Prevalence Of Restless Legs Syndrome In Patients Research Articles

A randomized double-blind pilot study to evaluate the efficacy, safety, and tolerability of intravenous iron versus oral iron for the treatment of restless legs syndrome in patients with iron deficiency anemia.

Restless legs syndrome (RLS) is a neurological disorder that can have a profound effect on sleep and quality of life. Idiopathic RLS is associated with brain iron insufficiency despite normal peripheral iron stores. There is, however, a five- to six-fold increase in prevalence of RLS in patients with iron deficiency anemia (IDA). Several open-label trials have demonstrated symptomatic improvement in RLS following treatment of IDA using oral or intravenous iron supplementation. To date, there have been no randomized double-blind controlled trials of intravenous iron compared with oral iron for the treatment of RLS patients with IDA. In the current study, oral ferrous sulfate and ferumoxytol were compared for efficacy and speed of response for treatment of RLS occurring in patients with IDA. The planned recruitment for this study was 70 patients with RLS and IDA, to be randomly assigned 1:1 to oral or intravenous iron, using double-blind, double-dummy procedures. At Week 6, the primary outcomes of Clinical Global Impression-Improvement score and change from baseline in the International Restless Legs Syndrome Study Group rating scale score were assessed. Due to challenges, performing the clinical trial during the COVID-19 pandemic, final-week data were found missing for 30 patients. As a result, in order to maintain the prespecified statistical analysis, an additional 30 patients were recruited. Both IV and oral iron were associated with a marked improvement in RLS symptoms, with no statistically significant difference between treatment groups. No serious adverse events were observed in either treatment group.

Opioids and restless legs syndrome: a double-edged sword.

Opioids and restless legs syndrome: a double-edged sword.

Restless legs syndrome in patients with chronic low back pain.

Based on studies showing that both chronic low back pain (LBP) and restless legs syndrome (RLS) have similar pathophysiological mechanisms, we aimed to investigate the prevalence of RLS in patients with chronic LBP and to define which demographic and clinical features are prominent in those with LBP accompanied by RLS. One hundred and two eligible, volunteer participants with chronic LBP were enrolled in this study. Visual analog scale (VAS), the Oswestry Disability Index (ODI), Pittsburgh Sleep Quality Index, Beck Depression Inventory, and Short Form-36 scales were applied to the patients. All patients were evaluated face-to-face for RLS using the International RLS study group diagnostic criteria. Most of our patients were women (52%). The mean age was 40.96±13.34years and the mean disease duration was 46.16±41.98months. RLS was detected in 36 (35.3%) of the patients with LBP. It was found that the female gender was more dominant in patients with RLS and the difference was statistically significant (p < 0.001). The amount of coffee intake was significantly higher in patients with RLS compared to those without RLS (p = 0.001). The disease duration for LBP was significantly higher in the patients with RLS (p = 0.003). VAS score, ODI score, PUKI score, and Beck depression score were significantly higher in the RLS group (p value were 0.048, 0.040, 0.007, and 0.043, respectively). In the evaluation of quality of life, all parameters except role emotional limitations and mental health were found to be significantly worse in the RLS group.

Prevalence of Restless Legs Syndrome (RLS) in children with thalassemia major in Ali Asghar Hospital in Zahedan, Iran

Introduction Thalassemia major is one of the most debilitating chronic and inherited diseases caused by impaired hemoglobin production. To improve the quality of life in the long-term treatment of thalassemia patients, it is necessary to pay special attention to sleep-related disorders such as restless legs syndrome. The present study, thus, attempts to determine the frequency of restless legs syndrome in children and adolescents with thalassemia major.Methods This study was performed on 302 patients with thalassemia major with an age range of 5-20 years in Ali Asghar Hospital in Zahedan in 2018. After obtaining the patients’ consent and their information including age, sex, underlying disease, history of drug use, Insomnia, splenectomy, oral and injectable iron depletion, and serum ferritin levels, as well as restless legs syndrome were recorded. Then the data were analyzed by SPSS statistical software. Chi-square and T-test were used to compare the data.Results The results of this study revealed that the prevalence percentage of Restless Legs Syndrome in children and adolescents with thalassemia major was 17.2%. In addition, it had a direct and significant relationship with vitamin D (p-value=0.008) and calcium (p-value 0.05)Conclusion Due to the high prevalence of RLS in patients with thalassemia major, especially in patients with a history of vitamin D and calcium intake, screening for RLS is necessary. In this way, taking medical measures can help improving the quality of life among these patients.

