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Rastløse bein

Sist revidert:
Sist revidert av:


Definisjon:
Rastløse bein, syn. restless legs syndrome (RLS) eller Willis-Ekboms sykdom, karakteriseres ved episoder med ubehag/kribling i beina som forsvinner/reduseres ved bevegelse 
Forekomst:
Relativt hyppig, studier viser at så mange som 5-10% av befolkningen plages
Symptomer:
Kribling/murring/ubehag i beina, melder seg i hvile, spesielt om kveld eller natt, bedres ved aktivitet 
Funn:
Ved undersøkelse ingen tegn til annen nevrologisk sykdom. Økt risiko for depresjon
Diagnostikk:
Klinisk diagnose. Blodprøve med tanke på jernmangel og blodprosent bør tas. Jernlagre ofte i nedre del av normalområdet, ev. jernmangel (ferritin < 75)
Behandling:
Informasjon og rådgivning. Eventuelt jerntilskudd eller annen medikamentell behandling
  • Nasjonalt senter for søvnmedisin (SOVno) - nettsted 
  1. Allen RP, Picchietti DL, Garcia-Borreguero D, 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(8): 860-73. pmid:25023924 PubMed  
  2. Ekbom KA. Restless legs syndrome. Neurology 1960;10:868-873. Pmid 13726241
  3. Ohayon MM, O'Hara R, Vitiello MV. Epidemiology of restless legs syndrome: A synthesis of the literature. Sleep Med Rev 2011; 16: 283-95. PubMed  
  4. Bjorvatn B, Leissner L, Ulfberg J, et al. Prevalence, severity and risk factors of restless legs syndrome in the general adult population in two Scandinavian countries. Sleep Med 2005; 6(4): 307-12. pmid:15923140 PubMed  
  5. Bjorvatn B, Wensaas KA, Emberland KE et al.. Rastløse bein – en studie fra allmennpraksis. Tidsskr Nor Legeforen 2021. pmid:34758599 PubMed  
  6. Hening W, et al. Impact, diagnosis and treatment of restless legs syndrome (RLS) in a primary care population: The REST primary care study. Sleep Medicine 2004; 5: 237-46. PubMed  
  7. Ulfberg J, Nyström B, Carter N, Edling C. Restless legs syndrome among working-aged women. Eur Neurol 2001; 46: 17 - 9. PubMed  
  8. Ulfberg J, Nyström B, Carter N, Edling C. Prevalence of restless legs syndrome among men aged 18 to 64 years: an association with somatic diseases and neuropsychiatric symptoms. Mov Disord 2001; 16: 1159 - 63. PubMed  
  9. Manconi M, Govoni V, De Vito A, et al. Restless legs syndrome and pregnancy. Neurology 2004; 63: 1065-9. Neurology  
  10. Allen RP, Earley CJ. Restless legs syndrome: a review of clinical and pathophysiologic features. J Clin Neurophysiol 2001;18:128-147. PubMed  
  11. Milligan SA, Chesson A. Restless legs syndrome in the older adult. Diagnosis and management. Drugs Aging 2002; 19: 741 - 51. PubMed  
  12. Norsk barnelegeforening, Generell veileder i pediatri. Søvnrelaterte bevegelsesforstyrrelser. Sist revidert 2019. Siden lest 10.01.2022 www.helsebiblioteket.no  
  13. Trenkwalder C, Hogl B, Winkelmann J. Recent advances in the diagnosis, genetics and treatment of restless legs syndrome. J Neurol. 2009 Apr. 256(4):539-53
  14. Ondo WG, Vyong KD, Wang Q. Restless legs syndrome in monozygote twins: clinical correlates. Neurology 2000; 55: 1404 - 6. Neurology  
  15. Earley CJ, Allen RP, Beard JL, Connor JR. Insight into the pathophysiology of restless legs syndrome. J Neurosci Res 2000;62:623-628. PubMed  
