Sections View Full Chapter Figures Tables Videos Annotate Full Chapter Figures Tables Videos Supplementary Content + Download Section PDF Listen ++ For further information, see CMDT Part 24-13: Movement Disorders + Key Features Download Section PDF Listen +++ ++ Affects 1–5% of people May occur as a primary (idiopathic) disorder or in relation to Parkinson disease Pregnancy Iron deficiency anemia Peripheral neuropathy (especially uremic or diabetic) May have a hereditary basis, and several genetic loci have been associated with the disorder + Clinical Findings Download Section PDF Listen +++ ++ Restlessness and curious sensory disturbances lead to an irresistible urge to move the limbs, especially during periods of relaxation Disturbed nocturnal sleep and excessive daytime somnolence + Diagnosis Download Section PDF Listen +++ ++ Diagnosis usually made on clinical grounds alone Ferritin levels should always be measured + Treatment Download Section PDF Listen +++ ++ Oral iron sulfate in patients with ferritin levels ≤ 75 mcg/L (13.4 mcmol/L) should be attempted prior to initiation of other pharmacotherapies Pramipexole (0.125–0.5 mg orally once daily), ropinirole (0.25–4 mg orally once daily) 2–3 hours before bedtime, or rotigotine (1–3 mg/24h transdermal patch once daily), or with gabapentin enacarbil (300–1200 mg orally each evening) Gabapentin (starting with 300 mg orally daily, increasing to approximately 1800 mg orally daily depending on response and tolerance) Pregabalin (150–300 mg orally divided twice to three times daily) Levodopa Generally reserved for those who do not respond to other measures May worsen symptoms Extended release oxycodone-naloxone (5 mg-2.5 mg to 10 mg-5 mg orally twice daily) is useful in patients with severe symptoms or those who are refractory to first-line therapies