Restless legs syndrome is increased in postural orthostatic tachycardia syndrome.

Postural orthostatic tachycardia syndrome (POTS) and restless legs syndrome (RLS) are both characterized by sleep disturbance along with autoimmune/inflammatory features and autonomic dysfunction. However, to our knowledge, there has been no direct study looking at the prevalence of RLS in patients with POTS patients compared with healthy participants (controls). Ninety-six physician-diagnosed patients with POTS (89 female and 7 male) and 130 controls (99 female and 31 male) were administered the Cambridge Hopkins questionnaire. Participants who were diagnosed with probable or definite RLS on the Cambridge Hopkins questionnaire were then contacted to determine the severity of RLS with the International Restless Legs Scale. More patients with POTS (15 of 96; 15.6%) than controls (6 of 130; 4.6%) were diagnosed with probable or definite RLS on the Cambridge Hopkins questionnaire (P = .0048). A sensitivity analysis with only female respondents yielded similar results. RLS severity was in the moderate range (12.23 ± 9.22). There is a higher prevalence of RLS in patients with POTS patients compared with controls. This association may have to do with shared increased inflammatory/autoimmune load and autonomic dysfunction.

The Prevalence of Restless Legs Syndrome in Patients with Migraine: A Systematic Review and Meta-Analysis.

Background Migraine is a severe and debilitating neurologic disorder and is claimed to be the sixth disabling illness in the world. This study aimed to determine the overall prevalence of restless legs syndrome (RLS) in patients with migraine through a systematic review and meta-analysis. Methods To identify and select related studies, the Scopus, ScienceDirect, Embase, SID, IranDoc, Web of Science, Knowledge Network System Medline (PubMed), and Google Scholar databases were searched. All related cross-sectional studies, published in English or Persian language between January 2000 and December 2019 and using the keywords such as migraine, restless leg syndrome, sleep disorder, RLS, and migraine disorder, were collected. The heterogeneity of the studies was assessed using the I2 index, and the data analysis was performed using the Comprehensive Meta-Analysis software. Results Analysis was conducted on the reported results of the final 12 articles with the total sample size of 15196. The overall prevalence of RLS in patients with migraine was 16.3% (95% CI: 12.6–20.8%). The prevalence of RLS migraine patients decreased with increasing the sample size, and the prevalence of RLS migraine patients increased with increasing the research year, which was statistically significant (P < 0.05). Conclusion This study highlights that RLS is high in patients with migraine, and therefore, the clinicians should be aware of its incidence and take preventive measures.

The prevalence of restless legs syndrome in patients undergoing coronary angiography and its relationship with the severity of coronary artery stenosis.

Results from studies on the relationship between restless legs syndrome (RLS) and coronary artery disease (CAD) are conflicting. Some studies associate RLS with CAD by heart rate variability, blood pressure variability, and other autonomic, neuronal reasons, while other studies do not support these observations. The aim of this study was to investigate the prevalence of RLS in patients undergoing coronary angiography for CAD and to assess RLS prevalence with severity of CAD. After inclusion and exclusion criteria were applied, enrolled patients with less than 50% coronary artery stenosis by angiography (0-49%) were assigned to group 1, and patients with 50% or more coronary artery stenosis were assigned to group 2. Patients were diagnosed with RLS if they met all five essential criteria of the International RLS study group. RLS prevalence and other comorbidities were compared between the two groups. Of 126 patients, 74 men (59%), mean age 64.0 ± 8.7 years, mean BMI 29.6 kg/m2, 47 (37%) were assigned to group 1 (no or nonobstructive CAD) and 79 (63%) were assigned to group 2 (obstructive CAD). No significant differences were found between the groups in terms of mean age, BMI, gender, or prevalence of hypertension, hypercholesterolemia, and DM. The prevalence of RLS in group 2 (29%) was significantly higher than in group 1 (15%), p = 0.013. These results suggest that prevalence of RLS is associated with CAD and with CAD severity. We conjecture that RLS may be related to vascular endothelial dysfunction in cardiovascular disease.

