不宁腿综合征

不宁腿综合征为临床常见中枢神经系统感觉运动障碍性疾病,发病机制尚不明确,与遗传因素或多巴胺能系统功能失调有关。发病原因与缺铁性贫血、妊娠、免疫系统疾病、肾衰竭、糖尿病、周围神经病等有关。临床主要表现为感觉障碍、运动症状,并于休息时、傍晚或夜间出现或加重。以铁离子、多巴胺制剂、多巴胺受体激动药、抗癫药及阿片类药物为主要治疗药物。     

继发性不宁腿综合征

本文回顾继发性不宁腿综合征的相关研究结果,介绍其常见病因。经研究显示,有多种因素可能与继发性不宁腿综合征的发生发展和严重程度相关,如肾衰竭、脊髓和周围神经病变、妊娠所致铁和叶酸缺乏及相应性激素变化;帕金森病多巴胺能系统功能紊乱;某些药物(抗抑郁药、抗精神病药、组胺受体阻断药);吸烟、饮酒;咖啡因;偏头痛等。临床应详细询问病史,去除病因,提高患者生活质量。     

继发性不宁腿综合征

本文回顾继发性不宁腿综合征的相关研究结果,介绍其常见病因。经研究显示,有多种因素可能与继发性不宁腿综合征的发生发展和严重程度相关,如肾衰竭、脊髓和周围神经病变、妊娠所致铁和叶酸缺乏及相应性激素变化;帕金森病多巴胺能系统功能紊乱;某些药物（抗抑郁药、抗精神病药、组胺受体阻断药）;吸烟、饮酒;咖啡因;偏头痛等。临床应详细询问病史,去除病因,提高患者生活质量。     

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。     

应关注不宁腿综合征的诊断与治疗

不宁腿综合征（RLS）又称为Ekbom综合征,是临床常见的神经系统感觉运动障碍性疾病。其患病率为0．10％～11．50％,不同种族患病率存在差异,亚洲国家患病率低干西方国家。     

应关注不宁腿综合征的诊断与治疗

不宁腿综合征(RLS)又称为Ekbom综合征,是临床常见的神经系统感觉运动障碍性疾病。其患病率为0.10%～11.50%,不同种族患病率存在差异,亚洲国家患病率低于西方国家。关于不宁腿综合征的研究历史,最早可以追溯到1685年英国医师Willis对该病的描述。随着神经病学研究方法和技术的迅速发展,在此后的300余年中,对其认识已经达到相当的高度,尤其在发病机制、诊断与治疗策     

帕金森病与不宁腿综合征

帕金森病为慢性进行性神经系统变性疾病，典型临床症状包括运动迟缓、静止性震颤、强直以及姿势平衡障碍。不宁腿综合征（restless legs syndrome，RLS）系指出现在腿部的不适感导致难以控制的移动下肢的冲动，多发生在夜间并由此而产生睡眠障碍。早在19世纪，《震颤麻痹》一书中就已首次提出帕金森病患在夜间会出现频繁的肢体运动。近年来不断有研究报道，帕金森病患不宁腿综合征的发病率高于普通人群，提示二之间可能存在某种联系。[第一段]     

门诊慢性失眠障碍合并不宁腿综合征的共病分析

目的 探讨门诊慢性失眠障碍（CID）合并不宁腿综合征（RLS）患者的共病特征。方法 收 集神经内科睡眠门诊就诊的CID连续病例,记录患者的一般资料、CID病因、RLS症状学调查及RLS严重 程度量表,比较CID伴RLS（CID+RLS）组和CID不伴RLS（CID-RLS）组失眠病因构成的差异。结果 连续 入组122 例,5 例因不能配合问卷调查而剔除,实际纳入117 例。50 例（42.7%）合并两种或以上病因。精 神心理障碍所致失眠、躯体问题所致失眠和心理生理性失眠分别为50 例（42.7%）、41 例（35.0%）和32 例 （27.4%）。33 例（28.2%）合并其他睡眠障碍,其中RLS 30 例（25.6%）。与CID-RLS 组相比,CID+RLS 组其 他躯体问题所致失眠的比例较高,睡眠卫生习惯不良和器质性病因待定失眠的比例较少,分别为（40.0% 比12.6%,P=0.001）,（3.3% 比18.4%,P=0.044）和（0% 比13.8%,P=0.032）。结论 神经内科门诊近半数 CID 患者合并两种或两种以上病因,CID 常见病因是精神心理障碍所致失眠、躯体问题所致失眠和心理 生理性失眠等。CID 伴RLS和不伴RLS的病因构成有明显差异。     

