Legs Syndrome In Patients Research Articles

Restless legs syndrome in patients on chronic hemodialysis

BackgroundTo access the prevalence of restless legs syndrome (RLS) in patients on chronic hemodialysis and to determine the risk factors for RLS. Materials and methodsFifty subjects undergoing chronic maintenance hemodialysis were included in this study after seeking informed consent. RLS was diagnosed according to International Restless Legs Syndrome study group criteria. Demographic data, clinical history and laboratory values are collected using standard interviews. ResultsRLS was reported in 14 of 50 hemodialysis patients (28%). Low hemoglobin, low serum ferritin levels and increased consumption of coffee in hemodialysis patients correlated significantly with onset of RLS. There was no difference in age, gender and duration of hemodialysis between RLS and non-RLS patients. ConclusionRLS is prevalent in patients on chronic hemodialysis. Further studies are needed to confirm the possible risk factors for RLS.

Restless legs syndrome in patients with systemic sclerosis

Restless legs syndrome in patients with systemic sclerosis

Prevalence of Restless Legs Syndrome in Patients Treated with Peritoneal Dialysis: Clinical and Biochemical Characteristics among Patients with and without Restless Legs Syndrome

Introduction and Aims:This is a prospective study identifying prevalence of Restless Legs Syndrome (RLS) in patients ongoing peritoneal dialysis (PD) due to end stage renal disease (ESRD) and comparing clinical and biochemical characteristics among patients with and without RLS. Methods: Two hundred ESRD patients who received PD at least six months assessed by neurologist and nephrologist with regards to presence of RLS. Also, clinical and biochemical features of these patients are determined. One hundred and forty four patients were excluded from study because they had other secondary causes of RLS except for ESRD. Results: Thirteen of 56 patients (23.2%) had RLS. The use of vitamin B + folic acid supplements was significantly lower in patients with RLS than in those without RLS (69.2% vs 97.7%; p = 0.008). There was no significant difference between patient groups with and without RLS in terms of age, gender, body mass index, cause of ESRD, peritoneal membrane transport characteristic, smoking, consuming alcohol, use of erythropoietin, duration of PD, hemoglobin, serum calcium, serum phosphorus, serum albumin, levels of serum iron, total iron binding capacity, ferritin, folic acid and vitamin B12, transferrin saturation, weekly Kt/V urea value, and amount of residual urine volume (p > 0.05). Conclusion: RLS is more common among PD patients than general population. Although essential cause is not exactly known, use of folic acid and vitamin B complex decrease the RLS prevalence in this particular patient group.

Effective Treatment of Restless Legs Syndrome in Patients on Haemodialysis

NephrologyVolume 18, Issue 1 p. 78-78 CORRESPONDENCE Effective Treatment of Restless Legs Syndrome in Patients on Haemodialysis S Kapoor, S Kapoor Private Practise, Schaumburg, Illinois, USASearch for more papers by this author S Kapoor, S Kapoor Private Practise, Schaumburg, Illinois, USASearch for more papers by this author First published: 17 December 2012 https://doi.org/10.1111/nep.12001Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinked InRedditWechat No abstract is available for this article. Volume18, Issue1January 2013Pages 78-78 RelatedInformation

Restless legs syndrome in Korean patients with drug-naïve Parkinson's disease: A nation-wide study

BackgroundRestless legs syndrome is a common neurologic disorder, and there is increasing evidence for a dopaminergic link between Parkinson's disease and restless legs syndrome. However, most previous studies did not take into account the effects of dopaminergic medication. We conducted a nation-wide, cross-sectional study to determine the prevalence and clinical characteristics of restless legs syndrome in Korean drug-naïve Parkinson's disease patients. MethodsOne hundred and fifty-one drug-naïve patients with Parkinson's disease were enrolled from 18 centers in South Korea over the course of one year. Clinical profiles of parkinsonism, restless legs syndrome, psychiatric symptoms, and laboratory data were collected. The findings of subjects with and without restless legs syndrome were compared. ResultsThe prevalence of restless legs syndrome in drug-naïve patients with Parkinson's disease was 16.5%. Subjects with restless legs syndrome had a higher mean Hoehn and Yahr stage and more severe limb parkinsonism, especially tremor. There was, however, no difference in iron metabolism between patients with and without restless legs syndrome. Analysis demonstrated that Beck's depression inventory score was associated with the severity of restless legs syndrome. ConclusionOur study demonstrated an increased prevalence of restless leg syndrome in drug-naïve patients with Parkinson's disease than in the general population. Based on the association between parkinsonism and restless legs syndrome, and the unique characteristics of restless legs syndrome in patients with Parkinson's disease, we suggest that the pathophysiology of restless legs syndrome in Parkinson's disease differs from that in patients without Parkinson's disease.

