Periodic Limb Movements while Awake (PLMA) as a Manifestation of Wearing-Off in Parkinson's Disease: A Case Series and Review of the Literature.

BACKGROUND

Periodic limb movements while awake (PLMA) are similar to Periodic limb movements in sleep (PLMS) but occurring during wakefulness and seen in association with restless leg syndrome (RLS).

OBJECTIVES

To describe PLMA as a wearing-off phenomenon in Parkinson's Disease (PD).

METHODS

We describe four individuals with PD and PLMS, who had associated similar periodic and stereotypic lower extremity movements during wakefulness, thought to be secondary to PLMA, and were highly responsive to dopaminergic treatment.

RESULTS

Despite the prevalence of RLS and PLMS in individuals with PD, the presence of similar movements during wakefulness has not been well characterized. The lack of a specific diagnostic criteria poses a significant diagnostic challenge.

CONCLUSIONS

We describe, for the first time to our knowledge, PLMA as a wearing-off phenomenon in PD. This entity could be classified in the spectrum of "low-dose dyskinesia," as we found that it was highly responsive to dopaminergic treatment.