Despite the controversy regarding specific mechanism of botulinum toxin action in pain relief, clinical results suggest that botulinum toxin type A may be promising treatment options for patients with primary chronic headache. To investigate this, we included sixteen patients with chronic tension-type headache in a prospective double blind, placebo-controlled crossover study and thirty patients in an open-label long-term study. All of the patients showed reduced severity of headache, reduced pericranial muscle tenderness and increased headache-free days during botulinum toxin A treatment. Moreover, constant and cumulative trend of improvement was present during long-term study indicating better quality of life during botulinum toxin treatment. There is need for further placebo-controlled clinical studies to identify the optimal dose, optimal number and place of injection sites as well as optimal injection techniques.
Objectives. Restless Legs Syndrome is a movement disorder characterized by unpleasant sensations in the legs described as a burning, tingling, etc. Symptoms become worse in the evening and are relieved by moving the limbs. The idiopathic form of the disease is associated with a lack of dopamine, and the secondary form is associated with iron deficiency anemia, pregnancy, and kidney disease. The aim of this study was to investigate the incidence of iron deficiency anemia in pregnant women and non-pregnant women suffering from RLS. Methods. The study was conducted on a sample of 231 pregnant women aged 18-50. The pregnant women were interviewed at the outpatient clinic of the Department of Gynaecology and Obstetrics. This study also included a control group of 231 age-compatible non-pregnant women. Women who met the international criteria for diagnosing the syndrome filled in a sociodemographic questionnaire. Results. A statistically significant association between the existence of iron deficiency anemia and RLS in the sample of the examined women was proven (p < 0.001). It was also shown that RLS is more frequent in a sample of anemic pregnant women than non-anemic pregnant women (p = 0.008). Conclusion. Iron deficiency anemia is related with RLS. Pregnant women with RLS are more likely to be anemic than pregnant women without RLS.
Uremia-related restless legs syndrome (RLS) is a known form of secondary RLS. This cross-sectional survey included patients (n = 82) on stable hemodialysis (HD; >3 months, Kt/V >1.2) who were iron-replete, free of neurodegenerative or psychiatric disorders, severe polyneuropathy and radiculopathy, not exposed to antipsychotics/antidepressants, and not severely anemic. Forty-nine (60%) were RLS ‘positive’, and 25 (31%) had severe/very severe symptoms (International Restless Legs Syndrome Study Group criteria). None had been diagnosed previously. In a multivariate analysis, the prevalence of RLS was higher in diabetic patients [vs. nondiabetics; prevalence ratio (PR) 2.32, 95% CI 1.50–3.60, p < 0.001] and those exposed to Ca2+ antagonists (vs. nonexposed; PR 2.02, CI 1.47–2.76, p < 0.001), and also increased with dialysis duration (PR 1.05, 95% CI 1.02–1.09, p < 0.001). Association of Ca2+ antagonists and RLS in uremic patients has not been reported previously and deserves further research.
Clinical diagnosis of WD was confirmed in 59 patients by detecting mutations on both ATP7B alleles. The age at onset of WD and the type of WD clinical presentation showed no significant correlation with the ATP7B genotype.
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