ewass at codon.nih.gov
Thu Sep 21 12:24:11 EST 1995
In article <41699.robin073 at maroon.tc.umn.edu>, "Alan J. Robinson"
<robin073 at maroon.tc.umn.edu> wrote:
> On Tue, 19 Sep 1995 15:39:34 -0700,
> Sandra L Wegert <sandraw at U.Arizona.EDU> wrote:
> >My mother has restless legs syndrome. I also have a less severe version
> >of it. Does this make sense genetically (am I heterozygous)? What
> >exactly is the mechanism? Exercise pretty much keeps it under control
> >for me. Would some (DA?) drugs help my mother? Thanks!
> Re genetics, the conventional picture of genetic disorders (dominant,
> recessive, etc.) does not apply to the broad spectrum of the
> neuropsychiatric immune functional disorders, which would include
> restless legs syndrome. The reason for this is that there are
> probably a large number of genes involved, many of which only make a
> small contribution - facial appearance is the same way.
> Though the evidence is still somewhat circumstantial, many of these
> disorders are probably centered in the diffuse ascending monoaminergic
> pathways from the reticular activating system in the brain stem.
> One function of these pathways is to suppress movement during REM
> Dopamine is probably the most important neurotransmitter here,
> so that is what treatment usually centers on. An important
> new development in the treatment of these disorders is the combination
> of dopaminergic and serotonergic agents, as in the phentermine +
> fenfluramine treatment which appears to treat some other conditions
> besides obesity.
Yes. Sinemet (DOPA/carbidopa) or bromocryptine is usually quite effective
in treating this syndrome and is an accepted treatment with relatively
mild side effects. I don't know about phentermine and fenfluramine. I
wonder what basis the writer has for classifying restless leg syndrom as a
"neuropsychiatric immune functional disorder", whatever that means. As
far as I know, there is no evidence of a psychiatric, immune or functional
component. Like many neurological disorders, of which restless leg
syndrome is certainly one, it could be arise from a single abnormal gene.
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