Journal of Korean Neurosurgical Society

The Korean Neurosurgical Society (대한신경외과학회)
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Demographic and Clinical Characteristics of Patients with Restless Legs Syndrome in Spine Clinic

  • Yang, Jin Seo (Department of Neurosurgery, Chuncheon Sacred Heart Hospital, College of Medicine, Hallym University) ;
  • Cho, Yong Jun (Department of Neurosurgery, Chuncheon Sacred Heart Hospital, College of Medicine, Hallym University) ;
  • Kang, Suk Hyung (Department of Neurosurgery, Chuncheon Sacred Heart Hospital, College of Medicine, Hallym University) ;
  • Choi, Hyuk Jai (Department of Neurosurgery, Chuncheon Sacred Heart Hospital, College of Medicine, Hallym University)
  • Received : 2013.09.02
  • Accepted : 2014.01.10
  • Published : 2014.02.28
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Abstract

Objective : The restless legs syndrome (RLS) is a common disorder affecting up to 5% to 15% of the general population, in which the incidence increases with age, and includes paresthesia in the legs. The purpose of this study is to investigate the incidence of RLS in spine center and to review clinical manifestations of this syndrome and its current treatments. Methods : Over a period of a year, retrospective medical record review and lumbar magnetic resonance images were performed on 32 patients with RLS in spine clinic who were diagnosed by National Institutes of Health criteria. Affected limbs were classified as five. Two grading systems were used in the evaluation of neural compromises. Results : The incidence of RLS was 5.00% (32/639). There were 16 males (50%) and 16 females (50%). The median age at diagnosis was 55.4 years (range, 25-93 years). There are no correlation between the affected limbs of RLS and neural compromises on the lumbar spine. Conclusion : The RLS is a clearly common neurologic disorder of the limbs, usually the legs. The awareness of this syndrome can help reduce diagnostic error; thereby, avoiding the morbidity and expense associated with unnecessary studies or inappropriate treatments in RLS patients.

