Topography of sensory symptoms in patients with drug-naïve restless legs syndrome

Koo, Yong Seo; Lee, Gwan Taek; Lee, Seo Young; Cho, Yong Won; Jung, Ki-Young

doi:10.1016/j.sleep.2013.09.006

Cited by 16 publications

(11 citation statements)

References 29 publications

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“…Our study is unique in this regard and thus is different from two previous studies that examined these parameters only in RLS subjects without other comorbid leg conditions. 4,28 All patients included said that they could readily distinguish any neuropathy, arthritis, leg cramp, or sciatic symptoms from their RLS symptoms. The most important finding is that the depth and distribution of RLS symptoms cannot be used as a way of discriminating between the sensations of idiopathic RLS and the sensations of RLS concurrent with other causes of leg discomfort.…”

Section: Discussionmentioning

confidence: 99%

“…Only two studies have specifically evaluated the topography of RLS patients' sensory symptoms. 4,28 The study by Karroum et al analyzed the topography of RLS symptoms in idiopathic RLS patients being treated with medications, 28 and the study by Koo et al analyzed drug-naïve RLS patients. 4 However, these studies analyzed the distribution of RLS symptoms solely in patients with idiopathic RLS.…”

Section: Brief Summarymentioning

confidence: 99%

“…4,28 The study by Karroum et al analyzed the topography of RLS symptoms in idiopathic RLS patients being treated with medications, 28 and the study by Koo et al analyzed drug-naïve RLS patients. 4 However, these studies analyzed the distribution of RLS symptoms solely in patients with idiopathic RLS. Neither the Karroum nor the Koo papers analyzed RLS patients with other conditions that affect the lower extremities, such as neuropathy, sciatica, leg cramps and arthritis.…”

Section: Brief Summarymentioning

confidence: 99%

“…2,3 Typically, patients with RLS report abnormal and unpleasant sensations that are deep and bilateral. [4][5][6] However, some studies have found that RLS patients can diverge from the depth and distribution of the classical presentation. 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.…”

Section: Introductionmentioning

confidence: 99%

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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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Section: Discussionmentioning

confidence: 99%

Section: Brief Summarymentioning

confidence: 99%

Section: Brief Summarymentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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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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“…15 RLS-related sensory symptoms typically are symmetrically located in the lower extremities, but asymmetric distribution was also reported in patients with more severe forms or late-onset RLS. 16,17 Although the sensory symptoms of RLS in patients with SCI could also meet the basic criteria for NP, the careful evaluation of the supportive criteria could increase the diagnosis accuracy. The predictive utility of verbal descriptors to distinguish between neuropathic and non-NP types is limited, 15,18 as most individuals with SCI report more than one pain problem.…”

Section: Discussionmentioning

confidence: 99%

Dopaminergic treatment of restless legs syndrome in spinal cord injury patients with neuropathic pain

Kumru

Albu

Vidal

et al. 2016

Spinal Cord Ser Cases

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Recent studies report high incidence of restless legs syndrome (RLS) in patients with spinal cord injury (SCI), who may also present pain and sensory disturbances. In the present manuscript, we examine and discuss diagnostic and treatment challenges of comorbid RLS and neuropathic pain (NP) in SCI. We evaluated seven men with a mean age of 55.6 (s.d. = 14.0) years, with chronic complete or incomplete SCI at the thoracic or lumbar level, for complaints of sensory disturbances in the legs, which initially were attributed to drug-resistant NP. Because overlapped RLS was suspected, clinical evaluation of NP and RLS, serum ferritin and iron level assessment, and video polysomnographic (VPSG) studies were conducted. Pramipexole (0.18 mg q.d. ) was added to treat RLS, and a follow-up was performed at 2 months. We found that in six subjects the RLS was comorbid with NP and in one subject the symptoms of RLS were misdiagnosed as NP. VPSG revealed periodic limb movements (PLMs) in all patients, including PLMs of the legs, arms or both. Serum ferritin was o50 ng ml − 1 in two patients. RLS improved significantly after 2 months with pramipexole. On the basis of current findings, we recommend physicians to be aware of the comorbidity between RLS and NP secondary to SCI to include suitable diagnostic procedures and effective treatments.

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Restless legs syndrome affecting the head region: “restless head syndrome”

et al. 2021

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Topography of sensory symptoms in patients with drug-naïve restless legs syndrome

Cited by 16 publications

References 29 publications

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

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

Dopaminergic treatment of restless legs syndrome in spinal cord injury patients with neuropathic pain

Restless legs syndrome affecting the head region: “restless head syndrome”

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