Restless legs

Eric Wassermann 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!
> >
> 
> Sandra:
> 
> 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 
> sleep.
> 
> 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.

Eric Wassermann



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