Prevalence and risk factors of restless legs syndrome in patients of migraine without aura

Background: An association between migraine and Restless Legs Syndrome (RLS) has been proposed due to shared dopaminergic dysfunction. Both have substantial effects on the quality of life. Identifying co morbidities of migraine helps in optimizing patient management. Objectives To study the prevalence of RLS in patients of migraine without aura, and associated co morbidities of RLS.Methods: This was a hospital based prospective observational study. All patients diagnosed as Migraine without aura as per ICHD-3 criteria completed the questions regarding migraine headache, Migraine Disability Assessment (MIDAS) questionnaire, Hospital Anxiety and Depression Scale (HADS), Pittsburgh Sleep Quality Index (PSQI) and International RLS Study Group (IRLSSG) Rating Scale. RLS was diagnosed using the IRLSSG criteria. Serological investigations were done to look for secondary causes of RLS.Results: Out of 200 consecutive patients of migraine without aura were included in the study over a period of 18 months. Frequency of RLS was 13.5% (n=27). All patients had primary RLS. Mean PSQI score was higher in the patients of migraine without aura with RLS than in non RLS patients of migraine without aura (3.30±2.66 vs 2.24±2.03 p≤0.0168). Poor sleep quality, anxiety, depression was found in 9%, 8% and 2.5% respectively in patients of migraine without aura.Conclusions: An association between migraine without aura and RLS was demonstrated. Migraine without aura was associated with increased frequency of poor sleep quality, anxiety and depression.

PREVALENCE OF RESTLESS LEGS SYNDROME IN CYSTIC FIBROSIS IN AN ACADEMIC ADULT CYSTIC FIBROSIS PROGRAM

SESSION TITLE: Wednesday Abstract Posters SESSION TYPE: Original Investigation Posters PRESENTED ON: 10/23/2019 09:45 AM - 10:45 AM PURPOSE: Restless Legs Syndrome (RLS) is a clinical syndrome that affects approximately 10% of the general population. It is more prevalent in patients with advanced age, renal failure, pregnancy, diabetes mellitus, medications, myopathy, neuropathy, rheumatoid arthritis, and iron deficiency anemia. Increased awareness of RLS in patients with these disorders has led to more timely treatment. However, the prevalence of RLS in patients with Cystic Fibrosis (CF) has not been fully investigated. The objective of the study was to determine the prevalence of RLS symptoms in patients with CF. We also evaluate the impact of this disorder on quality of life via RLS Quality of Life (QoL) survey and severity of symptoms via an International RLS Study Group (IRLS) Rating Scale. METHODS: This research project was done via prospective survey and chart review. Previously validated RLS survey tools were used to measure the presence of RLS. A one-page survey featuring the core symptoms of RLS was administered to 77 subjects with CF in an academic adult CF program. RLS herald symptoms as agreed upon by the IRLS were incorporated as 4 key questions addressing RLS. This survey was considered positive for RLS if 4 of 4 core symptoms were present and those patients were subsequently administered the IRLS Rating Scale and RLS QoL questionnaire. RESULTS: Results of our study show RLS symptoms prevalence of 27% in subjects with CF. Average calculated score on IRLS Rating Scale was 16, suggesting moderate severity. RLS QoL questionnaire, reveals that RLS affects concentration , social activity, sexual health and work productivity in this population. CONCLUSIONS: The association of RLS symptoms and CF has not been well defined. Our study suggests that RLS symptoms are prevalent in CF and affects their quality of life. The pathophysiology of this relationship has not been fully described, however it may involve iron deficiency anemia from chronic inflammation, hemoptysis, gastrointestinal blood loss or iron malabsorption. Additionally, colonization with Pseudomonas Aeruginosa can result in iron deficiency as it competes with its host for iron in creating its own biofilm. Furthermore, medication toxicity, renal failure and diabetes mellitus in this patient population can also be contributing factors. Further investigations are being done to better understand this association. CLINICAL IMPLICATIONS: CF patients, over time, may suffer from significant fatigue mainly because of their advancing lung disease. However, heightened awareness of other contributing factors such as RLS can aid in timely treatment and improving their overall quality of life. DISCLOSURES: No relevant relationships by Rose Franco, source=Web Response No relevant relationships by Jeanette Graf, source=Web Response No relevant relationships by Erin Hubertz, source=Web Response No relevant relationships by Dmitriy Kogan, source=Web Response No relevant relationships by Jatan Shah, source=Web Response

Association between restless legs syndrome and other movement disorders.

