMedCrossRef

92.

Glynn CJ, Lloyd JW. The diurnal variation in perception of pain. Proc R Soc Med. 1976;69:369–72.PubMedPubMedCentral

93.

Odrcich M, Bailey JM, Cahill CM, Gilron I. Chronobiological characteristics of painful diabetic neuropathy and postherpetic neuralgia: diurnal pain variation and effects of analgesic therapy. Pain. 2006;120:207–12.PubMedCrossRef

94.

Giummarra MJ, Bradshaw JL. The phantom of the night: restless legs syndrome in amputees. Med Hypotheses. 2010;74:968–72.PubMedCrossRef

95.

Galer BS, Gianas A, Jensen MP. Painful diabetic polyneuropathy: epidemiology, pain description, and quality of life. Diabetes Res Clin Pract. 2000;47:123–8.PubMedCrossRef

96.

Trenkwalder C, Hening WA, Walters AS, Campbell SS, Rahman K, Chokroverty S. Circadian rhythm of periodic limb movements and sensory symptoms of restless legs syndrome. Mov Disord. 1999;14:102–10.PubMedCrossRef

97.•

Garcia-Borreguero D, Kohnen R, Silber MH, Winkelman JW, Earley CJ, Högl B, et al. The long-term treatment of restless legs syndrome/Willis-Ekbom disease: evidence-based guidelines and clinical consensus best practice guidance: a report from the International Restless Legs Syndrome Study Group. Sleep Med. 2013. pp. 675–84. The latest guidelines for RLS treatment are here.

98.••

Allen RP, Chen C, Garcia-Borreguero D, Polo O, DuBrava S, Miceli J, et al. Comparison of pregabalin with pramipexole for restless legs syndrome. N Engl J Med. 2014;370:621–31. The evidence for a similar efficacy of pregabaline and pramipexole in restless legs syndrome.PubMedCrossRef

99.

Hoque R, Chesson Jr AL. Pharmacologically induced/exacerbated restless legs syndrome, periodic limb movements of sleep, and REM behavior disorder/REM sleep without atonia: literature review, qualitative scoring, and comparative analysis. J Clin Sleep Med. 2010;6:1–23.

Title: Restless Legs Syndrome and Pain Disorders: What’s in common?
Authors: Leonardo Ierardi Goulart
Raimundo Nonato Delgado Rodrigues
Mario Fernando Prieto Peres
Publication date: 01-11-2014
Publisher: Springer US
Published in: Current Pain and Headache Reports / Issue 11/2014
Print ISSN: 1531-3433
Electronic ISSN: 1534-3081
DOI: https://doi.org/10.1007/s11916-014-0461-0

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Restless Legs Syndrome and Pain Disorders: What’s in common?

Abstract

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

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