Application of the Cambridge–Hopkins diagnostic questionnaire for investigating restless legs syndrome in patients with chronic renal failure

midnight; but let him begin to nod in court and the advocates had difficulty in rousing him, however loudly they shouted’’ [4]. Clinical indications of upper airway restriction due to retrognathia, include supine snoring, increased wake after sleep onset as well as daytime hypersomnolence [5]. A portrait of Claudius on an Almost Uncirculated, silver coin clearly exhibits a pronounced mandibular retrusion indicative of this condition [see Fig. 1]. Presumably, posterior displacement of the tongue contributed to upper airway resistance and therefore snoring during inspiration.

Restless legs syndrome in patients with depressive disorders

Aim Recent community-based studies have shown strong associations between restless legs syndrome (RLS) and major depressive disorder and panic disorder. The aim of the study was to investigate whether patients with a manifest depressive disorder have an increased prevalence of RLS and whether there is an association with different depressive disorders.

Restless legs syndrome in patients on hemodialysis: Frequency, severity and risk factors

Objective. Restless legs syndrome is a neurologic disorder which especially affects patients on hemodialysis. The aim of our study was to estimate the frequency and severity of restless legs syndrome in hemodialysis patients' population and explore possible connection with some factors by analyzing differences in patients' sociodemographic characteristics, existence and severity of coexistent diseases, biochemical parameters and dialysis type between the patients with and without this syndrome. Methods. 96 subjects were included in our cross sectional study. The diagnosis of restless legs syndrome was made by using criteria of International Restless Legs Study Group. Severity of the syndrome was evaluated through the use of Restless Legs Syndrome Rating Scale questionnaire. Results. Restless legs syndrome was found in 39.6% of subjects. The most of patients had moderate (36.8%) or severe symptoms (50%). There was no statistically significant difference between the patients with and without restless legs syndrome regarding sociodemographic and biochemical characteristics and dialysis type. In terms of coexistent disease, it was found that patients with restless legs syndrome had a significantly greater frequency of ischemic heart disease and depression compared to the patients without the syndrome. There was no difference in index of coexistent disease. Severity of depression and insomnia was higher in patients with restless legs syndrome. Conclusion. This study confirmed that restless legs syndrome is very frequent in hemodialysis patients and indicated that even two-third of patients had severe to very severe symptoms. For future research, it is necessary to direct attention to influence of comorbidity in hemodialysis patient on restless legs syndrome, especially on influence of psychiatric disorders.

Prevalence of neuroleptic-induced restless legs syndrome in patients taking neuroleptic drugs

Dopamine deficiency or dopamine dysfunction has been implicated as one of the factors involved in the pathophysiology of restless legs syndrome (RLS). Our objective is to determine the prevalence of primary RLS in patients taking neuroleptic drugs. One hundred patients taking neuroleptic drugs and 100 healthy age- and sex-matched controls were interviewed with the Cambridge-Hopkins diagnostic questionnaire for RLS. Patients with malignancy, end-stage renal disease, neuropathy, history of spinal cord diseases, pregnancy and Parkinson's disease were excluded. Only one patient had symptoms consistent with RLS (1%), similar to one patient in the control group. She was a 40years old female with a diagnosis of depression. She started having RLS symptoms approximately four years after starting perphenazine. The symptoms persisted after the medications were discontinued but decreased in severity and frequency. Her serum ferritin level was 90.3ng/ml. The prevalence of primary RLS is low in patients attending the out-patient clinic who are taking neuroleptic drugs. Other factors apart from dopaminergic dysfunction are likely to be involved in the pathogenesis of RLS.

