Arm Restlessness as the Initial Symptom in Restless Legs Syndrome

Freedom, Thomas; Merchut, M P

doi:10.1001/archneur.60.7.1013

Cited by 37 publications

(28 citation statements)

References 13 publications

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“…The longer the course of the disease, the more likely the symptoms affect the arms or the other places of the body besides the legs. It’s not uncommon that patients developed arm restless syndrome with progressive disease (Freedom and Merchut, 2003). Movement such as walking, stretching, or bending the legs relieves the discomfort at least temporarily and partially (Trenkwalder et al, 2005).…”

Section: Clinical Presentations and Diagnostic Criteriamentioning

confidence: 99%

Restless Legs Syndrome: From Pathophysiology to Clinical Diagnosis and Management

Guo

Huang

Jiang

et al. 2017

Front. Aging Neurosci.

130

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Restless legs syndrome (RLS), a common neurological sensorimotor disorder in western countries, has gained more and more attention in Asian countries. The prevalence of RLS is higher in older people and females. RLS is most commonly related to iron deficiency, pregnancy and uremia. The RLS symptoms show a significant circadian rhythm and a close relationship to periodic limb movements (PLMs) in clinical observations, while the pathophysiological pathways are still unknown. The diagnostic criteria have been revised in 2012 to improve the validity of RLS diagnosis. Recent studies have suggested an important role of iron decrease of brain in RLS pathophysiology. Dopaminergic (DA) system dysfunction in A11 cell groups has been recognized long ago from clinical treatment and autopsy. Nowadays, it is believed that iron dysfunction can affect DA system from different pathways and opioids have a protective effect on DA system. Several susceptible single nucleotide polymorphisms such as BTBD9 and MEIS1, which are thought to be involved in embryonic neuronal development, have been reported to be associated with RLS. Several pharmacological and non-pharmacological treatment are discussed in this review. First-line treatments of RLS include DA agents and α2δ agonists. Augmentation is very common in long-term treatment of RLS which makes prevention and management of augmentation very important for RLS patients. A combination of different types of medication is effective in preventing and treating augmentation. The knowledge on RLS is still limited, the pathophysiology and better management of RLS remain to be discovered.

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Section: Clinical Presentations and Diagnostic Criteriamentioning

confidence: 99%

Restless Legs Syndrome: From Pathophysiology to Clinical Diagnosis and Management

Guo

Huang

Jiang

et al. 2017

Front. Aging Neurosci.

130

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show abstract

“…Clinical progression of RLS typically begins in the calves or thighs and may spread to other parts of the lower limbs, such as the foot. [7][8][9] Sensations have also been noted in the upper limbs in rare cases as the initial manifestation of RLS, 10,11 but usually RLS…”

Section: Introductionmentioning

confidence: 99%

Depth and Distribution of Symptoms in Restless Legs Syndrome/ Willis-Ekbom Disease

Yeh

Ondo

Picchietti

et al. 2016

Journal of Clinical Sleep Medicine

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Study Objectives: To determine the depth and distribution of sensory discomfort in idiopathic restless legs syndrome/Willis-Ekbom disease (RLS) and RLS concurrent with other leg conditions, specifically peripheral neuropathy, sciatica, leg cramps, and arthritis. Methods: RLS subjects (n = 122) were divided into 71 idiopathic RLS and 51 RLS-C, or Comorbid, groups. All subjects were examined by an RLS expert, answered standardized RLS questionnaires, and received a body diagram to draw the location and depth of their symptoms. Results: Age was 63.04 ± 12.84 years, with 77 females and 45 males. All patients had lower limb involvement and 43/122 (35.25%) also had upper limb involvement. Of the 122 subjects, 42.62% felt that the RLS discomfort was only deep, 9.84% felt that the discomfort was only superficial, and 47.54% felt both superficial and deep discomfort. There were no defining characteristics in depth or distribution of RLS sensations that differentiated those patients with idiopathic RLS from those patients with RLS associated with other comorbid leg conditions. The sensation of arthritis was felt almost exclusively in the joints and not in the four quadrants of the leg, whereas the exact opposite was true of RLS sensations. Conclusions: Depth and distribution cannot be used as a discriminative mechanism to separate out idiopathic RLS from RLS comorbid with other leg conditions. Although seen in clinical practice, the total absence of patients with non-painful RLS only in the joints in the current study attests to the rarity of this presentation and raises the possibility of misdiagnosis under these circumstances. We recommend that such patients not be admitted to genetic or epidemiological studies.

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“…The upper limbs are affected in up to 50% of RLS patients [7,12,13], generally in subjects with more severe RLS symptoms [2,9,13,14]. Involvement of the upper limbs is rarely the initial manifestation of RLS [15,16], and is probably preceded, in most of the cases, by lower limb involvement for many years [13,14]. In exceptional cases (that can challenge the diagnosis of RLS), the sensations can also spread to, irradiate from, or be confined to other body parts, including buttocks [17,18], groins [8,17,18], back [8,19], abdomen [9,17,18,20], loins [9], trunk [8,9,21], chest [19], neck [10,18,21], and face [8,10,21,22].…”

Section: Introductionmentioning

confidence: 99%

Topography of the sensations in primary restless legs syndrome

Karroum¹,

Leu‐Semenescu²,

Arnulf³

2012

Journal of the Neurological Sciences

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Arm Restlessness as the Initial Symptom in Restless Legs Syndrome

Abstract: Restless legs syndrome may initially exhibit upper extremity symptoms.

Cited by 37 publications

References 13 publications

Restless Legs Syndrome: From Pathophysiology to Clinical Diagnosis and Management

Restless Legs Syndrome: From Pathophysiology to Clinical Diagnosis and Management

Depth and Distribution of Symptoms in Restless Legs Syndrome/ Willis-Ekbom Disease

Topography of the sensations in primary restless legs syndrome

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