RESTLESS LEG SYNDROME

Restless legs syndrome (RLS) is a chronic condition, with onset at any age, characterized by urgency to move the legs and unpleasant sensations, worsening at rest and in the evening and relieved by the movement. Pharmacological approaches, including benzodiazepines, dopaminoagonists, levodopa and antiepileptics, showed substantial inter-individual variability of efficacy and side effects. We report the case of a woman who did not respond to any previous pharmacological treatment, successfully treated with hydroxyzine hydrochloride. The efficacy of this first-generation antihistamine with potent anticholinergic properties in our RLS case may resemble the action of several anticholinergic drugs in Parkinson Disease, reasserting the possibility of a common pathophysiological background shared by these two distinct clinical entities.

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Introduction

Restless legs syndrome (RLS) is a frequent neurological disorder characterized by nocturnal motor restlessness accompanied by lower limb paresthesias usually alleviated by the activity.
Epidemiological studies have estimated a prevalence of around 4-10% in the general population ^1].
Several observations suggest the presence of a dopaminergic dysfunction in RLS ¹,^2]. The differential diagnosis includes the neuroleptic-induced akathisia, polyneuropathies, the meralgia paresthetica and the nocturnal leg cramps.
While prochlorperazine, metoclopramide, neuroleptics and some antidepressants have been reported to exacerbate RLS, various classes of drugs showed beneficial effects, and ferrum replacement may be effective in iron-deficient patients [^2]. No previous reports indicated the potential application of hydroxyzine hydrocloride in RLS. We present the case of a patient suffering from RLS, not responding to common drugs, successfully treated with hydroxyzine hydrocloride.