Restless arm syndrome: a rare disease?

2021 ◽  
Vol 14 (9) ◽  
pp. e244890
Author(s):  
Ulrich Moser ◽  
Jasmin Schwab

Restless legs syndrome (RLS) is a common neurological disorder characterised by an irresistible urge to move the lower limbs, often accompanied by unpleasant sensations in the legs, typically occurring in the evening and at night and improving with movement. Restless arms syndrome (RAS) predominantly affects the arms, while the legs are rarely affected. RAS appears to be very rare, with very few cases described to date, but the diagnosis of RAS is probably made too infrequently, especially for milder and transient forms. The patient reported here even had severe symptoms for years that could have indicated RAS. He observed an immediate improvement in all RAS-related symptoms after administration of 100 mg L-dopa +25 mg benserazide, which continues to this day. Clinicians should always be alert for RLS-like symptoms in one or both arms that worsen at rest and improve with movement, thinking of possible RAS.

Circulation ◽  
2015 ◽  
Vol 131 (suppl_1) ◽  
Author(s):  
Karen Jacobo ◽  
Adriana Monge ◽  
Eduardo Ortiz-Panozo ◽  
Elsa Yunes ◽  
Andres Catzin-Khulmann ◽  
...  

Introduction: Restless legs syndrome (RLS) is a common chronic disorder characterized by an irresistible need to move the lower limbs that is usually worse in the evening and is associated with sleep disturbances. RLS has been associated with hypertension and has been proposed as a marker for increased cardiovascular risk. Hypothesis: Individuals with RLS have an increased common carotid intima-media thickness (cIMT) relative to individuals without RLS. Methods: We evaluated cross-sectional relation of RLS and cIMT in 1,147 disease-free Mexican women of the Mexican Teachers’ Cohort. In 2011, participants responded to a follow-up questionnaire that included standardized questions addressing the four minimal diagnostic criteria of the International Restless Legs Study Group. Participants were asked: “Do you have unpleasant leg sensations (like crawling, loss of sensation or pain) combined with restlessness and an urge to move your legs?”, “Do these symptoms occur only at rest?”, “Does moving improve these symptoms?”, “Are these symptoms worse in the evening or at night compared with the morning?” Women who answered yes to all the four questions were defined as having RLS. Between 2012 and 2013, a subsample of participants were invited for a clinical visit where neurologists assessed cIMT with an ultrasound. cIMT measurements were found to be reproducible in a substudy in 52 participants (intra-class correlation=0.89). We defined subclinical atherosclerosis as a cIMT ≥0.8 mm or the presence of plaque. Results: Among women with a mean age of 48.2 (SD±4.3), the prevalence of RLS was 14.2% (cases, 163). The age-adjusted mean difference of cIMT comparing participants with RLS to those without RLS was 0.009mm (95%CI -0.004 to 0.023). After further adjustment for diabetes, hypercholesterolemia, migraine, oral contraceptive use, menopause, smoking, body mass index, physical activity and alcohol, the mean difference of cIMT comparing participants with and without RLS was not statistically different (0.007mm; 95%CI -0.007 to 0.021). The prevalence of subclinical atherosclerosis was 27% (n=44) in those with RLS and 21.9% (n=215) in those without RLS. The age-adjusted OR comparing women with RLS to those without RLS was 1.23 (95%CI 0.83-1.82). In the multivariable model the OR remained non-significant (1.16, 95%CI 0.77-1.74). Conclusions: In this cross-sectional study in middle-aged women, RLS was not associated to cIMT. Our results do not support the observation that individuals with RLS are at an increased risk for cardiovascular disease.


2021 ◽  
Vol 46 (2) ◽  
pp. 159-170
Author(s):  
Shensen Li ◽  
Qingqing Liu ◽  
Shen Zhang ◽  
Meiling Zhu ◽  
Yun Hu ◽  
...  