不宁腿综合征2例报告

例１，女性，３４岁，会计。既往体健。２５岁首次怀孕，孕后两个月时，每当睡觉平躺喜欢用被子垫高双小腿。孕６个月时，入睡前小腿肌肉深部尤其是双侧腓肠肌内侧出现一种“酸胀的”、“收缩的”的感觉，非得不停地活动双腿，或起床活动，或按摩双小腿，这种不适感才会暂时消失。当入睡后，早晨清醒后以及白天均则不会出现这种不适感。因影响入睡，求诊于我院。体格及神经系统检查未发现异常，血常规、血钾、钠、氯、钙、镁正常。在娩前的３个多月内，每周均有２～３次上述情况发作，但分娩后消失。分娩１年后，此种情况又出现，每周２～３…     

提高对不宁腿综合征规范诊断与治疗的认识

<正>不宁腿综合征(RLS)亦称Willis-Ekbom病(WED),是临床常见的神经系统运动感觉性疾病。流行病学调查显示,不同国家和地区成人不宁腿综合征患病率不同,欧美国家患病率明显高于亚洲国家,其中欧美国家成人患病率为5.0%～14.3%~([1-2])、亚洲国家为0.1%～1.9%~([3-4])。不宁腿综合征可发生于任何年龄阶段,且随着年龄的增长、患病率逐年增加,女性患病率高于男性。由于不宁腿综合征的诊断主要依靠临床症状,缺乏特异性,加之短期内不会造成明显损害,因此目前对该病的诊断率较低,治疗方法不甚规范。     

Sensory symptoms in restless legs syndrome: the enigma of pain

Restless legs syndrome (RLS) is a common sensorimotor condition characterized by an urge to move the legs, worsening of symptoms at rest and during the evening/night, and improvement of symptoms with movement. Our review explores the role and impact of sensory symptoms in RLS. The phenomenology of RLS is discussed, highlighting the difficulty patients have in describing their sensations and in differentiating between sensory and motor symptoms. Sensory symptoms have a significant impact on quality of life but remain much less well understood than motor symptoms and sleep disturbances in RLS. Although RLS symptoms usually are not described as painful, sensory manifestations in RLS do share some similarities with chronic pain sensations, and RLS frequently occurs in chronic pain and neuropathic conditions. Peripheral neuropathies may account for some of the sensory disturbances in secondary RLS, while alterations in central somatosensory processing may be a more viable explanation for the sensory disturbances in primary RLS. The effectiveness of analgesics in treating RLS supports the concept of abnormal sensory modulation in RLS and suggests an overlap between pain modulatory pathways and sensory disturbances. Future studies are needed to better understand the experiential and biologic aspects of altered sensory experiences in RLS.     

Olanzapine-induced restless legs syndrome

Only nine patients with olanzapine-induced restless legs syndrome (RLS) have been reported in the literature to our knowledge. We describe two patients with olanzapine-induced RLS treated at our hospital and review the nine reported patients. There were five women and six men aged between 28 and 62 years in the overall group. RLS symptoms emerged at olanzapine doses between 2.5 and 20 mg. The symptoms improved in all patients when the dose was reduced and immediately disappeared when the medication was stopped. International Restless Legs Scale (IRLS) scores ranged from 10 to 35. Three patients had a family history of idiopathic RLS. Supplemental drugs were administered to control RLS symptoms in five patients. Ropinirole was effective in one patient, while two patients did not respond to the drug. Propoxyphene effectively relieved symptoms in one patient who did not respond to ropinirole or clonazepam. RLS symptoms did not recur following substitution of other antipsychotic drugs for olanzapine. In conclusion, olanzapine can induce RLS, particularly in patients with a family history of idiopathic RLS. More than half of the patients experienced severe to very severe symptoms. A dose-dependent relationship was observed between olanzapine and RLS symptoms. A gradual increase in dose may prevent olanzapine-induced RLS. The optimal treatment for olanzapine-induced RLS is discontinuation of olanzapine.     

不安腿综合征的诊治

目的 探讨不安腿综合征(RLS)的临床特征,为早期诊断和治疗提供参考.方法 结合相关文献,对16例确诊的不安腿综合征患者的临床表现、治疗、转归进行回顾性分析.结果 RLS是一种以双下肢感觉异常不适为主要症状的病因未明的疾病,可能与贫血、铁缺乏、糖尿病史、肾功能不全等有关.多巴胺受体激动剂为治疗该病的首选药,阿片类、抗惊厥药物、苯二氮类药物及铁剂治疗对部分患者有效.结论 RLS预后较好,及时的诊断和治疗可明显改善患者的生活质量.     

