Restless Legs Syndrome in Multiple Sclerosis

Department of Neurology, Tokat, Turkey.
European Neurology (Impact Factor: 1.36). 01/2011; 65(5):302-6. DOI: 10.1159/000327315
Source: PubMed

ABSTRACT Multiple sclerosis (MS) is a demyelinating neurodegenerative inflammatory autoimmune disease. Restless legs syndrome (RLS) is characterized as a strong urge to move the legs to stop abnormal sensations there. In this study, we aimed to investigate whether or not the increased RLS frequency seen in MS could be associated with depression and fatigue.
The study involved 98 patients with definite MS and 129 healthy volunteers. The Beck Depression Inventory and Fatigue Severity Scale were used to assess all participants. The patients and the healthy volunteers were examined for RLS according to the criteria of the International Restless Legs Syndrome Study Group.
When the factors related to RLS in MS were evaluated, there were significant relationships found among age, type of MS, pyramidal symptoms, intestinal and bladder symptoms, number of lesions in MR, depression, and fatigue. Risk factors for RLS were also seen more frequently in the MS group than in the healthy volunteers.
RLS was seen 2.55 times more frequently in patients with MS than in the control group. This was due to the existence of numerous factors rather than a single factor - including depression and fatigue.

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    ABSTRACT: Abstract Objective: This narrative review describes the differential diagnosis of restless legs syndrome, and provides an overview of the evidence for the associations between RLS and potential comorbidities. Secondary causes of RLS and the characteristics of pediatric RLS are also discussed. Finally, management strategies for RLS are summarized. Methods: The review began with a comprehensive PubMed search for "restless legs syndrome/Willis-Ekbom disease" in combination with the following: anxiety, arthritis, attention-deficit hyperactivity disorder, cardiac, cardiovascular disease, comorbidities, depression, end-stage renal disease, erectile dysfunction, fibromyalgia, insomnia, kidney disease, liver disease, migraine, mood disorder, multiple sclerosis, narcolepsy, neuropathy, obesity, pain, Parkinson's disease, polyneuropathy, pregnancy, psychiatric disorder, sleep disorder, somatoform pain disorder, and uremia. Additional papers were identified by reviewing the reference lists of retrieved publications. Results and Conclusions: Although clinical diagnosis of RLS can be straightforward, diagnostic challenges may arise when patients present with comorbid conditions. Comorbidities of RLS include insomnia, depressive and anxiety disorders, and pain disorders. Differential diagnosis is particularly important, as some of the medications used to treat insomnia and depression may exacerbate RLS symptoms. Appropriate diagnosis and management of RLS symptoms may benefit patient well-being and, in some cases, may lessen comorbid disease burden. Therefore, it is important that physicians are aware of the presence of RLS when treating patients with conditions that commonly co-occur with the disorder.
    Current Medical Research and Opinion 05/2014; DOI:10.1185/03007995.2014.918029 · 2.37 Impact Factor
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    ABSTRACT: Restless legs syndrome (RLS) is a sleep-related sensory-motor disorder characterized by an irresistible urge to move the legs accompanied by unpleasant sensations in the lower extremities. According to many recent studies patients with multiple sclerosis (MS) suffer frequently from symptoms of RLS. The prevalence of RLS in MS patients varies 13.3%-65.1%, which is higher than the prevalence of RLS in people of the same age in the general population. MS patients with RLS have higher scores in the Expanded Disability Status Scale compared to MS patients without RLS. Presence of RLS has a negative impact on sleep quality and fatigue of MS patients. Iron deficiency and chronic inflammation may be factors contributing to development of RLS in MS. The relationship between the course and treatment of MS and RLS requires further prospective studies. Copyright © 2014 Elsevier Ltd. All rights reserved.
    Sleep Medicine Reviews 10/2014; DOI:10.1016/j.smrv.2014.10.002 · 9.14 Impact Factor
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    ABSTRACT: Objective: to determine the prevalence of Restless leg syndrome (RLS) in a cohort of patients with demyelinating neuropathies. Methods: patients were retrospectively recruited from our cohort of different forms of demyelinating neuropathies, including chronic inflammatory demyelinating neuropathy (CIDP), Charcot-Marie-Tooth 1A (CMT1A) and Hereditary Neuropathy with Liability to Pressure Palsies (HNPP) referred to our Department of Neurology in a ten years period. The validated four-item RLS criteria was used for diagnosis of RLS. All patients with RLS that fulfilled criteria underwent a suggested immobilization test to confirm the diagnosis. A group of out-patients referring to the sleep disorders unit and the literature data were used as controls. Results: prevalence of RLS in demyelinating neuropathy group resulted higher than prevalence observed in control population (p = 0.0142) or in the literature data (p= 0.0007). In particular, in both comparison with control population and literature data, prevalence of RLS resulted higher in CIDP group (p= 0.0266 and p=0.0063, respectively) and in CMT1A group (p= 0.0312 and p=0.0105, respectively) but not in HNPP (p = 1.000 and p = 0.9320, respectively). Conclusions: our study confirms a high prevalence of RLS in inflammatory neuropathies as CIDP and, among inherited neuropathies, in CMT1A but not in HNPP. Considering that this is only a small cohort from a single-centre, retrospective experience, the link between RLS and neuropathy remains uncertain, and larger multicentre studies are probably needed to clarify the real meaning of the association between RLS and neuropathy.

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