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Consensus clinical practice guidelines for the diagnosis and treatment of restless legs syndrome/Willis-Ekbom disease during pregnancy and lactation - 05/06/15

Doi : 10.1016/j.smrv.2014.10.009 
Daniel L. Picchietti a, , Jennifer G. Hensley b, Jacquelyn L. Bainbridge c, Kathryn A. Lee d, Mauro Manconi e, James A. McGregor f, Robert M. Silver g, Claudia Trenkwalder h, i, Arthur S. Walters j
On behalf of the

International Restless Legs Syndrome Study Group (IRLSSG)

a University of Illinois College of Medicine at Urbana-Champaign and Carle Foundation Hospital, Urbana, IL, USA 
b College of Nursing, University of Colorado Denver, Aurora, CO, USA 
c Department of Clinical Pharmacy and Department of Neurology, University of Colorado Denver, Aurora, CO, USA 
d Department of Family Health Care Nursing, School of Nursing, University of California San Francisco, San Francisco, CA, USA 
e Sleep and Epilepsy Center, Neurocenter of Southern Switzerland, Civic Hospital of Lugano, Lugano, Switzerland 
f Department of Obstetrics and Gynecology, Women's and Children's Hospital, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA 
g Department of Obstetrics and Gynecology, University of Utah, Salt Lake City, UT, USA 
h Paracelsus-Elena Hospital, Center of Parkinsonism and Movement Disorders, Kassel, Germany 
i Department of Neurosurgery, University Medical Center, Goettingen, Germany 
j Department of Neurology Vanderbilt University School of Medicine, Nashville, TN, USA 

Corresponding author. University of Illinois College of Medicine and Carle Foundation Hospital, Department of Sleep Medicine, 602 W. University Avenue, Urbana, IL 61801, USA. Tel.: +1 217 383 3311; fax: +1 217 383 4468.

Summary

Restless legs syndrome (RLS)/Willis-Ekbom disease (WED) is common during pregnancy, affecting approximately one in five pregnant women in Western countries. Many report moderate or severe symptoms and negative impact on sleep. There is very little information in the medical literature for practitioners on the management of this condition during pregnancy. Accordingly, a task force was chosen by the International RLS Study Group (IRLSSG) to develop guidelines for the diagnosis and treatment of RLS/WED during pregnancy and lactation. A committee of nine experts in RLS/WED and/or obstetrics developed a set of 12 consensus questions, conducted a literature search, and extensively discussed potential guidelines. Recommendations were approved by the IRLSSG executive committee, reviewed by IRLSSG membership, and approved by the WED Foundation Medical Advisory Board. These guidelines address diagnosis, differential diagnosis, clinical course, and severity assessment of RLS/WED during pregnancy and lactation. Nonpharmacologic approaches, including reassurance, exercise and avoidance of exacerbating factors, are outlined. A rationale for iron supplementation is presented. Medications for RLS/WED are risk/benefit rated for use during pregnancy and lactation. A few are rated “may be considered” when RLS/WED is refractory to more conservative approaches. An algorithm summarizes the recommendations. These guidelines are intended to improve clinical practice and promote further research.

El texto completo de este artículo está disponible en PDF.

Keywords : Restless legs syndrome, Willis-Ekbom disease, Sleep disorder, Pregnancy, Lactation, Consensus


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© 2014  Publicado por Elsevier Masson SAS.
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Vol 22

P. 64-77 - août 2015 Regresar al número
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