Restless legs syndrome is highly prevalent in patients with post-polio syndrome

ObjectiveFew studies have quantified the prevalence of restless legs syndrome (RLS) in patients with post-polio syndrome (PPS). Our objective was to assess the prevalence and severity of RLS in patients with PPS and to examine the demographic characteristics of this population.MethodThis was a cross-sectional study conducted from April 2010 to May 2012 at the outpatient Neuromuscular Disorders clinic of Universidade Federal de São Paulo, São Paulo, Brazil. We evaluated 119 patients with PPS, consecutively recruited, and investigated for RLS based on the diagnostic criteria established by the International Restless Legs Syndrome Study Group (IRLSSG). Patients were evaluated with the Brazilian version of the IRLSSG severity scale.ResultsThe prevalence of RLS was 36% (n = 43; 32 women and 11 men). The ages at onset of RLS (median = 41 years) and PPS (median = 41 years) were concurrent, and the correlation between onset of symptoms of RLS and onset of symptoms of PPS was positive and very strong (Spearman r = 0.93, p = 0.01). The median RLS severity was 23 (range, 20–28). Low educational achievement and depression were predictive of RLS development.ConclusionIn the largest population of patients with PPS studied to date, our results indicate a high prevalence of RLS, marked disease severity, and concomitant onset of both conditions in many patients with PPS. Further studies are needed to elucidate a possible pathophysiologic mechanism linking these two conditions. We suggest that all post-polio patients with sensory and motor complaints in the legs be investigated for RLS.     

普拉克索治疗不宁腿综合征的Meta分析

目的 系统评价普拉克索治疗不宁腿综合征(restless legs syndrome,RLS)的疗效与安全性.方法 检索中国期刊全文数据库( CNKI)、美国国立医学生物信息中心PubMed数据库( PubMed)、荷兰医学文摘数据库(Embase)、Cochrane Library数据库关于普拉克索治疗RLS的随机、双盲、安慰剂对照研究.对符合条件的研究结果用RevMan 5.0软件进行Meta分析.以普拉克索组和安慰剂组在国际不宁腿研究组评分量表( International RLS Study Group rating scale,IRLS)评分变化方面的加权均数差(weighted mean difference,WMD)和普拉克索组相对于安慰剂组在临床疗效总评(clinical global impression-improvement,CGI-I)方面疗效显著率的相对危险度(relative risk,RR)为指标进行疗效评价,以其在不良事件方面的相对危险度为指标进行安全性评价.结果 共纳入5项研究,1776例患者被随机分配,其中普拉克索组945例,安慰剂组831例.Meta分析结果显示,普拉克索组相对于安慰剂组在IRLS评分变化方面的WMD=-6.34 (Z=12.76,P＜0.01),在CGI-I显著性评估方面的RR=1.65 (Z=10.39,P＜0.01);两组在不良事件方面的RR=1.14 (Z=1.87,P=0.06).结论 普拉克索是治疗RLS的有效且安全的药物.     

不宁腿综合征40例临床分析

目的 探讨不宁腿综合征(RLS)的临床表现,观察吡贝地尔对RLS的治疗效果.方法 对40例不宁腿综合征患者的临床特征和治疗结果 进行回顾性分析.结果 40例患者均有肢体不能忍受的不适感,迫切希望活动肢体,夜间症状加重,常伴失眠.根据国际不宁腿综合征研究组(IRLSSG)的诊断标准,平均得分24分.40例患者均给予吡贝地尔50mg睡前口服,治疗4周后,大多数患者主观症状明显改善,IRLSSG评分明显减少(平均得分11分).结论 不宁腿综合征常表现下肢不适,夜间加重,活动后减轻,常伴睡眠障碍,诊断主要依据临床表现,吡贝地尔治疗有一定效果.     

普拉克索治疗原发性不安腿综合征疗效观察

目的观察普拉克索治疗原发性不安腿综合征（RLS）的临床疗效及安全性。方法将66例原发性RLS患者随机分为普拉克索组与美多巴组,应用国际不安腿综合征评估量表（IRLS）和汉密尔顿抑郁量表（HAMD）分别于治疗前及治疗后6周进行病情评估,观察比较2组治疗前后各量表评分情况,并记录2组患者出现的药物不良反应。结果2组患者治疗后IRLS与HAMD评分较治疗前均明显下降（P〈0．05）,相比美多巴组,普拉克索组治疗后IRLS评分差异无统计学意义（P〉0．05）,但HAMD评分下降更为明显（P〈0．01）,2组药物不良反应发生率差异无统计学意义（P〉0．05）。结论普拉克索能有效缓解原发性RLS症状,且药物不良反应较小,相比美多巴其抗抑郁的优势更为明显。