  16. Odin P, Mrowka M, Shing S. Restless legs syndrome. Eur Neurol 2002; 9 (suppl 3): 59 - 67.
  17. Allen RP, Picchietti DL, Auerbach M, et al. Evidence-based and consensus clinical practice guidelines for the iron treatment of restless legs syndrome/Willis-Ekbom disease in adults and children: an IRLSSG task force report. Sleep Med 2018; 41: 27-44. pmid:29425576 PubMed  
  18. Earley CJ, Allen RP, Connor JR, et al. The dopaminergic neurons of the A11 system in RLS autopsy brains appear normal. Sleep Med 2009; 10: 1155-7. pmid:19307154 PubMed  
  19. Kinge E, Lossius MI. Rastløse bein. Tidsskr Nor Lægeforen 2004; 124: 25-7. PubMed  
  20. Eisensehr I, Wetter TC, Linke R, Noachter S, Lindeiner Hv, Gildenhaus FJ et al. Normal IPT and IBZ SPECT in drug-naive and levodopa-treated idiopathic restless legs syndrome. Neurology 2001; 57: 1307 - 9. Neurology  
  21. Walters AS, Winkelmann J, Trenkwalder C , Fry JM, Kataria V, Wagner M et al. Long-term follow up on restless legs syndrome patients treated with opioids. Mov Disord 2001; 16: 1105 - 9. PubMed  
  22. Earley CJ, Connor JR, Beard JL, Malecki EA, Epstein DK, Allen RP. Abnormalities in CSF concentrations of ferritin and transferrin in restless legs syndrome. Neurology 2000; 54: 1698 - 700. Neurology  
  23. Phillips B, Hening W, Britz P, et al. Prevalence and correlates of restless legs syndrome: results from the 2005 National Sleep Foundation Poll. Chest 2006; 129: 76-80. PubMed  
  24. Bara-Jimenez W, Aksu M, Graham B, Sato S, Hallet M. Periodic limb movement in sleep: state-dependent excitability of the spinal flexor reflex. Neurology 2000; 54: 1609 - 16. Neurology  
  25. Allen RP, Earley CJ. Defining the phenotype of the restless legs syndrome (RLS) using age-of-symptom-onset. Sleep Med 2000;1:11-9. PubMed  
  26. Winkelmann J, Polo O, Provini F, et al. Genetics of restless legs syndrome (RLS): state-of-the-art and future directions. Mov Disord (in press).
  27. Lee KA, Zaffke ME, Baratte-Beebe K. Restless legs syndrome and sleep disturbance during pregnancy: the role of folate and iron. J Womens Health Gend Based Med 2001;10:335-341. PubMed  
  28. Trenkwalder C, Allen R, Högl B, et al. Restless legs syndrome associated with major diseases: A systematic review and new concept. Neurology 2016; 86(14): 1336-1343. pmid:26944272 PubMed  
  29. International restless legs syndrome study group (IRLSSG). 2012 revised IRLSSG diagnostic criteria for RLS. www.irlssg.org  
  30. Allen RP, Picchietti D, Hening WA, Trenkwalder C, Walters AS, Montplaisi J et al. Restless legs syndrome: diagnostic criteria, special consideration, and epidemiology: a report from the restless legs syndrome diagnosis and epidemiology workshop at the National Institutes of Health. Sleep Med 2003; 4: 101 - 19. PubMed  
  31. Earley CJ. Restless legs syndrome. N Engl J Med 2003; 348: 2103-9. PubMed  
  32. Bozorg AM. Restless legs syndrome. Medscape, last updated Jul 24, 2015. emedicine.medscape.com  
  33. O'Keeffe ST, Gavin K, Lavan JN. Iron status and restless legs syndrome in the elderly. Age Ageing 1994; 23: 200-3. PubMed  
  34. Walters AS, LeBrocq C, Dhar A, et al.. Validation of the International Restless Legs Syndrome Study Group rating scale for restless legs syndrome. Sleep Med 2003 Mar; 4(2): 121-32. pmid:14592342 PubMed  
  35. Kohnen R, Martinez-Martin P, Benes H, et al. Rating of daytime and nighttime symptoms in RLS: validation of the RLS-6 scale of restless legs syndrome/Willis-Ekbom disease. Sleep Med 2016; 20: 116-22. pmid:27318235 PubMed  
  36. Trotti LM, Becker LA. Iron for the treatment of restless legs syndrome. Cochrane Database Syst Rev 2019; 1: CD007834. pmid:30609006 PubMed  
  37. Scholz H, Trenkwalder C, Kohnen R, et al. Dopamine agonists for restless legs syndrome. Cochrane Database of Systematic Reviews 2011; 3: CD006009. Cochrane (DOI)  
  38. Trenkwalder C, Winkelmann J, Inoue Y, et al. Restless legs syndrome-current therapies and management of augmentation. Nat Rev Neurol. 2015;11(8):434-45. PubMed  
  39. Garcia-Borreguero D, Cano-Pumarega I. New concepts in the management of restless legs syndrome. BMJ. 2017 Feb 27;356:j104. PMID: 28242627. PubMed  
  40. Leschziner G, Gringras P. Restless legs syndrome. BMJ 2012; 344: e3056. BMJ (DOI)  
  41. Baker WL, White CM, Coleman CI. Effect of nonergot dopamine agonists on symptoms of restless legs syndrome. Ann Fam Med 2008; 6: 253-62. PubMed  
  42. Allen RP, Chen C, Garcia-Borreguero D, et al. Comparison of pregabalin with pramipexole for restless legs syndrome. N Engl J Med. 2014 Feb 13;370(7):621-31. PubMed  
  43. Montplaisir J, Denesle R, Petit D. Pramipexole in the treatment of restless legs syndrome: a follow-up study. Eur J Neurol 2000; 7 Suppl. 1: 27-31.
