LaBan M M, Viola S L, Femminineo A F, Taylor R S
Department of Physical Medicine and Rehabilitation, William Beaumont Hospital, Royal Oak, MI 48072.
Arch Phys Med Rehabil. 1990 May;71(6):384-8.
Lumbosacral and associated leg pain and paresthesias arousing patients from a sound sleep, or Vesper's curse, has been previously reported. An increase in right atrial filling pressure reflected in elevated paraspinal venous volumes within the reduced confines of a stenotic lumbar spine has been cited as the cause of this syndrome. Six cases of concomitant nocturnal calf cramps and fasciculations associated with the night pain and paresthesias are reported. In all cases a reduction in cardiopulmonary compliance was noted, with clinical and electromyographic evidence of paraspinal and lower extremity fasciculations increasing at night. Symptoms were relieved by assuming an erect or semi-reclining sleep position. In five of the six reported cases of lumbar spinal stenosis, spondylolisthesis was also present. The motor equivalent of Vesper's curse was evaluated by electromography, evoked potentials, CAT scan, and myelography. The multiple factors involved in the pathomechanics and pathophysiology of lumbar radiculopathy, and spinal stenosis and the role of the paravertebral plexus of veins are reviewed as they relate to the genesis of the restless legs syndrome.
腰骶部及相关腿部疼痛和感觉异常会使患者从熟睡中惊醒，即所谓的“黄昏诅咒”，此前已有报道。腰椎管狭窄导致椎管空间减小，椎旁静脉血容量增加，进而引起右心房充盈压升高，这被认为是该综合征的病因。本文报告了6例伴有夜间小腿痉挛和肌束震颤的病例，这些症状与夜间疼痛和感觉异常相关。所有病例均发现心肺顺应性降低，临床及肌电图证据显示椎旁和下肢肌束震颤在夜间增多。采取直立或半卧位睡眠姿势可缓解症状。在报告的6例腰椎管狭窄病例中，有5例同时存在腰椎滑脱。通过肌电图、诱发电位、计算机断层扫描（CAT）和脊髓造影对“黄昏诅咒”的运动等效情况进行了评估。本文回顾了腰椎神经根病、椎管狭窄的病理力学和病理生理学中的多种因素，以及椎旁静脉丛在不安腿综合征发病机制中的作用。