Keywords

References

  1. Allen R : Dopamine and iron in the pathophysiology of restless legs syndrome (RLS). Sleep Med 5 : 385-391, 2004 https://doi.org/10.1016/j.sleep.2004.01.012
  2. Allen R, Chen C, Soaita A, Wohlberg C, Knapp L, Peterson BT, et al. : A randomized, double-blind, 6-week, dose-ranging study of pregabalin in patients with restless legs syndrome. Sleep Med 11 : 512-519, 2010 https://doi.org/10.1016/j.sleep.2010.03.003
  3. Allen RP, Barker PB, Wehrl F, Song HK, Earley CJ : MRI measurement of brain iron in patients with restless legs syndrome. Neurology 56 : 263-265, 2001 https://doi.org/10.1212/WNL.56.2.263
  4. Allen RP, Earley CJ : Augmentation of the restless legs syndrome with carbidopa/levodopa. Sleep 19 : 205-213, 1996
  5. Allen RP, Earley CJ : Restless legs syndrome : a review of clinical and pathophysiologic features. J Clin Neurophysiol 18 : 128-147, 2001 https://doi.org/10.1097/00004691-200103000-00004
  6. Allen RP, Kushida CA, Atkinson MJ, RLS QoL Consortium : Factor analysis of the International Restless Legs Syndrome Study Group's scale for restless legs severity. Sleep Med 4 : 133-135, 2003 https://doi.org/10.1016/S1389-9457(02)00193-4
  7. Allen RP, Picchietti D, Hening WA, Trenkwalder C, Walters AS, Montplaisi J, et al. : Restless legs syndrome : diagnostic criteria, special considerations, and epidemiology. A report from the restless legs syndrome diagnosis and epidemiology workshop at the National Institutes of Health. Sleep Med 4 : 101-119, 2003 https://doi.org/10.1016/S1389-9457(03)00010-8
  8. Bassetti CL, Mauerhofer D, Gugger M, Mathis J, Hess CW : Restless legs syndrome : a clinical study of 55 patients. Eur Neurol 45 : 67-74, 2001 https://doi.org/10.1159/000052098
  9. Beattie PF, Meyers SP, Stratford P, Millard RW, Hollenberg GM : Associations between patient report of symptoms and anatomic impairment visible on lumbar magnetic resonance imaging. Spine (Phila Pa 1976) 25 : 819-828, 2000 https://doi.org/10.1097/00007632-200004010-00010
  10. Boden SD, Davis DO, Dina TS, Patronas NJ, Wiesel SW : Abnormal magnetic-resonance scans of the lumbar spine in asymptomatic subjects. A prospective investigation. J Bone Joint Surg Am 72 : 403-408, 1990
  11. Budhiraja P, Budhiraja R, Goodwin JL, Allen RP, Newman AB, Koo BB, et al. : Incidence of restless legs syndrome and its correlates. J Clin Sleep Med 8 : 119-124, 2012
  12. Chesson AL Jr, Wise M, Davila D, Johnson S, Littner M, Anderson WM, et al. : Practice parameters for the treatment of restless legs syndrome and periodic limb movement disorder. An American Academy of Sleep Medicine Report. Standards of Practice Committee of the American Academy of Sleep Medicine. Sleep 22 : 961-968, 1999 https://doi.org/10.1093/sleep/22.7.961
  13. Cho YW, Shin WC, Yun CH, Hong SB, Kim JH, Allen RP, et al. : Epidemiology of restless legs syndrome in Korean adults. Sleep 31 : 219-223, 2008
  14. Cirillo DJ, Wallace RB : Restless legs syndrome and functional limitations among American elders in the Health and Retirement Study. BMC Geriatr 12 : 39, 2012 https://doi.org/10.1186/1471-2318-12-39
  15. Civi S, Kutlu R, Tokgoz S : Frequency, severity and risk factors for restless legs syndrome in healthcare personnel. Neurosciences (Riyadh) 17 : 230-235, 2012
  16. Comella CL : Restless legs syndrome : treatment with dopaminergic agents. Neurology 58 (4 suppl 1) : s87-s92, 2002 https://doi.org/10.1212/WNL.58.suppl_1.S87
  17. Ekbom KA : Restless legs : a clinical study. Acta Med Scand 158 (suppl) : 1-123, 1945
  18. Erikson KM, Jones BC, Beard JL : Iron deficiency alters dopamine transporter functioning in rat striatum. J Nutr 130 : 2831-2837, 2000
  19. Erikson KM, Jones BC, Hess EJ, Zhang Q, Beard JL : Iron deficiency decreases dopamine D1 and D2 receptors in rat brain. Pharmacol Biochem Behav 69 : 409-418, 2001 https://doi.org/10.1016/S0091-3057(01)00563-9
  20. Gupta R, Lahan V, Goel D : Restless Legs Syndrome : a common disorder, but rarely diagnosed and barely treated--an Indian experience. Sleep Med 13 : 838-841, 2012 https://doi.org/10.1016/j.sleep.2012.03.018
  21. Hemmer B, Riemann D, Glocker FX, Lücking CH, Deuschl G : Restless legs syndrome after a borrelia-induced myelitis. Mov Disord 10 : 521-522, 1995 https://doi.org/10.1002/mds.870100422
  22. Högl B, Frauscher B, Seppi K, Ulmer H, Poewe W : Transient restless legs syndrome after spinal anesthesia : a prospective study. Neurology 59 : 1705-1707, 2002 https://doi.org/10.1212/01.WNL.0000036606.56405.3D
  23. Hoque R, Chesson AL Jr : Pharmacologically induced/exacerbated restless legs syndrome, periodic limb movements of sleep, and REM behavior disorder/REM sleep without atonia : literature review, qualitative scoring, and comparative analysis. J Clin Sleep Med 6 : 79-83, 2010
  24. Inoue Y, Hirata K, Uchimura N, Kuroda K, Hattori N, Takeuchi M : Gabapentin enacarbil in Japanese patients with restless legs syndrome : a 12-week, randomized, double-blind, placebo-controlled, parallel-group study. Curr Med Res Opin 29 : 13-21, 2013
  25. Karppinen J, Malmivaara A, Tervonen O, Pääkkö E, Kurunlahti M, Syrjälä P, et al. : Severity of symptoms and signs in relation to magnetic resonance imaging findings among sciatic patients. Spine (Phila Pa 1976) 26 : E149-E154, 2001 https://doi.org/10.1097/00007632-200104010-00015
