Happe S, Paulus W
Abteilung Klinische Neurophysiologie, Klinikum Bremen-Ost, Bremen.
Nervenarzt. 2006 Jun;77(6):652, 654-6, 659-62. doi: 10.1007/s00115-005-2025-3.
The restless legs syndrome (RLS) is a clinical diagnosis based on the four essential criteria defined by the International Restless Legs Syndrome Study Group (IRLSSG). An idiopathic form can be separated from a symptomatic form. Neurophysiological studies have investigated the pathophysiology of the idiopathic RLS or have been used to exclude a symptomatic cause, in particular polyneuropathy. So far cortical excitability changes, corticomotor, somatosensory and auditory pathways, spinal cord excitability, B-wave rhythm and cycling alternating pattern, as well as reflex mechanisms have been investigated by electroencephalography, evoked potentials, Bereitschaftspotentials, nerve conduction and thermal threshold measurements, electromyography, transcranial Doppler sonography, measurements of the spinal flexor reflex as well as neuroimaging techniques. The etiology of the RLS cannot be revealed by these methods, neurophysiological studies in RLS are, however, useful for a better understanding of the pathophysiology and for exclusion of a polyneuropathy or other symptomatic causes. In addition to neurophysiological investigations, small fiber neuropathy, which seems to be a more common finding in RLS patients than expected to date, may need biopsy for confirmation. This review will focus on investigations of the different systems involved with diverse neurophysiological methods.
不宁腿综合征(RLS)是一种基于国际不宁腿综合征研究组(IRLSSG)定义的四项基本标准的临床诊断。特发性形式可与症状性形式区分开来。神经生理学研究已经探究了特发性RLS的病理生理学,或已被用于排除症状性病因,尤其是多发性神经病。到目前为止,已经通过脑电图、诱发电位、运动前电位、神经传导和热阈值测量、肌电图、经颅多普勒超声、脊髓屈肌反射测量以及神经成像技术,对皮质兴奋性变化、皮质运动、躯体感觉和听觉通路、脊髓兴奋性、B波节律和周期性交替模式以及反射机制进行了研究。这些方法无法揭示RLS的病因,然而,RLS的神经生理学研究有助于更好地理解其病理生理学,并排除多发性神经病或其他症状性病因。除了神经生理学研究外,小纤维神经病变在RLS患者中似乎比迄今预期的更为常见,可能需要活检来确诊。本综述将重点关注使用多种神经生理学方法对不同系统进行的研究。