Restless legs syndrome in Wilson's disease: frequency, characteristics, and mimics

Abstract

RLS was frequent in this cohort of WD and might be causally related to WD. RLS should be included in the diagnostic work-up of WD. In complex motor disorders, differential diagnosis of RLS might require evening/nighttime examination and video-polysomnography. In WD patients with a clinically significant RLS, treatment with dopaminergic substances may be considered.

Sleep disorders in Wilson's disease

“…This might explain the discrepancy with the results of other studies on the topic. 15 RLS was severe in two patients in our study. They were both efficiently treated with gabapentin (600 mg/day).…”

“…In the few studies on sleep in WD, [11][12][13][14][15]28 symptoms of insomnia were also reported. These results were combined in a meta-analysis showing a higher frequency and severity of insomnia in WD compared to controls.…”

“…9,10 Frequent nocturnal awakening, poor nocturnal sleep quality, delayed morning wake-up and sleepiness with frequent naps during the day have been reported. [11][12][13][14][15] Restless legs syndromes (RLS), REM sleep behavior disorders (RBD), and cataplexia were described. 12,13 Many mechanisms may explain sleep disorders in WD including lesions of sleep wake pathways, motor, dysautonomic and psychiatric disorders, and treatments.…”

Sleep disturbance in movement disorders: insights, treatments and challenges

“…70,71 There is some limited evidence for higher rates of RLS amongst those with Wilson's disease compared to the general population, with 31% of a single cohort (n=42) meeting diagnostic criteria, and subsequent PSG demonstrating increased PLMS compared to controls (p=0.009). 72 Albeit in a single case-report, D-penicillamine resolved complaints of hypersomnia, while a case-control study identified higher rates of probable RBD found in those treated with D-penicillamine. 71,73…”