  26. Kim KW, Jhoo JH, Lee SB, Lee SD, Kim TH, Kim SE, et al. : Increased striatal dopamine transporter density in moderately severe old restless legs syndrome patients. Eur J Neurol 19 : 1213-1218, 2012 https://doi.org/10.1111/j.1468-1331.2012.03705.x
  27. Lee S, Lee JW, Yeom JS, Kim KJ, Kim HJ, Chung SK, et al. : A practical MRI grading system for lumbar foraminal stenosis. AJR Am J Roentgenol 194 : 1095-1098, 2010 https://doi.org/10.2214/AJR.09.2772
  28. Manconi M, Ferri R, Zucconi M, Oldani A, Giarolli L, Bottasini V, et al. : Pramipexole versus ropinirole : polysomnographic acute effects in restless legs syndrome. Mov Disord 26 : 892-895, 2011 https://doi.org/10.1002/mds.23543
  29. Michaud M, Chabli A, Lavigne G, Montplaisir J : Arm restlessness in patients with restless legs syndrome. Mov Disord 15 : 289-293, 2000 https://doi.org/10.1002/1531-8257(200003)15:2<289::AID-MDS1012>3.0.CO;2-E
  30. Montplaisir J, Boucher S, Poirier G, Lavigne G, Lapierre O, Lespérance P : Clinical, polysomnographic, and genetic characteristics of restless legs syndrome : a study of 133 patients diagnosed with new standard criteria. Mov Disord 12 : 61-65, 1997 https://doi.org/10.1002/mds.870120111
  31. Montplaisir J, Karrasch J, Haan J, Volc D : Ropinirole is effective in the long-term management of restless legs syndrome : a randomized controlled trial. Mov Disord 21 : 1627-1635, 2006 https://doi.org/10.1002/mds.21050
  32. Mosko SS, Dickel MJ, Ashurst J : Night-to-night variability in sleep apnea and sleep-related periodic leg movements in the elderly. Sleep 11 : 340-348, 1988
  33. Ohayon MM, O'Hara R, Vitiello MV : Epidemiology of restless legs syndrome : a synthesis of the literature. Sleep Med Rev 16 : 283-295, 2012 https://doi.org/10.1016/j.smrv.2011.05.002
  34. Ondo W, Romanyshyn J, Vuong KD, Lai D : Long-term treatment of restless legs syndrome with dopamine agonists. Arch Neurol 61 : 1393-1397, 2004 https://doi.org/10.1001/archneur.61.9.1393
  35. Panda S, Taly AB, Sinha S, Gururaj G, Girish N, Nagaraja D : Sleep-related disorders among a healthy population in South India. Neurol India 60 : 68-74, 2012 https://doi.org/10.4103/0028-3886.93601
  36. Peeraully T, Tan EK : Linking restless legs syndrome with Parkinson's disease : clinical, imaging and genetic evidence. Transl Neurodegener 1 : 6, 2012 https://doi.org/10.1186/2047-9158-1-6
  37. Phillips B, Young T, Finn L, Asher K, Hening WA, Purvis C : Epidemiology of restless legs symptoms in adults. Arch Intern Med 160 : 2137-2141, 2000 https://doi.org/10.1001/archinte.160.14.2137
  38. Rizzo G, Tonon C, Testa C, Manners D, Vetrugno R, Pizza F, et al. : Abnormal medial thalamic metabolism in patients with idiopathic restless legs syndrome. Brain 135 (Pt 12) : 3712-3720, 2012 https://doi.org/10.1093/brain/aws266
  39. Schizas C, Theumann N, Burn A, Tansey R, Wardlaw D, Smith FW, et al. : Qualitative grading of severity of lumbar spinal stenosis based on the morphology of the dural sac on magnetic resonance images. Spine (Phila Pa 1976) 35 : 1919-1924, 2010 https://doi.org/10.1097/BRS.0b013e3181d359bd
  40. Scholz H, Trenkwalder C, Kohnen R, Riemann D, Kriston L, Hornyak M : Dopamine agonists for restless legs syndrome. Cochrane Database Syst Rev (3) : CD006009, 2011
  41. Scott LJ : Gabapentin enacarbil : in patients with restless legs syndrome. CNS Drugs 26 : 1073-1083, 2012 https://doi.org/10.1007/s40263-012-0020-3
  42. Tan EK : Restless legs syndrome and Parkinson's disease : is there an etiologic link? J Neurol 253 Suppl 7 : VII33-VII37, 2006
  43. Tan EK, Seah A, See SJ, Lim E, Wong MC, Koh KK : Restless legs syndrome in an Asian population : a study in Singapore. Mov Disord 16 : 577-579, 2001 https://doi.org/10.1002/mds.1102
  44. Trenkwalder C, Paulus W : Restless legs syndrome : pathophysiology, clinical presentation and management. Nat Rev Neurol 6 : 337-346, 2010 https://doi.org/10.1038/nrneurol.2010.55
  45. Unrath A, Juengling FD, Schork M, Kassubek J : Cortical grey matter alterations in idiopathic restless legs syndrome : an optimized voxel-based morphometry study. Mov Disord 22 : 1751-1756, 2007 https://doi.org/10.1002/mds.21608
  46. Weber M, Lauterburg T, Tobler I, Burgunder JM : Circadian patterns of neurotransmitter related gene expression in motor regions of the rat brain. Neurosci Lett 358 : 17-20, 2004 https://doi.org/10.1016/j.neulet.2003.12.053
  47. Weimerskirch PR, Ernst ME : Newer dopamine agonists in the treatment of restless legs syndrome. Ann Pharmacother 35 : 627-630, 2001 https://doi.org/10.1345/aph.10271
  48. Wetter TC, Eisensehr I, Trenkwalder C : Functional neuroimaging studies in restless legs syndrome. Sleep Med 5 : 401-406, 2004 https://doi.org/10.1016/j.sleep.2004.01.009
  49. Winkelman JW, Johnston L : Augmentation and tolerance with long-term pramipexole treatment of restless legs syndrome (RLS). Sleep Med 5 : 9-14, 2004 https://doi.org/10.1016/j.sleep.2003.07.005
  50. Winkelmann J, Schadrack J, Wetter TC, Zieglgänsberger W, Trenkwalder C : Opioid and dopamine antagonist drug challenges in untreated restless legs syndrome patients. Sleep Med 2 : 57-61, 2001 https://doi.org/10.1016/S1389-9457(00)00025-3
  51. Zwartbol RT, Jellema K, Boiten J, Rijsman R : Acute exacerbation of restless legs due to cervical spinal cord ischaemia. BMJ Case Rep : 2013, 2013

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