This review focuses on the possible association between restless legs syndrome (RLS) and movement disorders, including Parkinson disease (PD), other parkinsonian syndromes, essential tremor, choreic and dystonic syndromes, Tourette syndrome, and heredodegenerative ataxias. Review of PubMed from 1966 to September 2018 and identification of references of interest for the topic. A meta-analysis of eligible studies on the frequency of RLS in patients with PD and controls using Meta-DiSc1.1.1 software and using the PRISMA guidelines was performed. Although there are substantial clinical, neuroimaging, neuropathologic, and genetic differences between RLS and PD, many reports describe a higher than expected prevalence of RLS in patients with PD, when compared with the general population or with matched control groups; several studies have also suggested that RLS could be an early clinical feature of PD. RLS symptoms are frequent in multiple system atrophy, essential tremor, Tourette syndrome, Friedreich ataxia, and spinocerebellar ataxia type 3 as well. Finally, possible genetic links between PD and RLS (the presence of allele 2 of the complex microsatellite repeat Rep1 within the α-synuclein gene promoter) and between Tourette syndrome and RLS (several variants in the BTBD9 gene) have been reported in 2 case-control association studies, although these data, based on preliminary data with small sample sizes, need to be replicated in further studies.

Restless legs syndrome in end stage renal disease patients undergoing hemodialysis

BackgroundThe prevalence of Restless legs syndrome (RLS) in End Stage Renal Disease (ESRD) patients is higher than that in the general population. However, the associations of RLS within the ESRD population are inconsistent and RLS is usually neglected in dialysis centers, although it impairs the life quality among ESRD patients. We aim to investigate the prevalence of RLS in patients with ESRD undergoing maintenance hemodialysis and evaluate the risk factors of developing RLS and the effect of RLS on quality of life among ESRD patients.MethodsESRD patients undergoing maintenance hemodialysis in Shanghai General Hospital dialysis unit from July 2016 to October 2016 were enrolled in the study. RLS was diagnosed according to the criteria of the International Restless Legs Syndrome Study Group (IRLSSG). IRLSSG Severity Scale was used to evaluate the severity of RLS. Pittsburgh Sleep Quality Index (PSQI) was used to evaluate sleep quality, and Hospital Anxiety and Depression Scale (HADS) was used to estimate anxiety and depression. Serologic and historic variables were analyzed to determine predictors of RLS in the ESRD population.ResultsA total of 137 ESRD patients were enrolled. The prevalence of RLS among the ESRD patients was 20.44%. The risk of RLS was increased significantly in females (OR = 2.729, p = 0.032) and daily alcohol drinkers (OR = 4.716, p = 0.022). RLS increased the risks of sleep disorders (25/28, 89.3% vs 73/109, 67.0%, p = 0.02) and sedative hypnotics intake (7/28, 25.0% vs 10/109, 9.2%, p = 0.047) and impaired the sleep quality (7/109 vs 11/28, p = 0.001) according to PSQI sum scores.ConclusionA high RLS prevalence among the ESRD patients undergoing hemodialysis was confirmed. ESRD patients who are women and drinking alcohol have a higher risk of RLS. The sleep quality was significantly impaired and sleeping medication use was more common among the ESRD patients with RLS.

Prevalence of restless legs syndrome in functional movement disorders: a case–control study from the Czech Republic

ObjectivesThe prevalence of restless legs syndrome (RLS) in functional movement disorders (FMD) is not known. Patients with FMD often present with multiple motor and sensory symptoms. Some of these symptoms...

Severity and frequency of restless legs syndrome in patients with familial Mediterranean fever.

