Periodic Limb Movement Disorder (PLMD)

Denise Sharon, MD, PhD, FAASM and Rochelle Zak, MD Reviewed 04/2024

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 ...

TREATMENT

Treatment paradigm similar to that for RLS, except that all medications are off-label for PLMD (2,4,5)[B]

GENERAL MEASURES

Assess for and correct iron insufficiency.
Adequate nightly sleep
Reg...

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 b...

REFERENCES

Hornyak M, Feige B, Riemann D, et al. Periodic leg movements in sleep and periodic limb movement disorder: prevalence, clinical significance and treatment. Sleep...

ADDITIONAL READING

American Academy of Sleep Medicine. Periodic limb movement disorder. In: International Classification of Sleep Disorders ...

CODES

ICD10

G47.61 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.
Assuring adequate iro...

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