Restless Legs Syndrome: clinical features, diagnosis and a practical approach to management

Wijemanne, Subhashie; Ondo, William G.

doi:10.1136/practneurol-2017-001762

Cited by 62 publications

(68 citation statements)

References 45 publications

(30 reference statements)

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“…An important aspect that must be taken into account when evaluating EDS in PD is the presence of RLS, since this is a sensorimotor disorder characterized by an urge to move associated with unpleasant sensations in the legs. 50 This condition seems to be implicated in the development of EDS. We observed that RLS was more common among PD patients with EDS than those without EDS.…”

Section: Discussionmentioning

confidence: 99%

Clinical Predictors of Excessive Daytime Sleepiness in Patients with Parkinson's Disease

et al. 2018

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Background and PurposeExcessive daytime sleepiness (EDS) is a common complaint among patients with Parkinson's disease (PD). Several factors have been associated with EDS in PD, especially neuropsychiatric symptoms. This study aimed to determine the relationships between neuropsychiatric symptoms, sociodemographic and clinical parameters, and EDS in PD.MethodsThis cross-sectional study analyzed 85 patients with PD. All patients underwent socioeconomic and clinical data evaluations followed by a psychiatric interview and a neurological examination, including the assessment of sleep features. Patients were divided into two groups according to the presence or absence of EDS, which was defined as a score higher than 10 on the Epworth Sleepiness Scale. Binary logistic regression was performed in order to describe the predictors of EDS.ResultsWe found that EDS affects 40% of PD patients and is associated with older age, restless legs syndrome, depressive and anxious symptoms, and worse sleep quality. In the multivariate analysis, older age, levodopa use, and worse sleep quality remained as significant predictors of EDS in PD.ConclusionsNighttime sleep problems, older age, and levodopa use are significantly associated with EDS in PD. A careful assessment and the management of sleep problems in PD patients might help to improve their quality of life.

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Section: Discussionmentioning

confidence: 99%

Clinical Predictors of Excessive Daytime Sleepiness in Patients with Parkinson's Disease

et al. 2018

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“…Iron and folate metabolism: during pregnancy, the level of serum iron, ferritin, and folate diminishes, possibly due to their dilutions in a larger blood volume, given the demand by the fetus. Genetics: there is a hypothesis suggesting that pregnancy may cause initiation of symptoms in women who are genetically predisposed to developing RLS [14][15][16][17][18].…”

Section: Introductionmentioning

confidence: 99%

“…In order to treat RLS, in mild cases, typically nonpharmacological methods such as stretching the legs before sleep and use of elastic socks when accompanied by varicose veins are suggested [14][15][16][17][18]. If RLS symptoms are mild or trivial, changes in the lifestyle such as regular exercise may be beneficial.…”

Section: Introductionmentioning

confidence: 99%

The prevalence of Restless Legs Syndrome/Willis-ekbom disease (RLS/WED) in the third trimester of pregnancy: a systematic review

et al. 2020

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Background: RLS is known as one of the most common movement disorders during pregnancy, which is most aggravated in the third trimester of pregnancy and can affect up to one-third of pregnant women. This study intends to determine the total prevalence of RLS in the third trimester of pregnancy through a systematic review. Methods: The present study was conducted via meta-analysis method up to 2019. The papers related to the subject of interest were obtained through searching in SID, MagIran, IranDoc, Scopus, Embase, Web of Science (ISI), PubMed, Science Direct, and Google Scholar databases. Heterogeneity of the studies was examined via I 2 index, and the data were analyzed in Comprehensive meta-analysis software. Results: In investigating 10 papers capturing 2431 subjects within the age range of 25-39 years, the total prevalence of RLS in the third trimester of pregnancy based on meta-analysis was obtained as 22.9% (95% CI: 14.7-33.8%). Further, as the sample size increased, the RLS prevalence diminished, while with increase in years, this prevalence increased, where this difference was statistically significant (P < 0.05). Conclusion: Prevalence of RLS in the third trimester of pregnancy is high, healthcare policymakers should organize educational classes to improve the life dimensions among this group of pregnant women.

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“…Restless legs syndrome (RLS) is a sensorimotor neurological disease, characterized by an urge to move that is usually associated with abnormal sensations in the legs, symptoms that are engendered or worsened by rest, relieved by movement, and are most severe at night. The estimated prevalence is 5–12%, and it is more commonly seen in females [ 1 , 2 , 3 ]. The endothelium in the microvessels of the blood brain barrier serves as the reservoir of iron in the brain and its deficiency is linked to the pathophysiology of RLS [ 4 ].…”

Section: Introductionmentioning

confidence: 99%

Botulinum Toxin in Restless Legs Syndrome—A Randomized Double-Blind Placebo-Controlled Crossover Study

Mittal

Machado

Richardson

et al. 2018

Toxins

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Background: Restless Legs Syndrome (RLS) is a common movement disorder with an estimated prevalence of up to 12%. Previous small studies with onabotulinumtoxin A (OnaA) for RLS have shown inconsistent results. Methods: Twenty-four patients with an International RLS score (IRLS) of >11 (moderate-severe) were enrolled in this blinded, placebo-controlled crossover study. Twenty-one patients completed the evaluations at 4, 6, and 8 weeks after each injection. One-hundred units of Incobotulinumtoxin A (IncoA) or normal saline were injected into tibialis anterior, gastrocnemius, and biceps femoris muscles each side. Results: Improvement from a severe (IRLS >21) to a mild/moderate (IRLS ≤20) score was significant at four weeks (p = 0.0036) and six weeks (p = 0.0325) following IncoA administration compared to placebo. Additionally, there was significant improvement in pain score at six weeks as measured by Visual Analogue Scale (p = 0.04) and the Johns Hopkins Quality of Life Questionnaire (p = 0.01) in the IncoA group. Definite or marked improvement on Patient Global Impression of Change was seen in 7 out of 21 patients in the IncoA group vs. 1 out of 21 patients in the placebo group at 4 weeks (p = 0.012). Conclusion: IncoA injection lead to a reduction in severity of RLS symptoms, pain score, and quality of life, without any adverse effects.

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Restless Legs Syndrome: clinical features, diagnosis and a practical approach to management

Cited by 62 publications

References 45 publications

Clinical Predictors of Excessive Daytime Sleepiness in Patients with Parkinson's Disease

Clinical Predictors of Excessive Daytime Sleepiness in Patients with Parkinson's Disease

The prevalence of Restless Legs Syndrome/Willis-ekbom disease (RLS/WED) in the third trimester of pregnancy: a systematic review

Botulinum Toxin in Restless Legs Syndrome—A Randomized Double-Blind Placebo-Controlled Crossover Study

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