CASE REPORT
A patient with insomnia due to restless leg and periodic limb movement syndrome after stroke–A clinical case
More details
Hide details
1
Department of Optometry and Occupational Diseases, Faculty of Public Health, Medical University “Prof Paraskev Stoyanov”–Varna, Varna, BULGARIA
2
Department of Neurological Diseases and Neuroscience, Faculty of Medicine, Medical University “Prof Paraskev Stoyanov”–Varna, Varna, BULGARIA
Online publication date: 2023-01-01
Publication date: 2023-03-01
Electron J Gen Med 2023;20(2):em445
KEYWORDS
ABSTRACT
Restless legs syndrome (or Willis-Ekbom) presents with an overwhelming need for movement of the lower limbs in order to eliminate the unpleasant sensations in them, which appear during rest and sleep. The unpleasant sensations are described as “tingling, pulling or pain” in the knees, ankles, or through the entire lower limbs. Periodic limb movement syndrome presents with involuntary movements of the lower limbs or the body during sleep, for which the patient has no recollection, unlike in those in restless leg syndrome. In most cases they present with four or more successive movements of dorsal flection of the toes and ancles with partial flection of the knees and hips divided into five to 90 second intervals.
A 44-year-old man, a taxi driver, is admitted in a neurological clinic with complaints of a headache, dizziness, exhaustion, which he associates with difficulty falling asleep and maintaining a sleeping state after an ischemic stroke in the right middle cerebral artery four months earlier. The conducted polysomnography reveals an increased sleep latency, periodic limb movement syndrome and multiple arousals before entering REM sleep.
REFERENCES (12)
2.
Mansur A, Castillo PR, Cabrero FR, Bokhari SRA. Restless legs syndrome. Treasure Island, FL: StatPearls Publishing; 2022.
3.
Guo S, Huang J, Jiang H, et al. Restless legs syndrome: From pathophysiology to clinical diagnosis and management. Front Aging Neurosci. 2017;9: 171.
https://doi.org/10.3389/fnagi.... PMid:28626420 PMCid:PMC5454050.
4.
Koo BB, Bagai K, Walters AS. Restless legs syndrome: Current concepts about disease pathophysiology. Tremor Other Hyperkinet Mov (N Y). 2016;6:401.
https://doi.org/10.5334/tohm.3... PMid:27536462.
5.
Joseph V, Nagalli S. Periodic limb movement disorder. Treasure Island, FL: StatPearls Publishing; 2022.
6.
Sieminski M, Pyrzowski J, Partinen M. Periodic limb movements in sleep are followed by increases in EEG activity, blood pressure, and heart rate during sleep. Sleep Breath. 2017;21(2):497-503.
https://doi.org/10.1007/s11325... PMid:28190164 PMCid:PMC5399045.
7.
Tüchsen F, Hannerz H, Roepstorff C, Krause N. Stroke among male professional drivers in Denmark, 1994-2003. Occup Environ Med. 2006; 63(7):456-60.
https://doi.org/10.1136/oem.20... PMCid:PMC2092514.
8.
Lemke MK, Apostolopoulos Y, Hege A, Wideman L, Sonmez S. Work, sleep, and cholesterol levels of U.S. long–haul truck drivers. Ind Health. 2017;55(2):149-61.
https://doi.org/10.2486/indhea... PMid:28049935 PMCid:PMC5383412.
9.
Brown DL, Feskanich D, Sánchez BN, Rexrode KM, Schernhammer ES, Lisabeth LD. Rotating night shift work and the risk of ischemic stroke. Am J Epidemiol. 2009; 169(11):1370-7.
https://doi.org/10.1093/aje/kw... PMid:19357324 PMCid:PMC2727250.
10.
Baylan S, Griffiths S, Grant N, Broomfield NM, Evans JJ, Gardani M. Incidence and prevalence of post-stroke insomnia: A systematic review and meta-analysis. Sleep Med Rev. 2020;49:101222.
https://doi.org/10.1016/j.smrv... PMid:31739180.
11.
Sechi GP, Agnetti V, Galistu P, et al. Restless legs syndrome and periodic limb movements after ischemic stroke in the right lenticulostriate region. Parkinsonism Relat Disord. 2008;14(2):157-60.
https://doi.org/10.1016/j.park... PMid:17442610.