Huzursuz Bacaklar Sendromu: Tanıdan Tedaviye

Abstract

Huzursuz bacaklar sendromu (HBS), uzuvları hareket ettirme dürtüsünün tipik olarak rahatsız edici bir hisle örtüşmesiyle tanımlanabilir. Dinlenme veya hareketsizlik sırasında belirtiler başlayabilir veya daha kötü gelişebilir; genellikle kişi hareket ettiğinde veya yürüyüşe çıktığında kaybolurlar. HBS hem idiyopatik hem de demir eksikliği, diyabet, obezite, hipotiroidizm ve kronik böbrek yetmezliği gibi birçok sağlık durumuna sekonder olabilir. İlk başvuruda ikincil nedenler ve transferrin saturasyonu, ferritin gibi demir testleri değerlendirilmelidir. Semptomlar kötüleştiğinde veya augmentasyon geliştiğinde değerlendirmeler tekrarlanmalıdır. Augmentasyon, levodopa ve dopamin agonistleriyle yapılan tedavinin önemli bir olumsuz etkisidir. Belirtilerin daha şiddetli olması, belirtilerin erken ortaya çıkması ve belirtilerin bacaklardan diğer vücut bölgelerine yayılması augmentasyonun göstergesidir. Farmakolojik olmayan tedaviler bazı HBS hastalarının semptomlarını kontrol altına almasına yardımcı olur. Demir replasman tedavisi, vücut demir depolarının düşük olduğu belirtileri olan hastalar için birinci basamak tedavi seçeneğidir. Son zamanlarda dopamin agonistleri yerine başlangıç tedavileri olarak α2δ ligandlarının kullanılması önerilmiştir.

Keywords

• Huzursuz bacaklar sendromu
• augmentasyon
• demir eksikliği
• demir tedavisi

Restless Legs Syndrome: From Diagnosis to Treatment

Abstract

Restless legs syndrome (RLS) can be described by an urge to move limbs that typically coincides with an uncomfortable sensation. When at rest or inactivity, signs may start or develop worse; they usually go away when one moves or gets up for a walk. RLS can be both idiopathic or secondary to many kinds of health conditions, such as deficiency of iron, diabetes, obesity, hypothyroidism, and chronic renal failure. At the admission, secondary causes and iron tests, such as transferrin saturation and ferritin, must be evaluated. Assessments should be repeated when symptoms worsen, or when augmentation develops. Augmentation is a significant adverse effect of therapy by levodopa and dopamine agonists. More severe signs, early appearance of symptoms, and spreading of symptoms from the legs to other body parts are indicative of augmentation. Non-pharmacological treatments help some RLS patients control their symptoms. Iron-replacement therapy is a first-line treatment option for patients with indications of low body iron stores. The use of α2δ ligands as initial treatments instead of dopamine agonists has been recommended recently.

Keywords

• Restless legs syndrome
• augmentation
• iron deficiency
• iron therapy

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