Objective: Restless legs syndrome (RLS) is a common sensory motor disorder. RLS an urge to move the extremities that may be accompanied by dysesthesias, and significantly affects quality of life of affected patients. The frequency of RLS is higher in different systemic inflammatory diseases. Familial Mediterranean fever (FMF) is an inherited inflammatory disease characterized by attacks of polyserositis, arthritis, and fever. The prevalence of RLS in patients with FMF is unknown. This study aimed to evaluate the prevalence rate of RLS in a sample of patients with FMF and compare this prevalence with that of a matched normal population.Method: A total of 60 patients with FMF and 60 healthy controls were studied. All participants underwent a neurological examination. Diagnostic criteria as proposed by the International Restless Legs Syndrome Study Group (IRLSSG) were used to define RLS. The IRLSSG rating scale for the severity of RLS was applied to determine the severity of symptoms.Results: The prevalence of RLS was not significantly different between patients and controls. Although the mean International Restless Legs Syndrome Rating Scale (IRLSRS) scores tended to be higher in patients compared with controls, this difference was not significant. When each item of the severity scale was compared between the two groups, significantly higher scores were found in some items of the IRLSRS in patients with FMF compared with controls.Conclusion: According to this result, RLS symptoms in patients with FMF were more frequent and lasted longer than those in controls.

Prevalence of Restless Legs Syndrome in Patients with Inflammatory Bowel Disease

There has been increased interest in sleep disorders in patients with inflammatory bowel disease (IBD). Studies in North America and Europe reported that the prevalence of restless legs syndrome (RLS) is much higher in patients with Crohn's disease (CD) than in the general population. The aim of this study was to reveal the prevalence and clinical features of RLS in Japanese patients with IBD and investigate the influence of RLS on sleep quality and quality of life (QOL). The study included 80 outpatients with IBD who visited Nagasaki University Hospital between December 2012 and July 2014. All patients completed the international RLS study group rating scale, a validated measure of the presence of RLS. Sleep quality was assessed using the Japanese version of the Pittsburgh Sleep Quality Index (PSQI), and health-related QOL was assessed using the Japanese version of the 36-item short form healthy profile (SF-36) version 2. The prevalence of RLS in patients with IBD was 20%, including rates of 21.7% in patients with ulcerative colitis (UC) and 17.6% in patients with CD. Among patients with CD, the proportion of women and serum level of CRP were higher in the RLS group than in the non-RLS group. Among those with UC, there were no differences in clinical characteristics between the RLS and non-RLS groups. Patients in the RLS group slept significantly less well than those in the non-RLS group (PSQI>5; 62.5 vs. 34.4%, P<0.05). No significant relationships were observed between QOL indices and the presence of RLS (SF-36 physical score, 46.8 vs. 50.1; mental score, 43.8 vs. 45.7; role/social score, 48.1 vs. 49.2). RLS occurs frequently in Japanese patients with UC as well as CD. RLS affects sleep quality but not QOL, and it should be considered one of the causes of sleep disturbance in patients with IBD.

Spasticity or restless legs syndrome?

The Restless Legs Syndrome (RLS) is a sensorimotor disorder characterized by an urgent need to move the limbs (typically the legs), associated with unpleasant feelings, sometimes painful, in the evening or early night. Periodic leg movements (PLM) may occur during sleep. These are characterized by an extension movement of the hallux, dorsiflexion of the ankle and sometimes knee flexion and hip. The pathophysiology of RLS is not fully understood. Studies have shown an increased prevalence of RLS in patients with Spinal cord Injury (SCI) or Multiple Sclerosis. The diagnosis of spasticity or RLS in patients complaining of repeated nocturnal spasms in patients initially seen in consultation because of spasticity resisting to pharmacological treatment. Prospective study, from March 2014 to March 2015, monocentric, in the MPR Service Hospital Raymond-Poincaré. Inclusion criteria: age over 18 years, SCI, MS patients, with nocturnal predominance spasms. Exclusion criteria: presence of pressure sores, unable to achieve a polysomnogram. Weekday hospital patients for predominantly nocturnal spasms resistant to pharmacological treatment of spasticity orally or even to intrathecal therapy (IT) IT baclofen, associated with sleep disorders, underwent a polysomnography. If RLS exists, 0.18 mg of pramipexole was administered to the patient, followed by a control polysomnography. Eleven patients (5 MS, 5 SCI and a patient with hereditary spastic paraplegia) were included. All had polysomnography for RLS. A significant improvement was experienced on 10 patients, with a important reduction PLM on polysomnography control, after administration of pramipexole. This pilot study shows that RLS may be a differential diagnosis of spasticity. The presence of nocturnal or supine position spasms, in patients with central nervous system lesions of SCI or MS types must result in the research for RLS and test the effect of dopamine agonists in the case of positive diagnosis.

