Department of Medicine, Federal University of Ceará, Fortaleza, CE, Brazil.
Eur J Neurol. 2011 Jan;18(1):144-9. doi: 10.1111/j.1468-1331.2010.03099.x.
the objective was to evaluate the presence of Restless Legs Syndrome (RLS) in acute stroke, its association with sleep disturbances and clinical outcome during long-term follow-up.
this was a longitudinal study (N = 96, 59 men, mean age 64.0 ± 8.9) of cases with acute ischaemic stroke. Patients were asked about the occurrence of RLS symptoms before the cerebrovascular event. RLS was diagnosed using the criteria established by the International RLS Study Group. Stroke outcome was estimated by the Barthel Index and the modified Rankin Scale. Daytime somnolence (Epworth Sleepiness Scale -ESS > 10), poor sleep quality (Pittsburgh Sleep Quality Index -PSQI > 5) and risk of obstructive sleep apnea (OSA) (Berlin questionnaire) were evaluated.
twelve patients (12.5%) met the diagnostic criteria for RLS. All cases had symptoms of RLS before stroke. However, none of the cases had a previous medical diagnosis of RLS or were on use of specific medication. In only one case, a family history of RLS was found. In all patients, RLS symptoms started after the age of 40 (mean age 64 ± 6.7). Daytime sleepiness (44.8%) and poor quality sleep (62.8%) were present. Patients with RLS (12.5%) presented greater neck circumference (P = 0.04) and worse sleep quality (P = 0.007). Risk of OSA (56.2%) was associated with hypertension [OR = 0.12; CI=0.03-0.42]. Stroke outcome was significantly worse at three and 12 months (ancova, P < 0.005) in patients with RLS, remaining after adjustment for diabetes and body mass index (P < 0.05).
patients with acute stroke and RLS have worse clinical outcome, at three and 12 months of follow-up.
本研究旨在评估急性脑卒中患者是否存在不宁腿综合征（RLS），及其与睡眠障碍的关系，以及在长期随访期间对临床预后的影响。
这是一项对 96 例急性缺血性脑卒中患者（59 例男性，平均年龄 64.0±8.9 岁）的纵向研究。患者在发生脑血管事件前被询问是否存在 RLS 症状。采用国际 RLS 研究组制定的标准诊断 RLS。通过巴氏指数和改良 Rankin 量表评估脑卒中预后。评估日间嗜睡（Epworth 嗜睡量表评分>10）、睡眠质量差（匹兹堡睡眠质量指数评分>5）和阻塞性睡眠呼吸暂停风险（Berlin 问卷）。
12 例患者（12.5%）符合 RLS 的诊断标准。所有病例在脑卒中前均有 RLS 症状。然而，所有病例均无 RLS 既往病史或正在使用特定药物。仅 1 例有 RLS 家族史。所有患者 RLS 症状均在 40 岁后出现（平均年龄 64±6.7 岁）。存在日间嗜睡（44.8%）和睡眠质量差（62.8%）。有 RLS 的患者（12.5%）颈围更大（P=0.04），睡眠质量更差（P=0.007）。阻塞性睡眠呼吸暂停风险（56.2%）与高血压相关[OR=0.12；95%CI=0.03-0.42]。RLS 患者在脑卒中后 3 个月和 12 个月时的预后明显更差（ANCOVA，P<0.005），但经糖尿病和体重指数校正后仍如此（P<0.05）。
急性脑卒中合并 RLS 的患者在 3 个月和 12 个月的随访中，临床预后更差。
