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Restless Legs Syndrome: Would You Like That with Movements or Without?

Koo BB - Tremor Other Hyperkinet Mov (N Y) (2015)

Bottom Line: RLS is associated with periodic limb movements during sleep (PLMS) in up to 90% of RLS sufferers; however, their presence is neither sufficient nor necessary for the diagnosis of RLS.The purpose of this opinion piece is to outline the many similarities between RLS and PLMS in order to make an argument for the inclusion of PLMS as a supplementary diagnostic criterion of RLS, termed electro-clinical RLS, which would consist of the current clinical RLS diagnosis plus PLMS.This additional criterion could be used in cases where diagnosis is unclear to increase specificity or in research projects where proper diagnosis is desired at the investigational level.

View Article: PubMed Central - PubMed

Affiliation: Department of Neurology, VA Connecticut Healthcare System, West Haven, Connecticut, USA ; Department of Neurology, Yale University School of Medicine, New Haven, Connecticut, USA.

ABSTRACT
The restless legs syndrome (RLS) is a common sensorimotor condition that often results in discomfort and sleep disturbance. Diagnosis of RLS is entirely clinical and based upon a patient's description of subjective symptoms, and thus when considering RLS diagnosis non-specificity is a real problem. RLS is associated with periodic limb movements during sleep (PLMS) in up to 90% of RLS sufferers; however, their presence is neither sufficient nor necessary for the diagnosis of RLS. The disease RLS and the motor phenomenon of PLMS share similarities in various areas, which include pathophysiology, pharmacology, genetics, and epidemiology. The purpose of this opinion piece is to outline the many similarities between RLS and PLMS in order to make an argument for the inclusion of PLMS as a supplementary diagnostic criterion of RLS, termed electro-clinical RLS, which would consist of the current clinical RLS diagnosis plus PLMS. This additional criterion could be used in cases where diagnosis is unclear to increase specificity or in research projects where proper diagnosis is desired at the investigational level.

No MeSH data available.


Related in: MedlinePlus

Periodic Limb Movements during Sleep. Pictured is a 2-minute epoch that shows periodic limb movements during sleep (PLMS), which occur every 20–30 seconds. Electroencephalographic activations and accelerations in heart rate occur at the same time as PLMS.
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f01: Periodic Limb Movements during Sleep. Pictured is a 2-minute epoch that shows periodic limb movements during sleep (PLMS), which occur every 20–30 seconds. Electroencephalographic activations and accelerations in heart rate occur at the same time as PLMS.

Mentions: PLMS consist of stereotypic movements made up of foot dorsi- and plantar flexion to a greater extent than flexion–extension at the knee.55 Reflecting this pattern of movement, muscles involved in descending order of frequency in PLMS are tibialis anterior, gastrocnemius, biceps femoris, and rectus femoris. Rarely, arms are involved. Typically, PLMS are detected by electromyography (EMG) during a sleep study or PSG. In an in-laboratory sleep study, bilateral tibialis anterior EMG electrodes are included as part of the standard montage. Using this technology, PLMS appear as discrete, 0.5–5-second EMG bursts that occur approximately every 20–40 seconds (Figure 1). Although PLMS can be detected by EMG during overnight sleep study, the determination of whether or not an individual has PLMS is not an indication for PSG. So what are the other means by which PLMS can be detected and measured?


Restless Legs Syndrome: Would You Like That with Movements or Without?

Koo BB - Tremor Other Hyperkinet Mov (N Y) (2015)

Periodic Limb Movements during Sleep. Pictured is a 2-minute epoch that shows periodic limb movements during sleep (PLMS), which occur every 20–30 seconds. Electroencephalographic activations and accelerations in heart rate occur at the same time as PLMS.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4499805&req=5

f01: Periodic Limb Movements during Sleep. Pictured is a 2-minute epoch that shows periodic limb movements during sleep (PLMS), which occur every 20–30 seconds. Electroencephalographic activations and accelerations in heart rate occur at the same time as PLMS.
Mentions: PLMS consist of stereotypic movements made up of foot dorsi- and plantar flexion to a greater extent than flexion–extension at the knee.55 Reflecting this pattern of movement, muscles involved in descending order of frequency in PLMS are tibialis anterior, gastrocnemius, biceps femoris, and rectus femoris. Rarely, arms are involved. Typically, PLMS are detected by electromyography (EMG) during a sleep study or PSG. In an in-laboratory sleep study, bilateral tibialis anterior EMG electrodes are included as part of the standard montage. Using this technology, PLMS appear as discrete, 0.5–5-second EMG bursts that occur approximately every 20–40 seconds (Figure 1). Although PLMS can be detected by EMG during overnight sleep study, the determination of whether or not an individual has PLMS is not an indication for PSG. So what are the other means by which PLMS can be detected and measured?

Bottom Line: RLS is associated with periodic limb movements during sleep (PLMS) in up to 90% of RLS sufferers; however, their presence is neither sufficient nor necessary for the diagnosis of RLS.The purpose of this opinion piece is to outline the many similarities between RLS and PLMS in order to make an argument for the inclusion of PLMS as a supplementary diagnostic criterion of RLS, termed electro-clinical RLS, which would consist of the current clinical RLS diagnosis plus PLMS.This additional criterion could be used in cases where diagnosis is unclear to increase specificity or in research projects where proper diagnosis is desired at the investigational level.

View Article: PubMed Central - PubMed

Affiliation: Department of Neurology, VA Connecticut Healthcare System, West Haven, Connecticut, USA ; Department of Neurology, Yale University School of Medicine, New Haven, Connecticut, USA.

ABSTRACT
The restless legs syndrome (RLS) is a common sensorimotor condition that often results in discomfort and sleep disturbance. Diagnosis of RLS is entirely clinical and based upon a patient's description of subjective symptoms, and thus when considering RLS diagnosis non-specificity is a real problem. RLS is associated with periodic limb movements during sleep (PLMS) in up to 90% of RLS sufferers; however, their presence is neither sufficient nor necessary for the diagnosis of RLS. The disease RLS and the motor phenomenon of PLMS share similarities in various areas, which include pathophysiology, pharmacology, genetics, and epidemiology. The purpose of this opinion piece is to outline the many similarities between RLS and PLMS in order to make an argument for the inclusion of PLMS as a supplementary diagnostic criterion of RLS, termed electro-clinical RLS, which would consist of the current clinical RLS diagnosis plus PLMS. This additional criterion could be used in cases where diagnosis is unclear to increase specificity or in research projects where proper diagnosis is desired at the investigational level.

No MeSH data available.


Related in: MedlinePlus