Acupuncture for Restless Legs Syndrome in Patients Previously Treated with Dopaminergic Drugs

The readers may be interested to learn about my success in using acupuncture to treat patients with restless legs syndrome and about the reduced responses in patients who have already received dopaminergic drugs. Restless legs syndrome (RLS) can wreck people's lives by preventing them from sitting down for long to do anything in the afternoons and evenings and disrupting their sleep every night. It is not an insignificant condition, but it is often regarded as something of a Cinderella with many patients not reporting it and many doctors not treating it – often regarding it as minor, trivial or psychological or not realising that treatments are available. Although there is considerable anecdotal evidence of the benefit of acupuncture in RLS, a Cochrane review in 20081 found only two trials that met their selection criteria and concluded that ‘there is insufficient evidence to support the use of acupuncture for the symptomatic treatment of restless legs syndrome’. Having practised acupuncture since 1990 (since 1996 with an NHS contract for patients referred), …

Increased prevalence of restless legs syndrome in patients with acromegaly and effects on quality of life assessed by Acro-QoL

Restless legs syndrome (RLS), a neurological sensory-motor disorder characterized by a compelling urge to move the limbs during the night, is a sleep disturbance that impairs quality of life. Prevalence of RLS and consequences on quality of life were investigated in acromegalic patients. Fifty-six patients (20 men, 55.0 ± 1.6 years), 22 with active acromegaly (group 1) and 34 with controlled disease (group 2), and 95 controls (35 men, 52.9 ± 1.1 years) were evaluated by a structured sleep interview concerning insomnia, circadian sleep disorders and excessive diurnal sleepiness (EDS). The Epworth Sleepiness Scale (ESS) questionnaire was administered to those reporting EDS. Patients were investigated by RLS diagnostic interview and International Restless Leg Syndrome-Rating Scale (IRLS-RS). Quality of life was investigated by AcroQoL questionnaire. RLS was diagnosed in 21% of acromegalics and in 4% of controls (P < 0.002). Prevalence of RLS and mean IRLS-RS was higher in group 1 than in group 2 (P < 0.05). Prevalence of insomnia (P < 0.0002) and of EDS (P < 0.05) and mean ESS score (P < 0.01) were higher in RLS-positive than in RLS-free acromegalics. Video-PSG showed that mean sleep latency (P < 0.01), micro-arousal index (P < 0.05) and wakefulness after sleep onset (P < 0.01) were higher, whereas sleep efficiency (P < 0.01) was lower, in RLS-positive than in RLS-free patients. Global and physical AcroQoL scores were significantly lower in RLS-positive than in RLS-free acromegalics (P < 0.01 and P < 0.001, respectively). Prevalence and severity of RLS is increased in patients with active acromegaly and impacts negatively on their physical performances, dramatically impairing quality of life.

The high frequency of restless legs syndrome in patients with amyotrophic lateral sclerosis

Restless legs syndrome (RLS) appears to be more frequent in certain neurodegenerative disorders. The aim of our study was to determine the frequency and the determinants of the association of RLS with amyotrophic lateral sclerosis (ALS) in a French cohort. Information on sex, age, age at onset, site of onset, body mass index, disease duration, ALS Functional Rating Scale-Revised and use of technical supports was obtained in a cohort of 69 ALS subjects (69.6 ± 9.7 years). RLS was diagnosed using the International RLS Study Group criteria. We compared our frequency rates by age with frequency rates of RLS in the French general population from literature. RLS was observed in 13 patients (18.8%). Frequency of RLS was higher (p = 0.007) in ALS patients older than 64 years than in the French general population of the same age group. There were no further demographic, clinical or biological differences between the patients with RLS and those without RLS, with the exception of a higher frequency of difficulty turning in bed and adjusting bedclothes (p = 0.023). In conclusion, RLS occurs frequently in ALS, and those affected should be identified and appropriately treated.

