Restless Legs Syndrome

Department of Neurology, Faculty of Medicine

University of Hasanuddin, Makassar, Indonesia

Abstract
Akathisia and Restless legs syndrome (RLS) share some common clinical features and a
common relationship with dopamine dysfunction. However, the underlying causes and
appropriate treatments for Akathisia and RLS are different. RLS is a sleep-related movement
disorder that involves an almost irresistible urge to move the legs at night. This urge tends to
be accompanied by unusual feelings or sensations, called “paresthesia,” that occur deep in the
legs. These uncomfortable sensations often are described as a burning, tingling, prickling or
jittery feeling. There are four types of RLS including Early Onset RLS, Late Onset RLS,
Primary RLS, Secondary RLS. The Causes of RLS are not yet fully known, but iron
deficiency and all conditions that produce it increase the risk of RLS, with iron deficiency
appearing to be a common factor for most secondary causes. Brain iron deficiency may be a
primary pathology of RLS. Several medications may precipitate or aggravate RLS, including
nonprescription allergy and cold medications that contain antihistamine, most antidepressants,
and major tranquilizers. Treatment of RLS for now is not to cure but only to eliminate
symptoms for a long time. Current therapy that is often given is with levodopa, opioids,
intravenous or iron therapy, and benzodiazepines. The use of caffeine, nicotine and alcohol
should be avoided because it can worsen RLS. Different from RLS, Akathisia is
neuropsychiatric syndrome, characterized by subjective and objective psychomotor
restlessness. The symptoms are not following a circadian rhythm, no paresthesia, improved
use of dopamine blockers, and psychomotor disorders. Treatment of Akathisia, which should
be tailored to the patient’s psychopathology and comorbidities, is needed as well.

Keywords: Restless Legs Syndrome, Akathisia, Iron Deficiency