SINDROME DE PIERNAS INQUIETAS: NOVEDADES EN EL DIAGNOSTICO Y EL TRATAMIENTO

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Las distintas alternativas terapéuticas para tratar el síndrome de las piernas inquietas, incluidos los agentes dopaminérgicos, debe ser considerada en cada caso particular, en función de la gravedad de los síntomas y del perfil de efectos adversos.
chik9.jpg Autor:
Yolanda Chik
Columnista Experto de SIIC

Institución:
Johns Hopkins School of Medicine


Artículos publicados por Yolanda Chik
Coautores
Rachel Salas* Charlene Gamaldo* 
MD, Johns Hopkins School of Medicine, Baltimore, EE.UU.*
Recepción del artículo
30 de Septiembre, 2009
Aprobación
25 de Febrero, 2010
Primera edición
22 de Junio, 2010
Segunda edición, ampliada y corregida
7 de Junio, 2021

Resumen
El síndrome de las piernas inquietas (SPI) es una enfermedad sensitivomotora frecuente que se asocia en general con alteraciones significativas del sueño y con molestias durante la vigilia, que potencialmente pueden incrementar el riesgo de comorbilidades. El SPI se diagnostica cuando se cumplen los siguientes cuatro criterios: la necesidad de movimiento, habitualmente en asociación con parestesias; inicio o exacerbación de los síntomas durante el descanso; alivio de los síntomas con el movimiento, y síntomas que se manifiestan con un ritmo circadiano. El SPI puede presentarse en adultos y niños y existe una predisposición genética vinculada con una presentación más temprana de los síntomas de la enfermedad, en general antes de los 45 años. Una variedad de trastornos pueden asemejarse al SPI, por lo cual es importante el diagnóstico diferencial durante la evaluación del paciente. El tratamiento del SPI incluye el suplemento de hierro, agentes dopaminérgicos (AD), opioides, benzodiazepinas y fármacos antiepilépticos. Los AD se asocian con un mayor efecto terapéutico y dos fármacos de este grupo son los únicos medicamentos aprobados por la FDA para el tratamiento del SPI en EE.UU. El suplemento de hierro en los pacientes con SPI puede ser de utilidad cuando se trata de enfermos con deficiencia de este mineral. Sin embargo, cada una de las alternativas terapéuticas, incluidos los AD, debe ser considerada en cada caso particular, en función de la gravedad de los síntomas y del perfil de los efectos adversos. La mayor identificación y el enfoque del SPI, un trastorno a menudo debilitante, puede asociarse con una mejoría en la calidad de vida y la potencial optimización de la salud en general para las muchas personas que lo padecen.

Palabras clave
síndrome de piernas inquietas, dopamina, epidemiología, tratamiento, diagnóstico, síndrome de piernas inquietas, movimientos periódicos de las piernas, diagnóstico, tratamiento, aceleración, dopamina


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Abstract
Restless legs syndrome (RLS) is a common sensorimotor disorder that is usually associated with significant sleep disturbance and daytime complaints potentially leading to increased co-morbid health risks. RLS is diagnosed by fulfilling the following four criteria: (1) an urge to move, usually associated with paresthesias, (2) onset or exacerbation of symptoms at rest, (3) relief of symptoms with movement, and (4) symptoms manifest in a circadian pattern. Adults and children can suffer from RLS and there is a genetic predisposition manifesting with an earlier age of onset of RLS symptoms, usually before the age of 45 years. A variety of conditions may mimic RLS so it is important to differentiate these during evaluation of the patient. Treatment of RLS includes iron supplementation, dopaminergic agents (DA), opioids, benzodiazepines, and anti-epileptic drugs (AEDs). DA demonstrate the largest treatment effect and include the only two FDA approved in the United States to treat RLS. Iron supplementation in RLS patients who are found to be iron deficient may be beneficial as well. However, each of the treatment options, including the use of DA, must be considered on a case-by-case basis taking into account symptom severity and side effect profiles. Increased recognition and management of RLS, an often debilitating condition, can lead to an improved quality-of-life and potentially improved overall health for the many who suffer from RLS.

Key words
restless legs syndrome, restless legs syndrome, periodic legs movement, dopamine, diagnosis, epidemiology, treatment, treatment, augmentation, diagnosis, dopamine


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Especialidades
Principal: Neurología
Relacionadas: Atención Primaria, Educación Médica, Farmacología, Geriatría, Medicina Familiar, Medicina Interna, Pediatría



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Yolanda Chik, Johns Hopkins School of Medicine Department of Neurology, MD 21205, 600 North Wolfe St., Baltimore, EE.UU.
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