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Exclude diabetes, uraemia, hypothyroidism, anaemia, various drugs. Mainly a functional disorder affecting the elderly.
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Diet: eliminate caffeine and follow a healthy diet.
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Exercises: gentle stretching of legs, particularly of hamstrings and calf muscles, for at least 5 mins before retiring (Fig. R2).
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1st choice: paracetamol 1000 mg (o) nocte or clonazepam 1 mg, 1 h before retiring or combination of these
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2nd choice: levodopa 100–200 mg (o) nocte
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May help: codeine, levodopa, baclofen, propranolol, pramipexole, ropinirole Generally unhelpful: carbamazepine, quinine, antipsychotics and antidepressants