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Dyskinesias while awake and periodic movements in sleep in restless legs syndrome

Treatment with opioids

Departments of Neurology (Drs. Hening, Walters, Côté, and Fahn), Rehabilitation Medicine (Dr. Côté), and Sleep Disorders Center (Drs. Kavey and Gidro-Frank), the College of Physicians and Surgeons of Columbia University, New York, NY.

In five unrelated patients with the restless legs syndrome, opioid drugs relieved restlessness, dysesthesias, dyskinesias while awake, periodic movements of sleep, and sleep disturbances. When naloxone was given parenterally to two treated patients, the signs and symptoms of the restless legs syndrome reappeared. Naloxone placebo had no effect. Opioid medications may offer a useful therapy for the restless legs syndrome. The endogenous opiate system may be involved in the pathogenesis of the syndrome.

Address correspondence and reprint requests to Dr. Walters, Department of Neurology, CN19, Rutgers Medical School, New Brunswick, NJ 08903.

Dr. Walters was supported in part by a grant from the Parkinson's Disease Foundation and by a Peggy Engl Fellowship. Dr. Hening was supported by the Dystonia Medical Research Foundation.

A preliminary version of this paper was presented at the 108th meeting of the American Neurological Association. New Orleans, LA, October 1983. A case report of patient 4 was presented to the International Myoclonus Conference, Arden House, NY, May 1983.

Accepted for publication February 25, 1986.

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