Elias Karroum

Publications (3)11.31 Total impact

• Article: Restless legs syndrome, rapid eye movement sleep behavior disorder, and hypersomnia in patients with two parkin mutations.

  Nadège Limousin, Eric Konofal, Elias Karroum, Ebba Lohmann, Ioannis Theodorou, Alexandra Dürr, Isabelle Arnulf
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  ABSTRACT: Parkin gene mutations cause a juvenile parkinsonism. Patients with these mutations may commonly exhibit REM sleep behaviour disorders, but other sleep problems (insomnia, sleepiness, restless legs syndrome) have not been studied. The aim of this study was to evaluate the sleep-wake phenotype in patients with two parkin mutations, compared with patients with idiopathic Parkinson's disease (iPD). Sleep interview and overnight video-polysomnography, followed by multiple sleep latency tests, were assessed in 11 consecutive patients with two parkin mutations (aged 35-60 years, from seven families) and 11 sex-matched patients with iPD (aged 51-65 years). Sleep complaints in the parkin group included insomnia (73% patients versus 45% in the iPD group), restless legs syndrome (45%, versus none in the iPD group, P = 0.04), and daytime sleepiness (45%, versus 54% in the iPD group). Of the parkin patients, 45% had REM sleep without atonia, but only 9% had a definite REM sleep behavior disorder. All sleep measures were similar in the parkin and iPD groups. Two parkin siblings had a central hypersomnia, characterized by mean daytime sleep latencies of 3 min, no sleep onset REM periods, and normal nighttime sleep. Although the patients with two parkin mutations were young, their sleep phenotype paralleled the clinical and polygraphic sleep recording abnormalities reported in iPD, except that restless legs syndrome was more prevalent and secondary narcolepsy was absent.
  Movement Disorders 09/2009; 24(13):1970-6. · 4.51 Impact Factor
• Article: Dopamine dysregulation syndrome in a patient with restless legs syndrome.

  Smaranda Leu-Semenescu, Elias Karroum, Agnès Brion, Eric Konofal, Isabelle Arnulf
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  ABSTRACT: A middle-aged architect, suffering from familial, idiopathic, levodopa-responsive restless legs syndrome (RLS) progressively abused levodopa for 10 years, to the point of taking 20 tablets/day (4000 mg/day) for 6 months. Such abuse (possibly linked to the rewarding effect of dopamine) has been recently monitored in the context of Parkinson's disease (PD) (the "dopamine dysregulation syndrome"). Physicians who now routinely treat RLS patients with dopaminergic agents should be aware of this abuse potential. This case also constitutes an experimental model. As levodopa abuse has only been described in patients with PD, it was suspected to be promoted by central dopamine depletion (with consequent sensitization of dopamine receptors). This idea should be revised because functional imaging showed that this RLS patient had no dopamine depletion. Later, he had no impulse disorders (no gambling, hypersexuality, excessive shopping), which occur with dopamine agonists, suggesting that levodopa abuse and impulse disorders can result through different mechanisms.
  Sleep Medicine 05/2009; 10(4):494-6. · 3.40 Impact Factor
• Article: Two early descriptions of restless legs syndrome and periodic leg movements by Boissier de Sauvages (1763) and Gilles de la Tourette (1898).

  Eric Konofal, Elias Karroum, Jacques Montplaisir, Jean-Philippe Derenne, Isabelle Arnulf
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  ABSTRACT: Boissier de Sauvages de La Croix and Gilles de la Tourette, French neurologists, noticed that patients with "anxiety in the lower limbs, shooting pain, tingling legs" may have an insomnia "at the time of wake-sleep transition [and] experience sudden jerks in the lower limbs." Their descriptions confirm that the clinical features of RLS were previously described in French literature in the 18th century.
  Sleep Medicine 09/2008; 10(5):586-91. · 3.40 Impact Factor