Periodic limb movements during sleep and restless legs syndrome in patients with ASIA A spinal cord injury

ObjectiveTo establish the occurrence of Periodic Leg Movements (PLM) and Restless Legs Syndrome (RLS) in Spinal Cord Injury (SCI) subjects. MethodsIn this study, twenty four patients were submitted to a full night polysomnography and were assessed with Epworth Sleepiness Scale and an adapted form of International Restless Legs Syndrome Scale Rating Scale (IRLS Rating Scale). Control Group (CG) was composed of 16 subjects, 50% of each sex, age: 24.38±4years old. Spinal Cord Injury Group (SCIG) was composed of 8 subjects (29±5years old) with a complete SCI (ASIA A) of about three and a half years of duration, 100% males. Results100% of SCIG had RLS compared to 17% in CG (p<0.0001). SCIG had 18.11±20.07 of PLM index while CG had 5.96±11.93 (p=0.01). Arousals related to PLM were recorded in CG and SCIG. There was a positive moderate correlation between RLS and age (r=0.5; p=0.01), RLS and PLM (r=0.49; p=0.01), adapted IRLS Rating Scale and PLM index (r=0.64; p=0.03) and also a negative moderate correlation between Epworth Sleepiness Scale and PLM index (r=-0.4; p=0.04) in both groups. ConclusionRLS and PLM are common findings in SCI patients with a complete injury.

Prevalence of restless legs syndrome in patients with irritable bowel syndrome

To determine the prevalence of restless legs syndrome (RLS) in patients with irritable bowel syndrome (IBS). Patients with diarrhea-predominant IBS (n = 30), constipation-predominant IBS (n = 30), or mixed-symptom IBS (n = 30) were recruited from the community between March 2008 and February 2009. Rifaximin 200 mg three times daily was administered empirically to alleviate small intestinal bowel overgrowth in all patients. The presence of RLS was assessed via an RLS questionnaire and polysomnography. Twenty-six patients with IBS (29%) were diagnosed with RLS using the RLS questionnaire. Twenty-four of the 26 patients (92%) underwent polysomnography, and all had confirmation of RLS. A greater percentage of patients with RLS had diarrhea-predominant IBS (62%) compared with patients with constipation-predominant IBS (4%) or mixed-symptom IBS (33%). Restless legs syndrome is prevalent in patients with IBS, especially those with diarrheal symptoms. Assessment of concomitant disorders may improve diagnosis and expand relevant treatment options for patients.

Restless legs syndrome in patients with amyotrophic lateral sclerosis

We aimed to evaluate the frequency and determinants of restless legs syndrome (RLS) in a group of 76 patients with amyotrophic lateral sclerosis (ALS) and 100 control subjects. A diagnosis of RLS was made according to the criteria of the International RLS Study Group, and severity was assessed by the RLS severity scale. RLS was significantly more frequent in patients with ALS (ALS/RLS(+)) than in control subjects (25% vs. 8%; P = 0.002). Compared with control subjects, patients with ALS/RLS(+) showed shorter history of RLS complaints and higher frequency of symptoms occurrence. Moreover, compared with those without RLS, patients with ALS/RLS(+) showed increased functional impairment and more often reported sleep complaints. Multivariate logistic regression confirmed the association between RLS and functional impairment. Our findings suggest that RLS should be considered as a possible cause of disrupted sleep in patients with ALS and should be specifically investigated in these patients.

Harvesting of Peripheral Blood Stem Cells Using Plerixafor (MOZOBIL) and Granulocyte-Colony Stimulating Factor in Patients Who Had Never Undergone Stem Cell Collection.

