Ruppert Elisabeth, Kilic-Huck Ulker, Wolff Valérie, Tatu Laurent, Lefebvre François, Chambe Juliette, Robin-Choteau Ludivine, Bataillard Marc, Bourgin Patrice
Department of Neurology, Sleep and Electrophysiology Clinic, Hôpital Civil, Strasbourg, France.
Eur Neurol. 2015;73(1-2):113-8. doi: 10.1159/000366416. Epub 2014 Nov 26.
Given the discordant results of studies that have reported cases of RLS associated with brainstem stroke and the absence of RLS in large series describing the clinical spectrum of brainstem infarctions, we decided to assess RLS in all patients admitted for brainstem stroke.
All patients who were consecutively referred to the Strasbourg stroke unit for brainstem infarction were prospectively evaluated for RLS. The different parameters analyzed were the topography of the ischemic lesions (magnetic resonance imaging), the different symptoms (sensory, motor, cerebellar, cranial nerves and dysarthria) and the NIH stroke scale. Statistical analyses used the Bayesian paradigm.
Thirty patients have been included, and RLS was observed in three patients (10%). Two patients suffered from an exacerbation of symptoms anterior to the stroke, and the other patient a de novo, but transient, RLS. Patients with stroke-induced sensory symptoms have a higher risk to develop brainstem stroke-related RLS as compared to patients without sensory symptoms.
The results suggest that RLS should be systematically screened in patients affected with brainstem stroke, especially in the case of stroke-induced sensory symptoms. Clinicians should be aware of this association, especially as efficient treatments are available and allow improving the management of patients affected with stroke.
鉴于一些研究报告了与脑干卒中相关的不宁腿综合征（RLS）病例，结果存在不一致性，且在描述脑干梗死临床谱的大型系列研究中未发现RLS，我们决定对所有因脑干卒中入院的患者进行RLS评估。
所有连续转诊至斯特拉斯堡卒中单元的脑干梗死患者均接受RLS的前瞻性评估。分析的不同参数包括缺血性病变的部位（磁共振成像）、不同症状（感觉、运动、小脑、颅神经和构音障碍）以及美国国立卫生研究院卒中量表。统计分析采用贝叶斯范式。
纳入了30例患者，其中3例（10%）观察到RLS。2例患者在卒中前症状加重，另1例患者出现新发但短暂的RLS。与无感觉症状的患者相比，有卒中诱发感觉症状的患者发生脑干卒中相关RLS的风险更高。
结果表明，对于脑干卒中患者应系统筛查RLS，尤其是在有卒中诱发感觉症状的情况下。临床医生应了解这种关联，特别是因为有有效的治疗方法，可改善卒中患者的管理。
