不宁腿综合征11例临床分析

目的探讨不宁腿综合征(RLS)的临床表现及可能的发病机制,观察多巴丝肼对RLS的治疗效果。方法对3年内收治的不宁腿综合征患者11例临床特征和治疗结果进行回顾性分析。结果11例均有活动肢体的迫切愿望,以减轻肢体的不舒服感觉,均在夜间症状加重,其中3例白天也有严重症状。根据国际不宁腿综合征研究组(IRLSSG)的诊断标准,平均得分为24分。经多巴丝肼每晚睡前服用,治疗4周后,多数患者主观症状明显改善,IRLSSG评分明显减少(平均得分14分),其中3例恢复正常。结论多巴丝肼可使RLS临床症状获得明显改善,不良反应较轻,患者依从性好,但长期疗效尚有待于进一步观察。     

吡贝地尔治疗不宁腿综合征的临床研究

目的探讨不宁腿综合征的临床特点、病因及治疗措施。方法自1997年1月到2006年3月在同济医院就诊的不宁腿综合征患者17例,询问病史并作全面体验及影像学检查等,10例患者应用氯硝西泮,另外7例患者给予吡贝地尔口服,于治疗前和治疗4周后分别应用国际不宁腿综合征评估量表(IRLS)进行评分。结果药物治疗后多数患者症状均有不同程度的改善,且吡贝地尔组疗效更明显(P<0.01)。结论不宁腿综合征可能是由多巴胺系统功能紊乱引起中枢神经系统兴奋抑制功能失调导致;多巴胺受体激动剂吡贝地尔可使临床症状获得明显改善,不良反应较轻,患者依从性好,但其长期疗效尚有待于进一步观察。     

急性脑桥梗死继发不宁腿综合征4例报道并文献复习

目的 探讨急性脑桥梗死继发不宁腿综合征(RLS)的临床表现、发病机制、诊断及治疗。方法 回顾性分析4例脑桥梗死继发RLS患者的临床资料,分析临床表现和治疗过程,总结临床特征并进行文献复习。结果 4例患者均急性起病,有神经功能缺损的体征,明确诊断为急性脑桥梗死,在脑桥梗死后0～3 d出现单侧或双侧肢体不适感,需活动肢体以减轻不适,其中3例予吡贝地尔缓释片口服后肢体不适症状消失。结论 脑桥梗死是继发性RLS的非常见病因,易漏诊,其发病机制有待于进一步研究,钙通道α2δ配体和多巴胺受体激动剂是一线治疗方案,该病早期诊治预后良好。     

不宁腿综合征23例临床分析

目的 探讨不宁腿综合征(RLS)的临床表现及可能的发病机制,观察多巴丝肼对RLS的治疗效果.方法 对符合原发性RLS诊断标准的23例患者进行回顾性分析.结果 23例患者均为中老年人,平均年龄56岁,平均发病年龄52岁.常以失眠和白日嗜睡为主诉,根据国际不宁腿综合征研究组(IRLSSG)的诊断标准,平均得分为25分,其中16例(69%)的患者为重度(21～30分).多导睡眠图(polysomnography,PSG)检查发现18例(78%)合并有周期性肢动,其中11例(61%)的患者周期性肢动指数为中度(25～49次);所有患者微觉醒指数均增高,其中16例(67%)的患者为中度.经多巴丝肼125 mg每晚睡前服用,治疗4周后,多数患者主观症状明显改善,IRLSSG评分明显减少(平均得分13分),其中5例恢复正常;合并周期性肢动的患者中,5例周期性肢动指数恢复正常,其余患者均为轻度;微觉醒指数明显减少,其中11例降为正常;19例患者睡眠潜伏期转为正常.6例(26%)患者出现一过性头痛、恶心、嗜睡.结论 对下肢不适感觉、活动后减轻、合并睡眠中腿动的患者,应尽早检查;多巴丝肼对治疗RLS有一定疗效.     