Abstract 4236 IntroductionThe collection of peripheral blood stem cells (PBSC) can be tedious and expensive. Moreover, PBSC yields can be severely compromised in patients who previously received chemotherapy. The use of plerixafor (MOZOBIL) for PBSC mobilization has been shown to significantly improve CD34 stem cell yields in patients whom PBSC collections have been adequate. However, this requires the patient to undergo further PBSC harvesting sessions; adding to the patient's inconvenience, exposure to adverse events and costs. We therefore investigated whether using plerixafor at the outset of PBSC mobilization would improve patient acceptability; reduce PBSC collection days and accordingly the patient's costs. Patients and MethodsThree adult patients who had never undergone PBSC harvesting were mobilized using subcutaneous (SC) granulocyte-colony stimulating factor (G-CSF) 10 μg/kg daily starting 4 days prior to PBSC harvesting; plus SC plerixafor 240 μg/kg 10 hours prior to PBSC harvesting. Both G-CSF and plerixafor were continued for as long as was required for PBSC collections. Two patients had multiple myeloma (MM) and were both in stringent complete remission (sCR). The third patient suffered from adult-onset spinomuscular atrophy (SMA) and stem cells were required for possible re-infusion therapy. Importantly, the bone marrows of all 3 patients were assessed to be normal prior to PBSC mobilization and collection. The target PBSC CD34 yield was 2 million CD34 cells/kg per PBSC collection. ResultsAs can be seen, the CD34 yields (expressed as x million CD34 cells/kg) exceeded expectations:PatientDiagnosisCell SeparatorDay 1Day 2Day 3Patient #1MMCOBE Spectra2.794.354.21Patient #2MMCOBE Spectra3.433.12not donePatient #3SMASPECTRA Optia8.105.565.50All patients tolerated the procedure very well and were discharged within 24 hrs of completing the final PBSC collection. The only adverse event was grade 1 restless legs syndrome in Patient #1 following the first injection of plerixafor. It was improved with oral diazepam and did not recur. Both patients with MM reported a sense of “rejuvenation” 2-3 weeks after PBSC collection. All patients were pleased with the relatively complication-free procedure. ConclusionsUpfront collection of PBSCs using G-CSF/plerixafor is both highly effective and safe. There is great patient acceptability as well as much fewer PBSC collection days and an accompanying reduction in procedure costs. The added advantage of using the SPECTRA Optia cell separator is worth further investigations. Disclosures:Off Label Use: Plerixafor (MOZOBIL) - Use in patients who had never undergone stem cell collection..

Prevalence of Restless Leg Syndrome in Patients With Functional Bowel Disease in the Community

Prevalence of Restless Leg Syndrome in Patients With Functional Bowel Disease in the Community

Factors contributing to the development of restless legs syndrome in patients with Parkinson disease

Although restless legs syndrome (RLS) commonly accompanies Parkinson disease (PD), the mechanism of RLS development in PD is still unclear. We investigated the prevalence of RLS in Korean patients with PD, and the possible contributing factors to the development of RLS in those patients. Four hundred forty-seven consecutive patients with PD were interviewed and examined. Among them, 73 patients (16.3%) were diagnosed with RLS. PD patients with RLS had a longer duration of PD symptoms, more severe PD disability, a greater degree of cognitive decline, and a longer duration of antiparkinson therapy than those without RLS. Multivariate logistic regression analysis revealed that the duration of antiparkinson therapy was the most significant factor contributing to the development of RLS in patients with PD. The present results support a higher prevalence of RLS in patients with PD and suggest that long-term antiparkinson therapy, rather than PD itself, may contribute to the development of RLS.

A Review of Restless Legs Syndrome in Patients on Hemodialysis

A Review of Restless Legs Syndrome in Patients on Hemodialysis

Validation of an algorithm for the diagnosis of Restless Legs Syndrome: The Restless Legs Syndrome-Diagnostic Index (RLS-DI)

Background There is a need for structured methods to improve sensitivity and specificity of diagnostic decision making in Restless Legs Syndrome (RLS). We present the RLS-Diagnostic Index (RLS-DI), a diagnostic algorithm which combines essential and supportive diagnostic criteria from patient interviews, polysomnography and neurological examination in an adaptive procedure. Method The RLS-DI consists of 10 items which are related to the essential diagnostic criteria established by the International RLS Study Group (five items) as well as their supportive criteria (3 items) and features associated with RLS (2 items). Items have to be completed using three categories per item that address frequency of occurrence of symptoms or certainty of presence or absence of other diagnostic information. Negative weights were given when the clinically most relevant items were not present. The RLS-DI was administered in a telephone interview to 179 patients (86 with RLS, 93 with other sleep disorders) of the 21 month cohort of one sleep center in Germany. Results With receiver-operating characteristics, a cut-off of ⩾11 points on a scale ranging from −22 (no RLS) to 20 (definite RLS) was identified by comparing the RLS-DI total score to the diagnosis of two independent sleep experts. Sensitivity was 93.0%, specificity was 98.9%, and 96.1% of the patients could be correctly diagnosed. Specificity was higher in items related to supportive or associated diagnostic information (95.7%) than in those related to the essential diagnostic criteria (81.7%). Patients with RLS scored a higher RLS-DI than those with primary insomnia or other neurological or psychiatric disorders ( p < .001). Conclusion The RLS-DI demonstrated the ability to validly diagnose an actual and persistently present Restless Legs Syndrome in patients of a sleep lab population and to exclude those patients whose sleep disturbances have other causes.