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Prevalence of neurological symptoms associated with fibromyalgia

Revista de la Sociedad Espanola del Dolor 2009年第4期16卷 222-229页

作者： Gómez-Argüelles, J.M. Anciones, B. Servicio de Neurología Sanatorio Nuestra Señora Del Rosario Madrid Spain

Introduction: Fibromyalgia can be considered a syndrome. The most frequent symptom and, in fact, the only diagnostic criterion is pain. Nevertheless, as a syndromic picture, fibromyalgia includes many other symptoms and igns, which are equally important and possibly sometimes as disabling as pain. Among all of these symptoms and signs, those related to the neurological sphere may be fundamental to understanding patients general state. Material and methods: We designed and performed a survey of patients with a prior diagnosis of fibromyalgia with specific items on neuropsychological signs or symptoms associated with this disease, as well as the possibility of receiving treatment for these manifestations. In addition, we enquired about the possible triggering factors of the disease, and the patients opinion on the possible cause of the fibromyalgia. Results: One hundred surveys were completed. A high percentage of the symptoms were related to the nervous system and, at the time of the survey, these symptoms were reported by over 50% of the patients. Almost two-thirds of the patients related the onset of their disease with a stress or triggering actor. On the cause of the fibromyalgia, the most frequent response was that the fibromyalgia was of unknown cause, ollowed by a possible rheumatologic origin, and thirdly, of a neurological origin. Conclusions: Patients with fibromyalgia reported a high frequency of associated neurological symptoms. Consequently, all clinicians involved in the study and treatment of fibromyalgia should bear in mind the role of neurological symptoms in this syndrome. © 2009 Elsevier Espãa S.L.

关键词： Bruxism Contractures Fatigue Fibromyalgia Headache Insomnia Pain Parestesia restless legs Temporomandibular dysfunction

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Treatment of Persistent Posttraumatic Headache with the Anti-CGRP Receptor Antibody Erenumab: a Case Report

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SN Comprehensive Clinical Medicine 2023年第1期5卷 1-5页

作者： Papenhoff, Mike Dudda, Marcel BG Klinikum Duisburg University of Duisburg-Essen Duisburg Germany University Hospital Essen University of Duisburg-Essen Essen Germany

Calcitonin gene-related peptide (CGRP) has only recently emerged as a potential target in posttraumatic headache. To our knowledge, this is the first description of a patient with persistent posttraumatic headache following severe traumatic head injury who has been treated with the CGRP receptor monoclonal antibody erenumab. A 56-year-old man presented with a 30-year history of frequent migraine-like posttraumatic headaches following a high-voltage head injury that he treated with an excessive intake of peripheral analgesics. Although amitriptyline was reasonably effective, it had to be discontinued when the patient developed restless legs syndrome in the second year of treatment. Under therapy with erenumab, he achieved a rapid and stable reduction in his symptoms down to only 2–3 headache days per month without adverse events. This case demonstrates that the inhibition of the CGRP-receptor with erenumab could be an effective treatment option in migraine-like posttraumatic headache even decades after the traumatic event.

关键词： Migraine-like posttraumatic headache CGRP Erenumab Amitriptyline restless legs Medication overuse Case report

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Evaluating the effects of medical disorders on sleep in the older patient

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GERIATRICS-US 2004年第3期59卷 37-42页

作者： Quan, SF Zee, P Univ Arizona Coll Med Sleep Disorders Ctr Tucson AZ 85721 USA Northwestern Univ Sch Med Chicago IL 60611 USA

Older adults often experience sleep disturbances, but most fall to mention these sleep problems to their physicians out of a false belief that sleep troubles are just a consequence of getting older. On the contrary, sleep complaints in older adults are often the result of medical or psychiatric illnesses that can be managed, resulting in a return to restful sleep. It is important for physicians and patients to communicate about sleep disturbances, and for physicians to ask appropriate questions targeted at identifying the underlying cause of the sleep problem, particularly in patients with chronic medical, conditions.