  44. Garcia-Borreguero D, Silber MH, Winkelman JW, et al. Guidelines for the first-line treatment of restless legs syndrome/Willis-Ekbom disease, prevention and treatment of dopaminergic augmentation: a combined task force of the IRLSSG, EURLSSG, and the RLS-foundation. Sleep Med 2016; 21: 1-11. pmid:27448465 PubMed  
  45. Bogan RK, Fry JM, Schmidt MH, Carson SW, Ritchie SY, and the TREAT RLS US Study Group. Ropinirole in the treatment of patients with restless legs syndrome: A US-based randomized, double-blind, placebo-controlled clinical trial. Mayo Clin Proc 2006; 81:17-27. PubMed  
  46. Trenkwalder C, Garcia-Borreguero D, Montagna P, Lainey E, de Weerd AW, Tidswell P, et al. Ropinirole in the treatment of restless legs syndrome: results from the TREAT RLS 1 study, a 12 week, randomised, placebo-controlled study in 10 European countries. J Neurol Neurosurg Psychiatry 2004; 75: 92-7. PubMed  
  47. Winkelmann J, Allen RP, Högl B, et al. Treatment of restless legs syndrome: Evidence-based review and implications for clinical practice (Revised 2017). Mov Disord 2018; 33(7): 1077-1091. pmid:29756335 PubMed  
  48. Salminen AV, Winkelmann J. Restless Legs Syndrome and Other Movement Disorders of Sleep-Treatment Update. Curr Treat Options Neurol 2018; 20(12): 55. pmid:30411165 PubMed  
  49. Trenkwalder C, Allen R, Högl B, et al. Comorbidities, treatment, and pathophysiology in restless legs syndrome. Lancet Neurol 2018; 17(11): 994-1005. pmid:30244828 PubMed  
  50. Garcia-Borreguero D, Larrosa O, de la Llave Y, Verger K, Masramon X, Hernandez G . Treatment of restless legs syndrome with gabapentin . Neurology 2002; 59: 1573-9. PubMed  
  51. Trenkwalder C, Benes H, Grote L, et al. Prolonged release oxycodone-naloxone for treatment of severe restless legs syndrome after failure of previous treatment: a double-blind, randomised, placebo-controlled trial with an open-label extension. Lancet Neurol. 2013 doi: 10.1016/S1474-4422(13)70239-4 DOI  
  52. Garcia-Borreguero D, Kohnen R, Silber MH, 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; 14(7): 675-84. pmid:23859128 PubMed  
  53. Innes KE, Selfe TK, Agarwal P. Restless legs syndrome and conditions associated with metabolic dysregulation, sympathoadrenal dysfunction, and cardiovascular disease risk: a systematic review. Sleep Med Rev 2012; 16: 309-39. PubMed  
  54. Li Y, Mirzaei F, O'Reilly EJ, et al. Prospective study of restless legs syndrome and risk of depression in women. Am J Epidemiol 2012; 176: 279-88. American Journal of Epidemiology  
  55. Zhuang S, Na M, Winkeleman JW, et al. Association of Restless Legs Syndrome With Risk of Suicide and Self-harm. JAMA Netw Open 2019. pmid:31441941 PubMed  
  • Bjørn Bjorvatn, spesialist i allmennmedisin, leder av Nasjonal kompetansetjeneste for søvnsykdommer og professor ved Institutt for global helse og samfunnsmedisin, Universitetet i Bergen
  • Tor Andre Johannessen, lege og redaktør NEL (tilpasning til NEL)

Tidligere fagmedarbeidere

  • Einar Kinge, spesialist i nevrologi, Sandvika Nevrologpraksis