sodium-oxybate and Restless-Legs-Syndrome

Gamma-hydroxybutyrate (GHB) has re-emerged as a major treatment for narcolepsy. As dopaminergic transmission is clearly involved in the pathophysiology of restless legs syndrome (RLS), and GHB reduces dopamine release, one may hypothesize that RLS may occur in narcolepsy in the presence of GHB. We report a case of narcolepsy with a severe occurrence of typical RLS with GHB, symptoms never previously experienced by the subject and reversible after withdrawal.

Topics: Diagnosis, Differential; Dose-Response Relationship, Drug; Drug Administration Schedule; Humans; Male; Middle Aged; Narcolepsy; Restless Legs Syndrome; Sodium Oxybate

Patients with sleep disorders present with a variety of complaints including excessive daytime sleepiness, daytime spells, inability to sleep, uncomfortable sensation in the extremities, and unusual night time behaviors. This article provides eight vignettes on patients with sleep disorders including narcolepsy, idiopathic hypersomnia, obstructive sleep apnea, restless legs syndrome, and rapid eye movement behavior disorder. The discussion provides data regarding the epidemiology, pathophysiology, and diagnostic approach for these conditions. The various treatment options for these sleep disorders are also identified.

Topics: Adjuvants, Anesthesia; Adolescent; Adult; Aged; Aged, 80 and over; Cataplexy; Disorders of Excessive Somnolence; Electroencephalography; Female; HLA Antigens; Humans; Male; Middle Aged; Narcolepsy; Polysomnography; REM Sleep Behavior Disorder; Restless Legs Syndrome; Sleep Apnea, Obstructive; Sleep Stages; Sleep Wake Disorders; Sodium Oxybate

Seven patients suffering from restless legs syndrome (RLS) and periodic movements in sleep (PMS) were investigated before and after treatment with L-Dopa. The effect of treatment was evaluated by polysomnography, structured interviews, and daily questionnaires. Sleep organization and subjective complaints improved during treatment with 100 to 200 mg of L-Dopa. Polysomnographic recordings also revealed a significant decrease of periodic leg movements during the first third of the night and a rebound during the last third. These results and previous biochemical findings raise the hypothesis that RLS and PMS may both result from reduced dopaminergic activity in the CNS, perhaps resulting from decreased sensibility of postsynaptic receptors.

Topics: Adult; Central Nervous System; Dopamine; Female; Humans; Levodopa; Male; Movement Disorders; Restless Legs Syndrome; Sleep Wake Disorders; Sodium Oxybate; Synaptic Transmission