Restless Bladder in an Elderly Woman: An Unusual Feature or a Variant of Restless Legs Syndrome?

Suzuki, Keisuke; Miyamoto, Masayuki; Uchiyama, Tomoyuki; Miyamoto, Tomoyuki; Matsubara, Takeo; Hirata, Koichi

doi:10.2169/internalmedicine.55.6815

Cited by 12 publications

(7 citation statements)

References 15 publications

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“…Reports of RLS variant has been increased and expand the clinical spectrum. Various other parts of the body than legs can be involved from arms, abdomens, face, head, oral cavity, bladder and genital area [9,11,[20][21][22]. Supportively, this case did not report daytime sleepiness, which was also supporting feature of RLS [6].…”

Section: Discussionsupporting

confidence: 56%

“…The prevalence are reported in a few% of adults in Japanese population, similar to European and American population [6][7][8]. RLS cases have also a various symptom form mainly legs symptom to head, oral cavity, abdomen, perineum, which are recognized as RLS variant cases [9][10][11]. The pathology of RLS is suggested to be from dopaminergic dysfunction on the level of dopamine receptors, and iron deficiency, kidney dysfunction, diabetes mellitus are the exacerbation factor [6].…”

Section: Introductionmentioning

confidence: 79%

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Case report of restless anal syndrome as restless legs syndrome variant after COVID-19

2021

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Background Coronavirus disease 2019 (COVID-19) has a broad spectrum from respiratory and nasopharyngeal symptoms, cerebrovascular diseases, impaired consciousness, and skeletal muscle injury. Emerging evidence has indicated the neural spread of this novel coronavirus. Restless legs syndrome (RLS) is a common neurological, sensorimotor disorder, but highly under diagnosis disorder. Restless anal syndrome as restless legs syndrome variant associated with COVID-19 has been previously not published. We report a case presenting with restless anal syndrome following COVID-19. Case presentation Although a 77-year-old male with COVID-19 improved to normal respiratory function 21 days after admission and treatment of favipiravir 200 mg per day for 14 days and dexamethasone 6.6 mg per day for 5 days, the insomnia and anxiety symptoms remained. Several weeks after discharge, he gradually began to experience restless, deep anal discomfort, approximately 10 cm from the perineal region. The following features were observed in the anal region; urge to move is essential, with worsening with rest, improvement with exercise, and worsening at evening. Colonoscopy revealed internal haemorrhoids without other rectal lesions. Neurological findings including deep tendon reflex, perineum loss of sensory and spinal cord injury, revealed no abnormalities. Diabetes militias, kidney dysfunction and iron deficiency status were not confirmed. Family history of RLS and periodic limb movements were not observed. Clonazepam at 1.5 mg per day resulted in the alleviation restless anal discomfort. Conclusions We reported a case presenting with restless anal syndrome following affection of COVID-19 as restless legs syndrome variant. This case fulfilled 4 essential features of RLS, urge to move, worsening with rest, improvement with exercise, and worsening at evening. To date, no case of restless anal syndrome associated with COVID-19 has been previously published. This case report may reflect the associative impacts of COVID-19 on the neuropsychiatric state. The long-term outcomes of neuropsychiatric conditions should continue to be monitored.

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Section: Discussionsupporting

confidence: 56%

Section: Introductionmentioning

confidence: 79%

Case report of restless anal syndrome as restless legs syndrome variant after COVID-19

2021

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“…A few authors have reported restless bladder mimicking overactive bladder syndrome. Restlessness in atypical body parts usually coincides with the classical RLS of lower limbs 11. Besides these, a significant association between RLS and pain of different origins have been reported in the literature 13.…”

Section: Discussionmentioning

confidence: 92%

“…IRLSSG consensus diagnostic criteria for RLS mention that arms (restless arms syndrome) and other body parts may be involved in addition to the legs. The abnormal unpleasant sensation may be noted in the abdomen (restless abdomen), genital area (restless genital syndrome), oral cavity (restless mouth syndrome), face, chest and back, and neck and head 7–12. The unpleasant sensation in different parts of the body may mimic several other diseases.…”

Section: Discussionmentioning

confidence: 99%

Dopa responsive irritable bowel syndrome: restless bowel syndrome or a gastrointestinal variant of restless legs syndrome?

Prakash

2021

BMJ Case Rep

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In addition to the legs, restless legs syndrome (RLS) affects various other parts of the body, including the arms, abdomen, face, head-neck, oral cavity, genital area and bladder. RLS is also associated with several comorbid conditions, including irritable bowel syndrome (IBS). We are reporting two cases of RLS who also had IBS, fulfilling the Rome IV criteria. The administration of levodopa and dopamine agonists provided a complete improvement in both IBS and RLS. Review of the literature suggest that the clinical semiology and clinical pattern of IBS (urge to defaecate, abdominal pain, abdominal distension, bloating, disturbed sleep and circadian rhythm) simulate the semiology and pattern of RLS. Similarities are also noted in the associated comorbid conditions, effective drugs and proposed hypotheses for both clinical syndromes. We hypothesise that RLS may affect intestine, and IBS-like symptoms in a subset of patients with RLS may be the part of RLS symptoms complex.

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“…As awareness of RLS has grown, several reports revealed that sensory disorders similar to RLS initially con ned to the arms, abdomen, and perineum occasionally occur [4][5][6][7][8][9][10]. These reported cases also partially meet the diagnostic criteria of RLS.…”

Section: Introductionmentioning

confidence: 98%

Restless abdomen: a spectrum or a phenotype variant of restless legs syndrome?

Wang

Zhu

Wang

et al. 2020

Preprint

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Background With the growing awareness of restless legs syndrome(RLS), sensory disorders similar to RLS initially confined to the arms, abdomen, and perineum are more and more being recognized. One of them is restless abdomen, which refers to a restless sensation in abdomen. Our study is designed to evaluate the clinical phenotype of restless abdomen and investigate its relationship with RLS. Methods We enrolled 10 patients with restless abdomen according to the RLS diagnostic criteria. Laboratory examinations were performed to exclude mimics and notable comorbidities. Results All 10 patients had RLS like symptoms in the abdomen and otherwise satisfied all other RLS diagnostic criteria, and responded to dopaminergic therapy. Conclusions Neurologists should be aware of the RLS-related restlessness that can occur in extra-leg anatomy in the absence of episodes of worsening or augmentation of restlessness.

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Restless Bladder in an Elderly Woman: An Unusual Feature or a Variant of Restless Legs Syndrome?

Cited by 12 publications

References 15 publications

Case report of restless anal syndrome as restless legs syndrome variant after COVID-19

Case report of restless anal syndrome as restless legs syndrome variant after COVID-19

Dopa responsive irritable bowel syndrome: restless bowel syndrome or a gastrointestinal variant of restless legs syndrome?

Restless abdomen: a spectrum or a phenotype variant of restless legs syndrome?

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