Prevalence and clinical characteristics of restless legs syndrome in diabetic peripheral neuropathy: comparison with chronic osteoarthritis

BackgroundThe prevalence of restless legs syndrome (RLS) in patients with peripheral neuropathy has been reported to be higher than that of the general population in some studies, which suggests an association between neuropathy and RLS, but not all studies show increased RLS with neuropathy. These differences may reflect adequacy of the diagnosis, effects of chronic pain complicating the diagnosis, or population differences. Moreover, if there is increased risk for RLS with neuropathy, it may reflect consequences of the chronic pain rather than other aspects of diabetes mellitus (DM). Therefore, we investigated the effects of diagnosis rigor on the estimated prevalence of RLS in patients with diabetic peripheral neuropathy (DPN) and those with chronic leg pain from osteoarthritis (OA), and then we compared the RLS prevalence in these two populations with each other and with population prevalence for Korea. MethodsOur study is a prospective case-control study of 199 patients with DPN and 220 patients with OA. After evaluating the presence of RLS in these subjects using the diagnostic criteria of the International RLS Study Group, we confirmed the diagnosis of RLS through face-to-face interviews using the 18-item Hopkins Diagnostic Questionnaire, which removes RLS mimics; and through independent examinations by two neurologists. ResultsOf the 199 subjects with DPN, 44 (22%) appeared to have RLS from their answers on the 4-item RLS diagnostic questionnaire compared to 8 (3.6%) of 220 subjects with OA. However, the prevalence of RLS in the DPN group dropped to 16 (8%) subjects but stayed at 8 (3.6%) OA subjects when using the Hopkins Telephone Diagnostic Interview (HTDI) adapted for clinical interview. The RLS prevalence determined by HTDI remained significantly higher (P=.042) in the DPN group compared to the OA group and was twice that reported for the general Korean population (8% vs 3.9%). Among subjects with DPN, those with RLS were older (68.06±8.43years vs 62.46±11.05years; P=.049) and had higher pain scores (visual analog scale [VAS], 4.69±2.52 vs 2.72±2.12; P=.002). The quality of sleep (MOS [Medical Outcomes Study] sleep scale) and health-related quality of life (QoL) (total score on the 36-Item Short-Form Health Survey [SF-36]) showed no significant difference between the two groups. ConclusionsThe prevalence of RLS in patients with DPN cannot be accurately assessed with only the four diagnostic criteria interview, but the prevalence was higher than expected for Koreans from the general population prevalence and also was higher than occurred with OA patients with chronic leg pains when accurately assessed with a structured interview. Chronic leg pain from OA does not significantly complicate RLS diagnosis, and chronic pain itself does not explain the increased RLS prevalence in diabetic neuropathy.

Multiple sclerosis and restless legs syndrome: a systematic review and meta‐analysis

Restless legs syndrome (RLS) has been reported to occur more frequently in patients with multiple sclerosis (MS) than in people without MS. Systematic review and meta-analysis of studies investigating RLS in patients with MS published through April 2012. We calculated the prevalences and 95% confidence intervals (CIs) of RLS in patients with MS and people without MS as well as odds ratios (ORs) and 95% CIs of the association between MS and RLS based on data from the publications. We then calculated pooled effect estimates for the association between MS and RLS. We identified 24 studies. RLS prevalence amongst patients with MS ranged from 12.12% to 57.50% and from 2.56% to 18.33% amongst people without MS. Heterogeneity amongst studies was high (RLS prevalence in patients with MS I(2) =94.4%; RLS prevalence amongst people without MS I(2) =82.2%). Hence, we did not pool the prevalence data for meta-analysis. Heterogeneity amongst studies investigating the association between MS and RLS was moderate (I(2) =53.6%). Pooled analysis indicates that MS is associated with a fourfold increased odds for RLS (pooled OR=4.19, 95% CI 3.11-5.66). This association was smaller amongst studies published as full papers (pooled OR=3.94, 95% CI 2.81-5.54) than amongst studies published as abstracts only (pooled OR=6.23, 95% CI 3.25-11.95). This systematic review indicates that RLS prevalence amongst patients with MS ranges from 12.12% to 57.50% in different populations. Pooled analysis further indicates that the odds of RLS amongst patients with MS are fourfold higher compared to people without MS.

