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Periodic Limb Movement Disorder (PLMD)

Denise Sharon, MD, PhD, FAASM and Rochelle Zak, MD Reviewed 06/2020
 


BASICS

DESCRIPTION

Sleep-related movement disorder characterized by periodic limb movements of sleep (PLMS) with significant sleep disturbance and/or daytime functional impairment: 
  • Periodic limb moveme...

DIAGNOSIS

HISTORY

  • Sleep disturbance:

    • Insomnia: difficulty maintaining sleep

    • Nonrestorative sleep

    • Daytime fatigue, tiredness, somnolence

    • Oppositional behaviors

    • Memory impairment

    • Depression

    • ADHD, particularly i...

TREATMENT

Treatment paradigm similar to that for RLS, except that all medications are off-label for PLMD (1,3,6)[B

GENERAL MEASURES

  • Assess for and correct iron insufficiency.

  • Adequate nightly sleep

  • Regu...

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

  • Repeat iron bl...

REFERENCES

1
Aurora RN, Kristo DA, Bista SR, et al; for American Academy of Sleep Medicine. The treatment of restless legs syndrome and periodic limb movement disorder in adults—an update for 2012: pra...

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...

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; when sleep disturbance associated with PLMs causes insomnia and/or daytime consequences, PLMD should be treated.

  • Ensuring adequate iro...

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