Triggered by a complex patient with myasthenia, polyneuropathy, RLS, organic psychosis and several more we discuss what is to be known about the restless legs syndrome, using
- Salas et al. Update in restless legs syndrome. Curr op neurology 2010
- The RLS chapter 31 of Jankovic’s Parkinson’s disease & movement disorders
For me the first source provided a fundamental insight into the pathophysiology of RLS (heightened circadianic dopamine variations with consecutive desensitization of dopamine receptors) that finally explains why dopaminergic medication can lead to augmentation.
I still can’t understand why we use long-acting dopamine agonists rather than short-acting or at least SR L-Dopa to cover symptoms and this pathophysiologic view would support the view.
Another brilliant development is transcranial sonography for imaging of the SN, finding hypoechogenicity – as reported in