Restless Legs Syndrome in Patients with Epilepsy: Risk analysis, Polysomnography, and Quality of Life evaluation
Restless legs syndrome (RLS) is a circadian rhythm related sensorimotor disorder due to brain iron deficiency, with lesion sites at the putamen and substantia nigra. However, epilepsy is a disease with abnormal electric discharge from the cortex and can be triggered with iron disequilibrium. We designed a case–control study to discover the association between epilepsy and RLS.
A total of 24 patients with epilepsy and RLS and 72 patients with epilepsy without RLS were included. Most of the patients underwent polysomnography and video electroencephalogram tests and took sleep questionnaires. We collected information on seizure characteristics, including general or focal onset, epileptogenic focus, current antiseizure medications, medically responsive epilepsy or refractory epilepsy, and nocturnal attacks. The sleep architectures of the two groups were compared. We analyzed the risk factors for RLS using multivariate logistic regression.
Among the patients with epilepsy, the occurrence of RLS was associated with refractory epilepsy (OR 6.422, P-value = 0.002) and nocturnal seizures (OR 4.960, P-value = 0.005). Sleep parameters were not significantly associated with RLS status. Quality of life was significantly impaired in the group with RLS in both the physical and mental domains.
Refractory epilepsy and nocturnal seizures were strongly correlated with RLS in patients with epilepsy. RLS should be considered a predictable comorbidity in patients with epilepsy. The management of RLS not only led to better control of the patient’s epilepsy but also improved their quality of life.
Application and Highlights:
1. For patients with epilepsy, refractory epilepsy and nocturnal seizures had strong links to RLS. RLS should be considered a predictable comorbidity for patients with epilepsy.
2. Epilepsy with RLS might have nocturnal paroxysmal symptoms related with RLS but not seizure per se. Thus, inappropriate dose increase or add-on of ASMs due to misidentification should be avoided.
3. Well-treated RLS helps patients with epilepsy gain better control of their condition and improves their nocturnal sleep quality, excessive daytime sleepiness, and physical and mental quality of life.
Research Team Members:Ying-Sheng Li, Wei-Chih Yeh, Chung-Yao Hsu
Representative Department:Neuroscience Research Center, Kaohsiung Medical University. Kaohsiung Medical University Hospital, Kaohsiung City, Taiwan. Department of Neurology, Kaohsiung Municipal Ta-Tung Hospital.
Introduction of Research Team:
The team has been committed to the risk factors and pathogenic mechanisms of sleep disorders.
Contact Email: cyhsu@kmu.edu.tw
Publication:Sleep. 2023.Mar 1;zsad054
Full-Text Article:https://pubmed.ncbi.nlm.nih.gov/36861219/