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Periodic Limb Movement Disorder (PLMD)

Denise Sharon, MD, PhD and John R. Burk, MD Reviewed 06/2018
 


BASICS

DESCRIPTION

  • Sleep-related movement disorder with episodes of periodic limb movements (PLMs) occurring during sleep (1)[A]

    • Periodic limb movements of sleep (PLMS) demonstrated during polysomnogr...

DIAGNOSIS

HISTORY

  • Sleep disturbance:

    • Insomnia: difficulty maintaining sleep

    • Nonrestorative sleep

    • Daytime fatigue, tiredness, and/or somnolence

    • Oppositional behaviors

    • Memory impairment

    • Depression

    • ADHD, parti...

TREATMENT

Treatment paradigm similar to that for RLS, except that all medications are off-label for PLMD (2,3,5)[B

GENERAL MEASURES

  • Assess for and correct iron deficiency.

  • Adequate nightly sleep

  • Regular...

ONGOING CARE

FOLLOW UP RECOMMENDATIONS

Patient Monitoring

  • At monthly intervals until stable

  • Assess symptom severity, medication side effects, augmentation.

  • Annual and PRN follow-up thereafter

  • If iron defic...

REFERENCES

1
Hornyak M, Feige B, Riemann D, et al. Periodic leg movements in sleep and periodic limb movement disorder: prevalence, clinical significance and treatment. Sleep Med Rev.  2006;10(3):...

ADDITIONAL READING

  • American Academy of Sleep Medicine. Periodic limb movement disorder. In: International Classification of Sleep Disorders. 3rd ed. Darien, IL: American Academy of Sleep Medicine; 2...

SEE ALSO

Restless Legs Syndrome 

CODES

ICD10

G47.61 Periodic limb movement disorder 

ICD9

327.51 Periodic limb movement disorder 

SNOMED

418763003 periodic limb movement disorder (disorder) 

CLINICAL PEARLS

  • Many patients with PLMs may not require treatment; however, when sleep disturbance from PLMs causes insomnia and/or daytime consequences, PLMD exists and should be treated.

  • Assessing ir...

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