不宁腿综合征的临床分析

目的 讨论不宁腿综合征的临床表现、诊断与治疗.方法 回顾分析不宁腿综合征8例. 结果不宁腿综合征以双下肢感觉异常为突出表现,静息时出现或加重,活动及被动运动症状缓解或消失,夜间症状突出而导致睡眠障碍,不宁腿综合征常常被误诊为其他疾病. 结论不宁腿综合征诊断主要依据特征性的临床表现,左旋多巴制剂及多巴胺受体激动剂疗效肯定.     

不宁腿综合征的研究进展

不宁腿综合征(RLS)又称不安腿综合征,是一种常见的神经系统疾病,以有强烈活动双下肢的欲望为特征,常伴有感觉异常,症状在休息或夜间时发生或加重,运动后减轻.由于临床医生对其认识不足,常将RLS的感觉运动症状归于失眠、应激、肌肉痛性痉挛、抑郁症、焦虑症等原因,临床上漏诊率和误诊率高.RLS常引起患者睡眠障碍、抑郁症和焦虑症的患病率增高、心血管疾病的风险增加,生活质量受到严重影响.现就RLS的研究进展作一综述.     

不宁腿综合征的临床分析

目的讨论不宁腿综合征的临床表现、诊断与治疗。方法回顾分析不宁腿综合征8例。结果不宁腿综合征以双下肢感觉异常为突出表现，静息时出现或加重，活动及被动运动症状缓解或消失，夜间症状突出而导致睡眠障碍，不宁腿综合征常常被误诊为其他疾病。结论不宁腿综合征诊断主要依据特征性的临床表现，左旋多巴制剂及多巴胺受体激动剂疗效肯定。     

加巴喷丁治疗奥氮平致不宁腿综合征1例

本文目的是提示临床使用奥氮平过程中加强对不宁腿综合征(RLS)的识别与治疗。本文报道1例精神分裂症患者服用奥氮平期间出现夜间双下肢不适、控制不住地想要活动双腿、无法入睡等RLS症状,服用加巴喷丁后,患者症状明显改善。     

症状恶化的不宁腹综合征1例

<正>不宁腿综合征(RLS)是一种感觉运动神经系统疾病,其特征是夜间腿部感觉不适和不可抗拒的移动腿部冲动,严重影响患者睡眠。多巴胺能激动剂具有缓解RLS症状和改善睡眠的效果,但长期治疗通常会发生症状恶化和疗效丧失。现报道1例症状恶化的不宁腹综合征如下。1 病例患者,男,73岁,因“腹部不适13年余,加重2个月”于2021年2月17日来我院门诊就诊。患者13年前无明显诱因下出现腹部难以名状的不适感,休息或夜间症状明显,     

尿毒症合并不安腿综合征患者护理

不安腿综合征又称腿多动症(restless leg syndrome,RLS),是一种常见神经系统感觉运动障碍性疾病,其发病率为3%～15%.主要临床表现为:下肢难以忍受、难以形容的酸困感、蚁走感、虫蚀感、麻木等感觉异常;可伴有烧灼痛、刺痛.感觉异常也可累及上肢,休息时出现或加重,活动后减轻,被迫移动受累肢体可缓解症状.症状呈昼夜节律变化,夜间加重,常常影响睡眠,白天疲乏无力,工作效率低下,生活质量下降,可继发于缺铁性贫血、尿毒症和多发性神经病[1].随着尿毒症人群的不断扩大,RLS人群也不断扩大,但在临床工作中RLS常被忽视.2007-01～2009-03在我院行血液透析的150例患者,出现不安腿综合征16例.现总结护理经验如下.     

Is there a restless arms syndrome?

Three patients are reported who had painful numbness in upper extremities regressing temporarily after performing rather intensive movements. Analgesics are non efficacious in relieving this symptom. The observed painful syndrome relieved for some time by movements of the upper extremities seems to be an analogy of the restless legs syndrome. Perhaps the designation "restless arms syndrome" could be introduced.     

