Restless legs syndrome. Pathophysiology, diagnosis and treatment

Restless Legs Syndrome is the most prevalent sleep-related movement disorder, affecting 5%–10% of the population, characterized by an urge to move that appears during rest or is exacerbated by rest, primarily in the lower extremities, that occurs in the evening or night and that disappears during movement or is improved by movement. Restless Legs Syndrome significantly impacts sleep, mood, and quality of life.

Its pathophysiology involves a complex interplay of genetic and environmental factors, as well as comorbidities, leading to alterations in brain iron resulting in dysfunction in dopaminergic, adenosine, and glutamatergic pathways.

Treatment typically includes iron supplementation and symptomatic therapy, traditionally utilizing dopamine agonists. However, their long-term use may exacerbate symptoms, relegating them to second-line treatment after α2δ ligands of calcium channels.