BACKGROUND: Restless legs syndrome (RLS) is a common complication in maintenance hemodialysis (MHD) patients. Current study was conducted to analysis the effectiveness and safety of electroacupuncture on 3 acupuncture points from lower limb meridians in the treatment of RLS.<br/> METHODS: A total of 7 MHD patients (5 Male and 2 Female) in our center with severe RLS symptom were enrolled. After one month of pharmacological washout period, patients received 12 sessions of electroacupuncture on three acupoints (Zusanli (ST36), Sanyinjiao (SP6) and Taichong (LR-3)) during HD. Severity of RLS symptoms and the sleep quality were evaluated by IRLSSG and ISI scores for 3 times (before, after and 1 month later of the electroacupuncture treatment).<br/> RESULTS: The average age of enrolled patients was 52.6±8.9 years, with median dialysis duration of 3.0 years. The hemoglobin level was 125.9±22.9 g/l. The IRLSSG score was significantly lower after electroacupuncture treatment (9.4±3.9) than that before treatment (17.3±4.7) (P <0.01). Both overall severity of RLS symptom average daily severity and frequency were significantly improved after electroacupuncture. It is also validated that the electroacupuncture treatment was contributed to sleep improvement in RLS patients after electroacupuncture treatment was discontinued for one month.<br/> CONCLUSION: Electroacupuncture on three lower limbs acupoints during MHD was as a safe and effective treatment for attenuating the symptoms of RLS and improvement of sleep quality in hemodialysis patients, and the therapeutic effect maintain for at least one month.


2012 ◽  
Vol 28 (2) ◽  
pp. 165-170 ◽  
Author(s):  
Giuseppina Talarico ◽  
M. Canevelli ◽  
G. Tosto ◽  
N. Vanacore ◽  
F. Letteri ◽  
...  

Background: Restless legs syndrome (RLS) is a neurological disorder characterized by the urge to move the legs associated with peculiar unpleasant sensations during periods of rest and inactivity that are relieved by movement. A few studies analyzed RLS in neurodegenerative diseases such as Alzheimer's Disease (AD). The aim of our study was to assess the prevalence and the clinical characteristics of RLS in a cohort of AD patients. Methods: Three hundred and thirty-nine subjects with a diagnosis of AD were recruited. Cognitive, functional, and neuropsychiatric measures were collected at baseline and six-monthly for a 2-years follow-up Results: Fourteen subjects met the RLS criteria. RLS subjects were more frequently male (p:0,006) and younger than AD subject without RLS (p:0,029). MMSE, ADL and IADL were not significantly different. NPI total scores did not differ significantly, however, AD patients with RLS were found to be more apathetic (p:0,001) than AD subjects without RLS. Conclusion: RLS prevalence in our AD cohort was estimated to be about 4%. RLS appeared to be associated with neuropsychiatric symptoms such as apathy. RLS and apathy might share a common pathophysiological basis represented by a dysfunction of the central dopaminergic system


2014 ◽  
Vol 8 (1) ◽  
pp. 19-23
Author(s):  
Isabella Righini ◽  
Livia Pasquali ◽  
Ilaria Calabrese ◽  
Alfonso Iudice

We report the case of a 83-year-old woman suffering from Restless Legs Syndrome since 2002 and Multiple Sclerosis since 2007. She had been diagnosed as Restless Legs Syndrome five years before multiple sclerosis, with the support of a polysomnographic examination. The clinical diagnosis of multiple sclerosis took place at the age of 75, when she complained of walking difficulties and abnormal sensitivity in lower limbs, especially in the evening. Associated symptoms included dysesthesias on the left leg and arm and left emitrunk, visual acuity reduction, blurred vision and fatigue. The brain magnetic resonance showed multiple lesions in white matter, inconsistent with a vascular disease but suggestive for a demyelinating disease. She was admitted at the hospital, where the spinal fluid examination and a second magnetic resonance confirmed the diagnosis. Since that, the patient regularly performed medical examinations and magnetic resonance controls which didn't show any increase of lesions burden nor pathological enhancement, but a slow worsening of ambulation. Due to the patient’s age, a disease modifying therapy for multiple sclerosis was not established, the only drugs being represented by symptomatic agents.


2021 ◽  
Author(s):  
Julia New-Tolley ◽  
Amy Reynolds ◽  
Sarah Appleton ◽  
Tiffany Gill ◽  
Susan Lester ◽  
...  