Restless legs syndrome in Korean patients with drug-naïve Parkinson's disease: A nation-wide study

BackgroundRestless legs syndrome is a common neurologic disorder, and there is increasing evidence for a dopaminergic link between Parkinson's disease and restless legs syndrome. However, most previous studies did not take into account the effects of dopaminergic medication. We conducted a nation-wide, cross-sectional study to determine the prevalence and clinical characteristics of restless legs syndrome in Korean drug-naïve Parkinson's disease patients.MethodsOne hundred and fifty-one drug-naïve patients with Parkinson's disease were enrolled from 18 centers in South Korea over the course of one year. Clinical profiles of parkinsonism, restless legs syndrome, psychiatric symptoms, and laboratory data were collected. The findings of subjects with and without restless legs syndrome were compared.ResultsThe prevalence of restless legs syndrome in drug-naïve patients with Parkinson's disease was 16.5%. Subjects with restless legs syndrome had a higher mean Hoehn and Yahr stage and more severe limb parkinsonism, especially tremor. There was, however, no difference in iron metabolism between patients with and without restless legs syndrome. Analysis demonstrated that Beck's depression inventory score was associated with the severity of restless legs syndrome.ConclusionOur study demonstrated an increased prevalence of restless leg syndrome in drug-naïve patients with Parkinson's disease than in the general population. Based on the association between parkinsonism and restless legs syndrome, and the unique characteristics of restless legs syndrome in patients with Parkinson's disease, we suggest that the pathophysiology of restless legs syndrome in Parkinson's disease differs from that in patients without Parkinson's disease.     

Variable expressivity in familial restless legs syndrome

A 62-year-old man with a 20-year history of excessive daytime somnolence and kicking during sleep was an obligate carrier of the restless legs syndrome gene because his paternal grandfather, father, and all three of his children had symptoms of restless legs syndrome. The patient himself, however, denied motor restlessness after a careful and exhaustive medical history and he was originally believed to have periodic movements in sleep without restless legs. Close clinical observation did reveal nighttime motor restlessness, although the patient continued to deny its importance. Polysomnography showed frequent periodic movements in sleep. We conclude that there can be variable expressivity of the clinical features in familial restless legs syndrome and that there are probably some relatively nonrestless patients with prominent periodic movements in sleep who are carriers of the restless legs syndrome gene. Some sleep-disordered patients who are believed to have only periodic movements in sleep may have a forme fruste of autosomal dominant restless legs syndrome. If one does not examine these patients carefully at night and take an adequate family history, one may miss the diagnosis of restless legs syndrome.     

Restless legs syndrome and akathisia as manifestations of acute pontine infarction

Although restless legs syndrome (RLS) and akathisia have similar clinical manifestations and seem to share a common pathophysiology, they are regarded as distinct clinical syndromes. We present three patients with acute pontine infarction and RLS or akathisia as clinical manifestations. They presented with abrupt onset of restlessness of various body parts, as well as other neurological signs including dysarthria or weakness of the legs. Brain MRI of all three patients showed acute pontine infarction. The clinical syndrome in two of the patients was compatible with RLS and one with akathisia. Their symptoms improved after a brief period. Our finding of secondary RLS and akathisia as manifestations of acute pontine infarction provides information that assists in understanding the common anatomical and pathophysiological basis of RLS and akathisia.     

Restless legs symptoms in a patient with above knee amputations: a case of phantom restless legs

We describe a 78-year-old gentleman who, following bilateral above-knee amputations, developed symptoms of restless legs syndrome in the absent portions of his lower extremities. These symptoms improved with dopamine agonist therapy. In addition, he later developed parkinsonism with prominent rest tremor on metoclopramide. This suggests that this individual had a dopamine-deficient state which predisposed him to both restless legs syndrome and drug-induced or drug-exacerbated parkinsonism. We propose expanding the spectrum of phantom limb phenomena to include phantom restless legs.     

