Background
Primary (idiopathic) disorder or related to:
- Parkinson disease
- Pregnancy
- Iron deficiency anemia
- Peripheral neuropathy (esp. uremic or diabetic)
Clinical
Symptoms
- Restlessness and & sensory Δ → urge to move the limbs
- During relaxation, particularly night-time
Investigations
- Ferritin levels (GP, not EM)
Management
- PO iron sulfate if ferritin ≤ 75 mcg/L (13.4 mcmol/L)
- Non-ergot dopamine agonists:
- Pramipexole (0.125-0.5 mg orally once daily) or
- Ropinirole (0.25-4 mg orally 3 hours before bed)
- Gabapentin (300mg OD)
- Pregabalin (50mg q8h)
- Slow-release oxycodone-naloxone in refractory