Abstract BACKGROUND: The aims of our study were two-fold. Firstly, to determine if there is an association between gout and OSA in a representative Australian adult population. Secondly, to explore associations between gout and patient reported sleep outcomes. METHODS: A cross-sectional national online survey of a representative sample of Australian adults > 18 years assessed self-reported doctor-diagnosed OSA, insomnia and patient reported sleep outcomes. Possible undiagnosed OSA was estimated using self-reported frequent loud snoring and witnessed apnoeas. Participants self-reported physician-diagnosed gout and other health conditions. Multivariable logistic regression analyses were performed for both objectives. Odds ratios with 95% confidence intervals were reported.RESULTS: There were 1948 participants of whom 126 (6.5%) had gout and 124 (6.4%) had diagnosed sleep apnoea. After adjusting for age, body mass index (BMI), sex, alcohol intake and the presence of arthritis, those with obstructive sleep apnoea diagnosed on polysomnography were twice as likely to report having gout compared to those without. (OR=2.6, 95% CI 1.5 - 4.6). Additionally, participants with symptoms suggestive of sleep apnoea were also twice as likely to have gout compared to those without (OR=2.8, 95%CI 1.6 - 5.1). There was also a higher likelihood of restless legs syndrome, insomnia and worry about sleep in patients with gout. CONCLUSION: Diagnosed and suspected OSA are associated with higher likelihood of gout. Participants with gout are also more likely to report suffering from restless legs syndrome, insomnia and worry about their sleep. Given the morbidity associated with sleep problems, we should be vigilant regarding sleep health in our patients with gout.


2022 ◽  
Vol 12 (1) ◽  
pp. 118
Author(s):  
Elena Antelmi ◽  
Lorenzo Rocchi ◽  
Anna Latorre ◽  
Daniele Belvisi ◽  
Francesca Magrinelli ◽  
...  

Although restless legs syndrome (RLS) is a common neurological disorder, it remains poorly understood from both clinical and pathophysiological perspectives. RLS is classified among sleep-related movement disorders, namely, conditions characterized by simple, often stereotyped movements occurring during sleep. However, several clinical, neurophysiological and neuroimaging observations question this view. The aim of the present review is to summarize and query some of the current concepts (known knowns) and to identify open questions (known unknowns) on RLS pathophysiology. Based on several lines of evidence, we propose that RLS should be viewed as a disorder of sensorimotor interaction with a typical circadian pattern of occurrence, possibly arising from neurochemical dysfunction and abnormal excitability in different brain structures.


Phlebologie ◽  
2014 ◽  
Vol 43 (06) ◽  
pp. 309-311
Author(s):  
P. Dziunycz ◽  
A.L. Frauchiger ◽  
N. Gräni ◽  
F. Kaufmann ◽  
N. Jaberg-Bentele ◽  
...  

SummaryRestless legs syndrome (RLS) is characterised by an uncontrollable urge to move, in particular the lower limbs, often accompanied by discomfort or a painful sensation that occurs typically at night. It is categorized under the ICD-Classification of extrapyramidal and movement disorders. As patients often suffer from insomnia due to the involuntary nocturnal leg movements and irritable sensations in the legs, RLS is also classified as a sleep-related movement disorder. The incidence of a mild form of RLS is frequent, although it often remains undiagnosed.After the exclusion of other diseases by differential diagnosis, RLS is diagnosed on the basis of a clinical test administering a single dose of levodopa. There are two forms of RLS: idiopathic and secondary. The secondary form is encountered in an astonishing number of diseases, including renal insufficiency, diabetes, chronic obstructive pulmonary disease (COPD) and iron deficiency. The treatment of RLS is complex and the benefits and risks of pharmacotherapy should be considered carefully. Non-ergoline dopamine agonists (e.g. ropinirole, pramipexole) are the first-line treatment in severe cases of RLS. Transdermal rotigotine is also a promising treatment option. Opioids in combination with naloxone are recommended for patients suffering from severe pain. In mild cases of RLS, patients benefit from a balanced lifestyle with gentle physical activity and avoiding the excessive consumption of caffeine or alcohol.


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