Pediatric sleep-related breathing disorders and restless legs syndrome: how children are different

Sleep-related breathing disorders and restless legs syndrome have traditionally been felt to affect primarily adults. Recent research suggests that these conditions are surprisingly common in children as well, and that clinical manifestations may differ considerably from those seen in adults. This review summarizes the clinical characteristics, epidemiology, pathophysiology, and treatment of sleep-related breathing disorders and restless legs syndrome in children. Particular emphasis is placed on recent research and on how the presentation and treatment of these conditions are different in children compared with adults.     

Absence of co-morbidity of Parkinson disease and restless legs syndrome: a case–control study in patients attending a movement disorders clinic

We have carried out a case–control survey of the prevalence of restless legs syndrome (RLS) in 118 Parkinson’s disease out-patients with different stage of disease severity by using the International restless legs syndrome Study Group clinical criteria. This study failed to demonstrate a significantly augmented prevalence of either primary and secondary restless legs syndrome pooled together or primary restless legs syndrome alone among Parkinson’s disease patients as compared to age and gender matched controls. The results of our survey do not confirm a significant co-morbid occurrence of the two disorders. However, an unavoidable limitation of this and all previous studies is that most of the patients examined were already treated with dopaminomimetic drugs, which could have abolished a mild unrecognized RLS anteceding the diagnosis of Parkinson’s disease or possibly masked the subsequent emergence of the sensory-motor disorder following the onset of Parkinson’s disease.     

Restless legs syndrome triggered by heart surgery

This report presents the case of a 9-year-old child with a familial history of restless legs syndrome who began to complain of restless legs syndrome symptoms after heart surgery. Hypotheses on the potential interactions between genetic and environmental factors in the development of her restless legs syndrome are discussed. Increasing evidence supports reduced brain iron in the pathophysiology of idiopathic restless legs syndrome. It is possible that the child inherited a compromised brain and peripheral iron regulation, which predisposed her to restless legs syndrome. The interaction between her dysfunctional iron management and her intraoperatory blood loss may have led to a significant decrease in brain iron, triggering restless legs syndrome symptoms. Other factors, such as immobilization and sleep deprivation after surgery, may have contributed to trigger the restless legs syndrome symptoms. If confirmed by further evidence, this patient suggests the need to carefully monitor for restless legs syndrome symptoms in young surgical patients who present with a familial history of restless legs syndrome.     

Pathological gambling plus hypersexuality in restless legs syndrome: a new case

Emerging clinical data indicate that dopaminergic agonists used to treat restless legs syndrome may be associated with dopamine dysregulation syndrome, particularly pathological gambling. We report a new case with pathological gambling plus hypersexuality and impotence in an old patient treated with a small dose (0.18 mg daily at bedtime) of pramipexole for restless legs syndrome for 5 months. The time relationship and the resolution upon discontinuation of dopaminergic agonists suggest a causative association. Our new case confirms that restless legs syndrome patients should be cautioned about potential dopamine dysregulation syndrome coinciding with dopaminergic agonists, as it can be reversed by drug withdrawal.     

Restless legs syndrome

PURPOSE OF REVIEW: In the review period since February 2004 a number of papers have been published that make significant contributions to the current understanding of the epidemiology, clinical assessment, pathophysiology and treatment of restless legs syndrome. Those with the most significant findings were selected and will be reviewed. RECENT FINDINGS: Several epidemiological studies about restless legs syndrome have become available in the review period. A new susceptibility locus for restless legs syndrome has been reported. Neuropathological studies have provided profound insights into the key role of iron regulation in the pathophysiology of restless legs syndrome. Several randomized, double-blind, placebo-controlled studies have demonstrated that dopamine agonists are efficacious in the treatment of restless legs syndrome. A few pilot treatment studies with intravenous iron have been performed. SUMMARY: In this paper, recent advances in the field of restless legs syndrome are reviewed. Special emphasis is placed on pathophysiology and treatment. Restless legs syndrome is still an underdiagnosed disorder. The evidence basis for its treatment has been considerably increased in the review period.