关键词： sleep review of systems insomnia apnea restless legs

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Ten-year natural course of habitual snoring and restless legs syndrome in a population aged 61-63 years at the baseline

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SLEEP AND BREATHING 2012年第3期16卷 639-648页

作者： Juuti, Anna-Kaisa Hiltunen, Liisa Rajala, Ulla Laakso, Mauri Harkonen, Pirjo Keinanen-Kiukaanniemi, Sirkka Laara, Esa Univ Oulu Inst Hlth Sci Oulu 90014 Finland Vaasa Hlth Care Dist Vaasa 65130 Finland Oulu Univ Hosp Unit Gen Practice Oulu 90221 Finland Hlth Ctr Oulu Oulu 90015 Finland Oulu Deaconess Inst Dept Sports Med Oulu 90100 Finland Univ Oulu Dept Math Sci Oulu 90014 Finland

We investigated the prevalence, natural course, and associated risk factors of habitual snoring (HS) and restless legs syndrome (RLS) over a period of 10 years among an aging population from their early sixties to their seventies. A population-based follow-up study among all persons born in 1935 and living in the city of Oulu in northern Finland was conducted. In this study, we examined subjects who had participated in two subsequent surveys conducted in 1996-1998 and 2007-2008. The data were gathered by questionnaires, as well as by laboratory and clinical measurements. Altogether 457 (55%) of the 838 eligible subjects participated in both surveys. The prevalence of both RLS and HS decreased during the 10 years from 21% to 15% and from 26% to 19%, respectively. Half of those who snored in 1996-1998 stopped snoring in 10 years time, and half of those who suffered from restless legs at least three times per week in 1996-1998 suffered from this syndrome never or less than once a week in 2007-2008. The 10-year incidence of new cases of both HS and RLS was 7%. Male gender predicted best the incidence of new HS in 10 years, while the Zung sum score as a marker of depressive symptoms and waist circumference predicted RLS. Overall, the prevalence of both HS and RLS seems to diminish during aging. The causes behind this still remain unknown and should be investigated with more sophisticated methods.

关键词： Habitual snoring restless legs Depressive symptoms Waist circumference Male gender Longitudinal study

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restless legs syndrome (letter)

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Neurology: Official Journal of the American Academy of Neurology 1999年第2期53卷 439-440页

作者： Galvez Jimenez-N Khan T Hanson M

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restless legs symptoms among incident dialysis patients: Association with lower quality of life and shorter survival

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AMERICAN JOURNAL OF KIDNEY DISEASES 2004年第5期43卷 900-909页

作者： Unruh, ML Levey, AS D'Ambrosio, C Fink, NE Powel, NR Meyer, KB Univ Pittsburgh Med Ctr Renal Electrolyte Div Pittsburgh PA 15261 USA Tufts New England Med Ctr Div Nephrol Boston MA USA Tufts New England Med Ctr Div Pulmonol Boston MA USA Johns Hopkins Univ Baltimore MD USA

Background Symptoms of restless legs are common among patients treated with long-term hemodialysis. We investigated the relation between symptoms of restless legs, quality of life, and survival among incident hemodialysis and peritoneal dialysis patients. Methods: This report includes 894 dialysis patients who responded to an item regarding severity of restless legs symptoms in the Choices for Healthy Outcomes in Caring for End-Stage Renal Disease Study. We examined participant responses both as categorized by the 5-point symptoms of restless legs item and classified with severe symptoms of restless legs if they reported they were very or extremely bothered by symptoms. Independent predictors of restless legs symptoms were estimated using logistic regression. The association of restless legs symptoms with quality of life was examined by means of mixed-model regression, and adjusted mortality risk was estimated by means of Cox proportional hazards. Results: Fifteen percent of dialysis patients were classified as having severe restless legs. Those characterized by severe restless legs were significantly more likely to be administered benzodiazepines, antidepressants, and antiepileptics. Age and diabetes mellitus were independently associated with severe symptoms of restless legs. Symptoms of restless legs were associated with lower Physical and Mental Component Scores, vitality, bodily pain, and sleep quality (all Prestless legs were significantly associated with an increased mortality hazard ratio of 1.39 (95% confidence interval, 1.08 to 1.79). Conclusion: Symptoms of restless legs were associated with lower quality of life and increased risk for death. The effect of treatment for symptoms of restless legs on quality of life and survival awaits additional study.

