Is there a higher risk of restless legs syndrome in peripheral neuropathy?

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Neurology. 2008 Nov 26.

Is there a higher risk of restless legs syndrome in peripheral

neuropathy?

Hattan E, Chalk C, Postuma RB.

From the Departments of Neurology & Neurosurgery and Medicine, McGill

University, Montreal General Hospital, Montreal, Quebec, Canada.

OBJECTIVE: Associations between peripheral neuropathy and restless

legs syndrome (RLS) have been described, but have not been

consistently reproduced. If RLS prevalence is truly increased by

neuropathy, this has important implications for RLS pathophysiology.

METHODS: In a case-control design, 245 patients with peripheral

neuropathy and 245 age- and sex-matched controls were screened for

RLS using a standardized phone questionnaire based on international

RLS diagnostic criteria. All persons who answered yes to three of

four criteria were considered screen-positive. All screen-positive

patients underwent a confirmatory diagnostic evaluation by a movement

disorders specialist blinded to the neuropathy status of the patient.

RLS prevalence was calculated and compared using Fisher exact test.

RESULTS: A total of 65 (26.5%) patients with neuropathy screened

positive compared to 25 (10.2%) controls (p < 0.0001). However, the

diagnosis was confirmed in only 46% of screen-positive patients with

neuropathy, vs 80% of controls (p = 0.005). Cramps and paresthesia

without true diurnal variation or rest exacerbation were the

commonest causes of false-positive screens. After diagnostic

confirmation, the overall prevalence of RLS did not differ between

neuropathy patients and controls (12.2% vs 8.2%, p = 0.14). However,

when classified by etiology, RLS was found in 14/72 (19.4%) patients

with hereditary neuropathy, a prevalence higher than found in

controls (p = 0.016) and acquired neuropathy (9.2%, p = 0.033). Among

patients with neuropathy, those with RLS more commonly had a family

history of RLS (37% vs 15%, p = 0.007) and were younger (49.9 vs

61.4, p = 0.0003).

CONCLUSIONS: Restless legs syndrome is more prevalent among patients

with hereditary neuropathy, but not in those with acquired

neuropathies.