Differential diagnosis of unpleasant sensations in the legs: Prevalence of restless legs syndrome in a primary care population

Background Restless legs syndrome (RLS) is a common neurological condition. We investigated the prevalence of RLS in patients suffering from unpleasant sensations in the legs. Methods We included 16,543 patients consulting one of 312 primary care practices in Germany on November 8, 2007. All patients filled out a self-assessment questionnaire. Patients who reported suffering from unpleasant sensations in the legs were then assessed by the physician. Main outcome measures were the overall prevalence of unpleasant sensations in the legs and the prevalence of RLS; the most common differential diagnoses in the subpopulation suffered from unpleasant leg sensations. Results Out of all participating patients 7704 (46.6%) suffered from unpleasant sensations in the legs and 1758 (10.6%) were diagnosed with RLS according to the four essential clinical criteria. Among patients with unpleasant leg sensations, the prevalence of RLS was considerably higher (22.7%) than in the total population. The most common differential diagnoses were osteoarthritis (21.5%), disc lesion (19.2%), varicose veins (18.8%) and muscle cramps (14.6%). Of the patients with RLS 53.4% had already consulted their physician about their leg problems in the past. Still, only 20.1% of the RLS patients had received the correct diagnosis. Comorbidity rates were significantly increased in RLS patients compared to patients suffering from leg symptoms of other origin. Conclusions This study showed a high prevalence of RLS in primary care patients with unpleasant sensations in the legs. Thus, in patients presenting with these symptoms the diagnosis of RLS should routinely be considered.

099 IMPROVEMENT OF RESTLESS LEGS SYNDROME AFTER RENAL TRANSPLANTATION IN CHILEAN PATIENTS WITH CHRONIC RENAL FAILURE

Introduction: Restless legs syndrome (RLS) is a common cause of sleep disturbance that is frequently experienced by patients on dialysis suffering from chronic renal failure (CRF). Previous studies have described a reduction in RLS symptomatology after successful renal transplantation. However, the underlyingmechanism is not fully understood, and there are no local studies regarding this subject. Objective: This study aimed to evaluate the prevalence of RLS in patients with CRF on dialysis, to assess the improvement of symptoms after renal transplantation and to analyze laboratory parameters related to changes in symptomatology. Methods: We conducted a retrospective study on patients suffering from CRF on dialysis who were subjected to renal transplantation procedures. A standardized survey was applied for RLS diagnosis, according to the International RLS Study Group criteria, and the severity of the symptoms was evaluated before and after transplantation by use of ad-hoc intensity measurement scores. Multiple laboratory parameters were evaluated preand post-transplantation. Results: A total of 58 patients subjected to renal transplantation were evaluated, with an average age of 44 years (range, 18-72 years), of which 30 were males and 28 were females. Of these patients, 16 (28%), 5 females and 11 males with an average age of 45 years (range, 24-69 years), met the diagnostic criteria for RLS. The RLS mean severity score pre-transplantation was 23.7 (10-35) and 1.4 after transplantation (0-7) (p<0.001). Of the RLS group, 75% presented complete remission of symptoms after transplantation, and 25% (4/16) showed significant improvement. The average time in which this improvement was observed was 5.4 weeks. This reduction in symptomatology was related to an improvement in serum phosphate level and renal function (p<0.001); improvement was also seen for hematocrit and parathyroid hormone (PTH) levels (p<0.002 and p<0.05, respectively). Conclusions: Patients suffering from CRF treated with dialysis have a high prevalence of RLS. Patients with CRF and RLS subjected to renal transplantation showed a significant reduction of their symptomatology (100% in our series), and in most of the cases, complete recovery was observed. Similar to results described in international reports, this improvement after transplantationwas associatedwith an improvement in hematocrit, renal function and serum levels of phosphate and PTH. Nevertheless, the specific biological process underlying this improvement is still not fully understood.

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.