关键词： restless legs dialysis health-related quality of life (HRQOL)

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Current guidelines and standards of practice for restless legs syndrome

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AMERICAN JOURNAL OF MEDICINE 2007年第1A期120卷 22-27页

作者： Hening, Wayne A. Univ Med & Dent New Jersey Robert Wood Johnson Med Sch Dept Neurol New Brunswick NJ 08903 USA

Algorithms for treatment of restless legs syndrome (RLS) include both nonpharmacologic and pharmacologic therapy. Patients with RLS are divided into 3 groups: (1) those with intermittent RLS symptoms;(2) those with daily RLS symptoms;and (3) those whose symptoms are refractory to standard treatments. Many patients do not require medication, and symptoms often can be relieved with good sleep hygiene and avoidance of medications and factors that provoke symptoms. Recent large-scale clinical trials have proved the efficacy of therapy for RLS when it is required. Several classes of medications are helpful, but dopaminergic therapy appears to be most effective and relieves symptoms rapidly. The first step in managing RLS is to ensure that there is an adequate diagnosis;this involves discriminating RLS from other conditions that may share a number of features. Finally, it is important to tailor treatment to the needs of each individual patient. (c) 2007 Elsevier Inc. All rights reserved.

关键词： anticonvulsants dopaminergics opioids restless legs sedative-hypnotics treatment

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Clinical Sleep-Wake Disorders I: Focus on Hypersomnias and Movement Disorders During Sleep

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Handbook of experimental pharmacology 2019年 253卷 245-259页

作者： Christian R Baumann Department of Neurology University Hospital Zurich University of Zurich Zürich Switzerland. christian.baumann@usz.ch.

Central disorders of hypersomnolence are characterized by daily periods of irrepressible need to sleep or daytime lapses into sleep, as defined in the current version of the International Criteria of Sleep Disorders. Thus, the unifying symptom is excessive daytime sleepiness which is not caused by any other sleep-wake disorder. Relevant disorders including narcolepsy type 1 and 2, idiopathic hypersomnia, Kleine-Levin syndrome, and insufficient sleep syndrome will be discussed. Other central disorders of hypersomnolence include hypersomnias due to medical or psychiatric disorders or because of medication or substance *** sleep-related movement disorders, the cardinal symptom consists of simple, often stereotyped movements occurring during sleep. The most frequent disorder in this category of sleep-wake disorders is restless legs syndrome, which is often associated with period limb movements during sleep.

关键词： Excessive daytime sleepiness Hypersomnia Multiple sleep latency test Narcolepsy Polysomnography restless legs

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Evaluating the effects of medical disorders on sleep in the older patient

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Geriatrics 2004年第3期59卷 37-42+45页

作者： Quan, Stuart F. Zee, Phyllis Dept. Med. Anesthesiol./Pub. Hlth. Sleep Disorders Center Univ. of Arizona College of Medicine Tucson AZ United States Dept. Neurol. Neurobiol./Physiol. Sleep Disorders Center NW University Medical School Chicago IL United States

关键词： Apnea Insomia restless legs Sleep review of systems

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DOPAMINERGIC AGENTS IN restless legs SYNDROME AND PERIODIC LIMB MOVEMENTS OF SLEEP - RESPONSE AND COMPLICATIONS OF EXTENDED TREATMENT IN 49 CASES

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SLEEP 1993年第8期16卷 713-716页

作者： BECKER, PM JAMIESON, AO BROWN, WD UNIV TEXAS SW MED CTRDEPT PSYCHIATDALLASTX

restless legs syndrome (RLS) is a common neurosensorimotor disorder that presents with paresthesias, sleep disturbances and, in most cases, periodic limb movements of sleep (PLMS). Although many treatments have been described, interest has recently been focused on dopaminergic mechanisms of etiology and treatment. The dopamine agonists L-dopa/carbidopa, bromocriptine mesylate or both were initiated in 49 patients with RLS/PLMS who sought consultation at a sleep disorders center. This retrospective study describes the symptoms, time course of response and complications in 36 men and 13 women with a mean age of 53.9 years. Only 47 of the patients were available for extended follow-up. The most common presenting complaints were the sensation of restless legs and sleep maintenance insomnia lasting over 20 years. In the extended follow-up group of 47, four failed to respond to L-dopa or bromocriptine, five discontinued treatment because of side effects and two reported loss of therapeutic effect within the first month. Between month one and six, only three additional subjects discontinued treatment. At a mean follow-up of 283 days (SD 316), 33 patients continued on L-dopa/carbidopa at a mean bedtime dose of 160 mg L-dopa (SD 300). Treatment-emergent morning leg restlessness developed in eight patients, seven of whom required daytime medication for relief. Other side effects, generally nausea, occurred in only eight of 43 patients. Psychiatric side effects of dyskinesia were not seen. The >70% long-term response is comparable to other studies in the literature.

关键词： restless legs MYOCLONUS L-DOPA BROMOCRIPTINE DOPAMINE

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